A patient wants to know your thoughts on frequent fliers... - page 4

by Clusterhead 4,697 Views | 34 Comments

First of all, forgive me, as I'm sure this will be a long post. Also, it's my first... so hello. To be clear, as the subject states, I am a patient and not a nurse. But given my history I'm thinking more and more that being an... Read More


  1. 0
    Quote from monkeybug
    Narcotics can be used quite effectively for some migraine patients. For episodic migraines, maybe not so much. Yes, triptans are a better option. But for some of the chronic patients, narcotics as a rescue med makes sense.
    Good point. I was oversimplifying, mostly based on what we often see with migraine admissions. In my first few years as a nurse, I strongly preferred dealing with neurosurgery residents. I liked our neuro residents, too, but they often seemed indecisive. As a male, "see it, cut it, fix it." is a mentality I can easily relate to. I was a carpenter before I was a nurse. Of late, I'm coming to understand that neurology seems like voodoo because it is like voodoo. Diagnoses are often reached by eliminating everything else, and sometimes never completely reached at all. And treatment seems to frequently be finding something that works and going with it. I'm not opposed to narcs. I'm opposed to pain.
  2. 0
    You are so right that neurology in general basically is voodoo. I don't know if I've mentioned in my other posts here, but I've had a number of procedures for my headaches (spenopalatine ganglion blocks). Once when we asked the doctor to explain how it works, seeing as the SPG is not thought to be the center of cluster pain (rather the trigeminal nerve), he basically said "oh we don't know, we just know that sometimes it does. Basically, it's magic."

    That's exactly who I want sticking a needle in my nose... :/ (I kid.)
  3. 0
    There are a lot of different factors.

    Sometimes it depends on what your neurologist and pcp say. A lot of patients have notes in their chart saying their pcp says to call them first. Then sometimes the patients say they've called their doctor and they said to come in. A phone call later and the pcp is mad because they did not receive a phone call. Sometimes it's a "we made an appointment but the office changed it." A call to the office and we find out that is not the case.

    Sometimes it is a case of the patient has chronic pain and wants a narcotic. The ERs are not supposed to treat chronic pain. Usually it's a shot and they go home with instructions to contact whatever doctor is overseeing their chronic pain. However, for migraines it's the migraine cocktail and no narcotics for most doctors (some kind of pact between the hospitals within 50 minutes from here, some doctors don't follow this).

    Another thing that will upset the doctors is if they found out that the patients have been switching up ERs. I think the most was about 50 times they were seen in an ER in a month. The doctor was furious.

    Another issue is that some of the patients will be referred to the resident clinic to manage their pain and try to get in for a doctor. The patients will rarely follow up and instead keep on coming in to the ER. We have a patient that we see at least twice a month and that's when I work. She comes in with a friend. The ER literally down the street will give us a heads up when they discharge one because the other one shows up in about 20 minutes usually.

    I would be more concerned if the doctor has taken the time to tell you need to talk to your pcp about this incidence instead of coming into the ER. That's usually a sign.
  4. 0
    Quote from Clusterhead
    You are so right that neurology in general basically is voodoo. I don't know if I've mentioned in my other posts here, but I've had a number of procedures for my headaches (spenopalatine ganglion blocks). Once when we asked the doctor to explain how it works, seeing as the SPG is not thought to be the center of cluster pain (rather the trigeminal nerve), he basically said "oh we don't know, we just know that sometimes it does. Basically, it's magic."

    That's exactly who I want sticking a needle in my nose... :/ (I kid.)
    There are treatments that work for certain things but we don't really have a solid explanation for them.
  5. 0
    Better get your pain under control on a non-narcotic pain med or treatment if you're serious about being a nurse. Practicing under the influence is a big no-no, even if you have a legit reason to be on such meds.


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