Non compliant and frequent flyer patients

TiredMD · Nov 11, 2007

I think that after awhile you can tell who is drug seeking and who is not.
I never want to disregard anyones pain, but you can tell who needs addiction counseling and who really hurts.

I whole-heartedly disagree.

Drug addicts get sick too, and actually more often than non-addicts. When they have pain, they need a ton of narcs to get past their already-saturated receptors. It's nothing to be afraid of, it's very hard to overdose them, and the hospital isn't the right place to start rehab anyway.

I have colleagues in my training program who think it is their job to sniff out who's a junkie and who actually needs narcotics. I think that's ridiculous.

Personally, I am more than happy to get a dozen addicts high, just so I make sure I don't miss the one guy who needed pain relief but came off as a drug-seeker.

nyapa, RN · Nov 11, 2007

It's interesting how this thread has turned to specifically talking about pain and iv drug users.

I think as nurses we will find there will always be frequent flyers. And we only need to look at ourselves to find out why. Do you eat a healthy balanced diet? Do you smoke? Do you exercise? Do you lift things (not just at work) appropriately? etc etc.

Now that doesn't mean that we will all be frequent flyers. Most of us will not want to use the acute health system because we know the pressure it places on it. But we do make ourselves prone to longterm diseases.

Yet we have the gall to judge others.

Some ppl who are frequent flyers have bad behaviour, but even that is not confined to their category.

I guess as frustrating as it is, we have to nurse and educate ppl to the best of our ability, even if whatever we try, falls on deaf ears.

EmmaG, RN · Nov 11, 2007

non compliance is one thing, and it is a constant battle in all areas of healthcare to combat this problem.
seeing someone as drug-seeking and having the attitude that goes with that viewpoint is really disturbing to me. remember that we are taught that pain is objective, and now is considered to be the 5th vital sign! if someone is in the hospital and the physician prescribes pain relief in whatever form, i fail to see how it is within our scope to withhold meds or reduce the dosage (for example, if the order reads 4-6mg, and the rn gives 4 based on his/her own conception of the patient's pain or lack of pain). the medicine is prescribed, in the amounts it is ordered, with phenergan or without, iv or otherwise.
i have seen this attitude in the clinical setting- usually in older (more experienced) nurses, but now it's obvious that the same attitudes are in younger, less experiences nurses.
who are we to judge a person's pain, whether they've been in our hospital or unit 1 time or 100 times? the physician's job is to manage care, ours is to implement, using our critical thinking skills yes, but not to the extent that we refuse to carry out the md's orders. our attitudes need to be checked at the patient's door, imo.

i agree. but sadly, there are those who are well aware of the mantra "pain is what the patient says it is", and will manipulate it for all it's worth. and it's because of those people that many others get tagged inappropriately as "drug seekers".

i wonder why they keep admitting those kind of patients if they will be non compliant with their health care anyway?

oh, that's easy.