How many visits until you label a frequent flyer or drug seeker?

[z's playa]

I'm going to try this again.LOL.:chuckle I posted yesterday and got one reply, so I took things into my own hands. I ended up calling my own PCP for a script to avoid the ER, and asked her if she thought I would be labelled a FF due to my visits that occur once a month, to every 4 months, for stubborn migraine. She said that if the staff sees that I've done all they've asked (ie; letter from PCP validating diagnosis and treatment, all follow ups honoured)...then there shouldn't be a problem. Do these actions really help? I'm sure when I get my degree, I'll be just as skleptical as some of you. I'll probably have to delve DEEP into my memory banks , in order to remember how humiliated I felt walking into the ER for yet; another migraine.

Any insight?

Thank you.

I'm guessing this is a touchy subject?

[chaschata]

what exactly is a frequent flyer? is that someone who shows up to the er and there is not anything wrong with them. on the other hand, is that someone who shows up to the er and they are truly ill or in need of medical assistance, but show up often and how often.

i am in the hospital at least 4 times a year, sometimes as many a 7, sometimes the er keeps me for 12 – 14 hours for observation, and to make sure i am stable. they know it is a 45 minute ride to the hospital and don’t want to send me home only to have to turn around and come back in. sometimes it means being hospitalized for a week or two. i have copd (my fault and my responsibility) and the paramedics have schooled me on when it is time to call them and there have been times they were able to take care of the situation without transporting me to the hospital, we live about 40 miles from the closest hospital which happens to also be the hospital i prefer.

the paramedics have told me, the er nurses and er docs do not even think about driving yourself to the hospital, or having someone else drive you to the hospital. one of two bad things are bound to happen, if you drive yourself you will probably kill yourself or worse someone else and if someone else drives you when you are in that condition, you are probably going to not make it to the er alive. therefore, does that make me a frequent flyer because i am a person with a chronic illness and use the facilities of the emergency room more often than others? moreover, if so, why does that make me a frequent flyer, which has a bad connotation to it, it sounds like a bad thing.

i take care of myself, i take my medication on time and don't skip does, i see my doctor on a regular basis and don’t skip appointments and i also see my doc when i am not feeling well, or at least what i consider not my norm. if i am not feeling well, that is i catch whatever is going around and feel i need to see my doctor, i see my doc, i don't use the emergency room as a substitute for my doctors care.

but yet there are times, 2:00 a.m. and i wake up gasping for air or a saturday afternoon and i really don't have any choice but to call the paramedics and ask for their help, i guess there is another choice and that would be not to do anything, but i am not yet ready to give it up yet. because they have transported me more often than we both would like to count, they ask me not to wait until i am circling the drain as they call it before i call. if i am having problems breathing not the normal problems breathing that go with having copd, but what i consider not the norm, i call 911, i start a neb treatment, take a xanax and wait for their arrival, fortunately they usually arrive within a few minutes.

i have all the respect and admiration in the world for the all the people who work in the er. but, it is the nurses that i respect, the ones i admire the most. nobody works harder than the nurses. they take care of me, they are the first ones i see, they are the ones that comfort me, they are the ones that come and check on me. they are the ones that remind me to breath slowly, they are the ones that come in and pat me on the arm and tell me we got you covered, you are going to be okay. they are the ones that try to make a bad situation not seem as bad as it is. they are the one that interact with me and give me words of encouragement. they are the ones that make me believe i am going to live to see another day. i am both thankful and grateful they are there when i need them. they have saved my life more than once. i would feel absolutely horrible if i thought for one moment i was wasting their time or taking away resources from someone else that needed their expertise, education, training time, and energy, not just the nurses but the er personnel and the same of the paramedics.

