abusers and losers. Can you top this one?

  1. Last monday, I had a lady come into triage with a godawful, pity-me limp. She proceeded to tell me that she had terrible pain from her low back radiating into her left leg. She offered up that maybe she had "over done it at her family picnic" the morning before. Then she said, "I think it might be sciatica!" (stage limp = 1st red flag, medical jargon from non-medical person = 2nd red flag). For some unknown reason, she felt she needed to share that she had had an MRI the previous thursday, but her Dr. didn't have the results yet. Now I am confused beyond reason....why did she have the MRI thursday, when the pain started Sunday am? (red flag #3). I simply told her that since it was now Monday, I would place her in a room, and call her PCP for the MRI results. Looking a bit nervous, she allowed me to place her in a room. I told her to get into a gown, and the Dr. would be in to see her shortly. She did get into the gown, then opened the door and laid back onto the cart. I called her PCP, and they said they would get back to me. A few minutes later, one of the nurses said, "Diane, you have a phone call from dr. so and so's office regarding the lady in bed #3". As I go to answer the phone, the patient appears on the other side of the desk, fully clothed (nt having seen the er dr yet), and proceeds into this tearful tyrant about her PCP having "washed his hands of me!" boo, hoo. As I am looking at her, her dr.'s office informs me that this lady did indeed have an MRI in April, however it was in 2002. I thank them, and hang up. Then the pt. tell me that her "othopedist" (red flag #45) "told me that if EVERYBODY in the world was taking oxycontin, then who would be left to govern the world?!!!" boo, hoo, hoo. I tell her, she hasn't even yet seen the ER dr. Would she like to return to her room to see him? She sniffs a few times, and goes into the room, only to return to the nurses desk a minute later, saying "I want to sign out AMA!" (another one of those medical jargon red flags". So, we sign her out...and upon cleaning the room, discover that the code cart key is broken, and the pre-filled valium syringes are gone. Great. BTW, another thing she had said in triage was "My co-worker dropped me off during my lunch break and will pick me up when I'm done" I hadn't even asked her how she got to the ER. She obviously Knew enough to say that, so that if she got narcs, we would think she had a ride. When she signed out AMA, she had her car keys in her hand.

    Call me....MS suspicious

    I shoulda been a cop
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  2. 36 Comments

  3. by   gwenith
    Could be innocent..................NOT!
  4. by   Rapheal
    This would never happen because the hospital would not like the publicity and hippa , and probally a dozen other reasons-but wouldn't it be great if:

    ER calls the police to report the theft of valium and gives the name of the patient-suspect. They go to her home or stop her while driving and find the valium and she is arrested for theft and possession of drugs.

    But alas, not in this lifetime.
  5. by   CCL"Babe"
    OK. Deep breath, pause.....

    I am very torn about this post. Been there as an ED nurse. Have felt the exact same way.

    Now. Herniated lumbar disc with sciatic pain this winter. Sometimes feel like God is getting me back for all the years of cynicism. Didn't go to ED for that reason. This has been the most frustrating experience in my life, and has opened my eyes to all the patients I judged.

