In the ER we rarely drill, unless it's really bad. Sometimes we do a digital block to get you through the night, but usually its just ice and pain meds. Advil (ibuprofin, or some other nsaid) to reduce swelling, stack it w/ tylenol to help w/ the pain, or vicodin if you have it. Ice for the first 48 hours. The nail may fall off it may not. Won't know until it happens. Other than that, rub some dirt on it, walk it off, insert some other manly comment here. Good luck.