[TraumaNurseRN]

what exactly is a frequent flyer? is that someone who shows up to the er and there is not anything wrong with them. on the other hand, is that someone who shows up to the er and they are truly ill or in need of medical assistance, but show up often and how often.

i am in the hospital at least 4 times a year, sometimes as many a 7, sometimes the er keeps me for 12 - 14 hours for observation, and to make sure i am stable. they know it is a 45 minute ride to the hospital and don't want to send me home only to have to turn around and come back in. sometimes it means being hospitalized for a week or two. i have copd (my fault and my responsibility) and the paramedics have schooled me on when it is time to call them and there have been times they were able to take care of the situation without transporting me to the hospital, we live about 40 miles from the closest hospital which happens to also be the hospital i prefer.

the paramedics have told me, the er nurses and er docs do not even think about driving yourself to the hospital, or having someone else drive you to the hospital. one of two bad things are bound to happen, if you drive yourself you will probably kill yourself or worse someone else and if someone else drives you when you are in that condition, you are probably going to not make it to the er alive. therefore, does that make me a frequent flyer because i am a person with a chronic illness and use the facilities of the emergency room more often than others? moreover, if so, why does that make me a frequent flyer, which has a bad connotation to it, it sounds like a bad thing.

i take care of myself, i take my medication on time and don't skip does, i see my doctor on a regular basis and don't skip appointments and i also see my doc when i am not feeling well, or at least what i consider not my norm. if i am not feeling well, that is i catch whatever is going around and feel i need to see my doctor, i see my doc, i don't use the emergency room as a substitute for my doctors care.

but yet there are times, 2:00 a.m. and i wake up gasping for air or a saturday afternoon and i really don't have any choice but to call the paramedics and ask for their help, i guess there is another choice and that would be not to do anything, but i am not yet ready to give it up yet. because they have transported me more often than we both would like to count, they ask me not to wait until i am circling the drain as they call it before i call. if i am having problems breathing not the normal problems breathing that go with having copd, but what i consider not the norm, i call 911, i start a neb treatment, take a xanax and wait for their arrival, fortunately they usually arrive within a few minutes.

i have all the respect and admiration in the world for the all the people who work in the er. but, it is the nurses that i respect, the ones i admire the most. nobody works harder than the nurses. they take care of me, they are the first ones i see, they are the ones that comfort me, they are the ones that come and check on me. they are the ones that remind me to breath slowly, they are the ones that come in and pat me on the arm and tell me we got you covered, you are going to be okay. they are the ones that try to make a bad situation not seem as bad as it is. they are the one that interact with me and give me words of encouragement. they are the ones that make me believe i am going to live to see another day. i am both thankful and grateful they are there when i need them. they have saved my life more than once. i would feel absolutely horrible if i thought for one moment i was wasting their time or taking away resources from someone else that needed their expertise, education, training time, and energy, not just the nurses but the er personnel and the same of the paramedics.

you are not a frequent flyer/drug seeker.....where i am from a frq. flyer is someone who has an addiction to narcotics, their primary physician has refused to prescribe the narcotics so they frequent my er and every er they can as often as they can to get the narcotics they need for their fix. it's abuse of the system. you can be rest assured that you would not be considered remotely a freq. flyer.....i'm sorry you have to go to the er in resp. distress and live so far away....my prayers are with you.:redbeathe

[ThrowEdNurse, BSN, RN]

We also call people frequent fliers if they frequently come!!! Go figure. There is a different between a FF and a drug seeker. You can be one or the other or both. Ergo, you can be a FF and not a drug seeker at. FF isn't always a derogatory term.

[HopeItWorksDNP]

You are a frequent flyer if:

I can name your allergies before you can...

If you have used every PCP within a 50 mile radius of the ER and fired them all...

If I can mention your name to a nurse in an ER 20 miles away and she starts laughing...

If you phone to see which doc is on call so often the admission clerk recognizes your voice...

