conundrum

...a tiny, absolutely gorgeous girl...she looks like Judy Garland .
17, with a two year old baby.

She showed up here in heart. lung and kidney failure.It turns out that she has a big piece of yuk in her heart that has seeded itself to her lungs and her kidneys. She is a meth addict, and shoots the stuff; and she pulled out her own infected tooth a few weeks ago. Seemed like a good idea at the time, I guess.

So now she's sitting in our unit, pissed as hell because we took out close to a half liter of  infected fluid from around her heart,so she's now able to breathe again and awake...but the drain hurts. (Another 350 cc of drainage in 2 hours. Her heart is now working fairly well...no longer tamponaded, so she can breath, and her heart is working well. )

She really doesn't care that she is in danger of emboli to her brain; that her kidneys may be permanently damaged.

"Can I get something for my anxiety? I was supposed to see a psychiatrist to get started  on good  drugs."
"Can't she get some narcotics?" her mom pipes up.

"Here. Let's give you some IV Toradol..it's great. Works really well for pain."
(Toradol is an IV version of ibuprofen, and anti-inflammatory.)
Within seconds of the drug being put into the IV, she nods off, head drooping like a daffodil in the rain. Her mom sighs in relief.
Trust me..the pharmcodynamics of the drug don't work that way; it's all in her  head. She got "something" pushed into a vein, so it "works"

How do we fix this one?
She'll be asking for narcotics again in the morning, as will her mom...

Someone must be taking care of the baby.