    Yes, you are right, there are losers, drug seekers. But having been unfairly accused of drug seeking, when I have never asked for pain meds has opened my eyes to a different veiwpoint.
  6. by   sueb
    Been there too and I get upset with nurses and doctors who think everyone who walks into the ED with back pain is drug-seeking. Each and every case has to be taken into account separately.
  7. by   amy
    OK. Here's my story. 30-ish yo female c/o excrutiating sinus pain. "I had a ct of sinus and there's a growth there--maybe cancer" Now a direct admit to ER obs by PMD. Ordered CT of head repeated (''it was done by my doctor in manhattan and if you call him he'll tell you the results''). Yeah, right, at 5:45 pm on friday... Pt refuses head/sinus CT, states she is not paying for a repeat test, worried about radiation exposure, yadda, yadda, yadda. Pt screaming then ensues, and she absolutely NEEDS to take shower first to 'clear the sinus pressure'. Cleared out ER ob/gyn room w/shower. Did I tell you it was mobbed?!? 45 minute shower later, screaming pain was worse (DUH) and needs demerol NOW!!! Literally screaming her head off in small unit. Long story short, PMD orders MSO4 PCA, pain continued x 24 hrs, direct floor admit. Finally she let them get sinus CT, and 5 days after inital ER escapade, her results are back. Not even sinusitis. Bet the floor pulled that PCA awful quick! I gave her demerol IM in obs unit after she promised to go for CT. After she refused, I refused additional pain meds per ER doc ok and let her scream the night away. 11-7 gave in. Do ya think she was seeking??? Oh, the kicker? Manhattan MD number disconnected...
  8. by   MishlB
    Not for me to say....agree with CCL babe, too much cynicism. I know how much pain I can handle, but not anyone else. People have odd ways of seeking help......
  9. by   just tired
    been there-done that had a resident who's CPC beleived everything that she told him ,even after we found meds in her bedside table, kept prescribing her pain narcs-durogesic patches,roxicet and was giving her restoril and xanax scheduled also. To make a long story short this resident went into CHF and the DR. made thestatement "I wonder how this happened"!! You know it is scary but here we have to follow DR"S orders even if we know it';s wrong. What I did is call my DON and she gave the Narcs and signed for them-Good DON!!!!!. There are abusers at every age but this one was legal at 58 years old!!!!!
  10. by   BadBird
    Last summer for the first time in my life I went to the ER, I herniated a disc in my back and the pain was so horrible, I was at home stuck in bed for 10 days and I just couldn't handle the pain anymore, My family physician prescribed Flexeril, Medrol Dose pack, Vicodin, none of which helped, each day the pain was worse, he changed my pain med to Percocet, didn't do squat, he wanted to phone in oxycontin, I told him I didn't have cancer and I wanted to be fixed, not swallow more pills. I finally couldn't stand even with crutches to make it to the bathroom, so off to the ER I go. I used to work in that hospital and the Dr. that saw me was known for not giving narcs. She was wonderful, I was shaking from so much pain, go IV Dilaudid to make it through my MRI which was the first time I was pain free almost lasted the whole MRI. Admitted and eventually had surgery. Thank God the nurses and Dr. didn't judge me, I swallowed Percocet every 2 hours for a week and it didn't help. IV Solumedrol did help a lot so I had to wait another month before surgery but that was the best, I awoke completely pain free and now 1 year later remain so. After having that much pain, I didn't care if they killed me just as long as the pain stopped. I know there are drug seekers out there but when you are in agony it is nice to know that there are medications that can help. I would not deny anyone pain med, if they are a addict that is their problem, and they will be one when they leave too but what if they really have a injury and need help? I guess since my injury I just view things differently.
  11. by   Uptoherern
    I would never deem to suggest that I wouldn't ask for a narc order for someone in obvious pain. However, when you take a pt. back into the ER, and notice that said same pt. was in a sister facility Just HOURS prior to our lovely visit, it is hard to be patient. ... Or the frequent flyer who always insists that he get a pain refill, never sees PCP, and always says "it fell into the toilet, I lost the Rx, someone stole my jacket and the med was in it....etc, etc.

    The original lady that I spoke about came limping (very dramatically I might add), into the ER, and walked out with nary a limp in sight.
  12. by   BadBird
    Yeah, we get those too sometimes, usually the Dr. will give the script for only 2 pills to get them throuh till they can see their pmd
  13. by   Rapheal
    I have alot of sympathy for people in pain. I think the problem with the before named patient is that she didn't even wait to see the ED doc. She signed out AMA after she stole the narcs from the code cart. If she was really in pain from an injury or illness wouldn't she have waited to see the doc and try to convince him to treat her pain?
  14. by   GAstudent
    I have a few stories. I have an uncle and aunt that the family does not talk to because of drugs problems. Two years ago my uncle was on crack and had no more meds (or no money to buy them because he had no job.) Well he decided to fake suicide so that they would take him to the doctor to get meds. He stabed himself with a knife and my aunt was on crack too and called the ambulance and they came and got him and of course he was in so much pain..please...they give him more meds. Then when he was in a crazy house they would do it again and get more meds.\

    This makes me want to start a new thread....

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