If you always bring a concerned family member with you to be your "go-tell-'em" person, i.e., "Go tell 'em I need to go back RIGHT NOW. Go tell 'em I'm vomiting. Go tell 'em I'm cold. Go tell 'em I'm hot. Go tell I'm 'em I'm gonna pass out. Go tell 'em I need another shot. Go tell 'em I'm thirsty. Go tell 'em I'm hungry. Go tell 'em I'm vomiting again. Go tell 'em i need more Phenergan. Go tell 'em I'm ready to go; bring my paperwork. Go tell 'em I'm too f'd up to walk now; I need a wheelchair. But don't tell 'em I'm getting behind the wheel when they aren't looking."

If you bring your 5 year old son to be your "go-tell-'em person, you aren't a ff. You're an blankety, blank!!

If you think I'm your buddy...and when I meet you in the waiting room ask me if I think the doc will give you a double tonight.

If you invite me to be your friend on MySpace.

If you stand at the Admissions desk moaning and hollering and demanding to be seen RIGHT NOW! Then you sit in your room doing the same. Degree of illness is inversely proportional to amount of ruckus raised! Really sick folks are usually the quietest ones in the department. And they are the ones that volunteer to let YOU go back first, cause you sound like you're hurting so bad. And they sit patiently in the waiting room having their MI....

If you are the reason I drive 50 miles out of town just to go to a different Walmart. Lord knows, they don't pay me enough to be nice to you on my day off.

If we have a fire drill and you leave your room to help me shut the doors (cuz it ain't your first rodeo)...

If I happen to be looking out the ambulance doors and see you leave the doc's office across the street and head straight to us....I don't know why the nurse would say you got a Dilaudid shot when you really didn't.

If you ever overhear the nurses making deals with each other in order not to get stuck with you. ...But I had her last time!!

If you are so sedated your husband has to drag you around the house on a sheet for 2 days and that doesn't seem odd to him, you probably are a frequent flyer. No, I'm not going to give you something for pain right after he slips up and mentions the last 2 days to me. Don't the enablers trip you out more than the FFs? I am often dumbfounded at what they are willing to do to get drugs for their loved one.

If the doctor tells you she has to have a stool sample for your diarrhea and abd pain before you can have a shot and you go into the bathroom and manually dig out "rocks" from your opiate induced constipation. Yep, that was me with them in the specimen cup shaking them like maracas.

If you rub a hole into the top of your head after you figured out a staph infection might get you admitted with IV drugs. Sorry...we've cultured it 3 times and it ain't growing out nothing! Please don't ask me again to give you examples of how staph might get into it.

If you have dog bite induced seizures that can ONLY be stopped with Valium and Dilaudid (or me removing your hands from the bed rails. Cant sit up and shake quiet as violently then).

If I can honestly say to you, "Jill, I copied your information from the chart we had earlier today. Nothing has changed in the past 2 hours has it?"

If all the labs we have done for your abd pain, n/v, all the CTs, Xrays, and USs come back negative time after time, but I can give you an injection of 10mg of Morphine with no meds for vomiting and your vomiting instantly stops, you might be an opiate addict in withdrawals.

If you eat massive amounts of strawberries to make us think you are vomiting up blood, you might be an idiot cuz noone's blood smells like strawberries.

If you prick your finger to bleed into the urine specimen cup to make us believe you have kidney stones, you might should stop the bleeding BEFORE you come out of the bathroom.

If when you finally come in wearing handcuffs, you think I really do care about you enough to take the hypodermic needle out of your pocket before the cops find it. Nah...not happening buddy.

If you have been to this ER 136 times in the last 9 months. And your name tops the list of ALL the return visits for ALL the hospitals in our multi-hospital corporation. Heck, you should have won a prize!!

All, unfortunately, real situations I've dealt with in the past 4 years. And I could go on and on....Anyone wonder why we get jaded really quick?

[Iam46yearsold]

Sometimes the truth is a bit like......tasting bad water when you are thirsty......you know, like well water.....still, it's water, you're thirsty, and you drink it anyway.

That takes way to much effort. For me I prefer talking with the patient, and determining what is best to help them in a therapeutic way. Sometimes I even ask, what works best for you and do you have a ride here to take you home. Like water, take the path of least resistance and trust that the pt is being square with you.

[ACRN06]

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