Nursing Interventions for drug seekers in the ED

[LiamBear]

Hello!

I am writing a critical thinking paper on drug seekers in the ED. Will any of you chime in on what nursing interventions you implement while providing care for this particular patient?

I was thinking, detailed documentation and having the patient open their mouth to show the pill has been swallowed. Any other suggestions? Thanks!

[jallen326]

She will just go to the next hospital for them to replace her g tube and get what she wants! I am pretty sure she doesn't even need the tube.

[JenniferG rN]

Sadly I'm sure she will. I have had many seekers come through but never have anyone take such an extreme measure. Being that she was in for left upper lobe pneumonia I felt it was in her best interest to not get the meds iv so I could try to get her moving and better- not have her snowed and just laying around in bed all day. When I shared this with a co worker her advice was "your not going to fix her, you should just give her what she wants, she'll probate be discharged in a couple days anyway" out of curiosity what would other opinions be?

[uRNmyway, ASN, RN]

Sadly I'm sure she will. I have had many seekers come through but never have anyone take such an extreme measure. Being that she was in for left upper lobe pneumonia I felt it was in her best interest to not get the meds iv so I could try to get her moving and better- not have her snowed and just laying around in bed all day. When I shared this with a co worker her advice was "your not going to fix her you should just give her what she wants, she'll probate be discharged in a couple days anyway" out of curiosity what would other opinions be?[/quote']

My opinion? You can't control other people's practice, only your own. If there is a valid reason to hold meds, I do it. If the BP is tanking, or they can't coherently ask for their meds, or as you say, you don't want them snowed because you want them moving and all, then don't give the meds. Just make sure to document. And document alternative methods offered (and probably refused) so the patient doesn't come back against you saying you didn't try to relieve their pain.

[zmansc, ASN, RN]

The flip side of the coin is that this pt is a human being too. At one point in her life she was not addicted to pain meds, and hopefully at some point in her life she will again be not addicted to pain meds. Addiction is an illness. I've seen frequent flyer drug seekers finally get off the narcs and get back to being productive members of society. So, don't look down on these pts (not saying anyone did, just that I've seen staff do so). They need our help too. Yes, it's not as rewarding and fun as running a code, and getting an MI back, or whatever get's your ER RN's adrenaline flowing, but it is a sick pt that needs our help. Can we cure them, no they have a chronic disease that needs more than what can be provided in the ER. Is the system stacked against them? Absolutely. All the more reason we need to put aside the harsh tx we get from them, and the frustration that we get from being put in the middle between the provider and the pt and do what we can to help.

I'll be the first to admit, I'd love to just turn that bed and get them out of my ER room. I have to make myself remember that this is a person with an illness, they weren't born this way. Yes, bad choices probably played a role in them getting like this, but at the same time bad choice played a role in many other pt's too. The motorcycle rider w/o a helmet in the room next door, the obese diabetic 46yo with chest pain, they all made bad choices that impacted their health, we all do.