Drug seeking patients? - page 11

What do people think about the term drug-seeking patients? I guess I have a hard time with it because usually these people are complaining of pain and who are we to judge whether they are or are not... Read More

  1. by   NurseCherlove
    SouthernYankee,

    I am so sorry this happened to you! Definitely call your PCP, especially if you don't start feeling better soon.

    I am curious, however, if you don't mind sharing, what your labs showed. I ask b/c while Toradol is an NSAID and good for reducing inflammation, I thought it was not supposed to be given to someone with compromised kidneys, and you did say something about having kidney problems prior to this episode.
  2. by   FranEMTnurse
    Quote from ssouthernyankee
    earlier this week i ended up in the ed of the hospital i am employed at with a severe kidney infection. i went in because i was retaining urine, fever, uncontrolable vomiting and flank pain 8 on pain scale. i ended up with a foley cath and iv for fluid loss. i received phenergen and toradol. after about an hour or so i asked for something else for pain as i was still in an incredible amount of pain. about another hour after i asked for a different med or at least another dose of toradol the nurse came in and asked if i had someone with me, a friend had brought me in and after they got me in a room she left to go check on her daughter i told them she would be back when i was ready to be released. i was told that she would have to come back and physically be seen in my room before they could do anything else. she showed up awhile later and then i was given one 5mg lortab and a phen. tablet. the doc came in and checked my urine output which was full of large amounts of blood clots and told me that i only had about 400 cc's and that to be considered retention it would need to be at least 500 cc's. i need to add that this was only the 2nd time i have been to an ed, the first being almost 2 years ago in which i was admitted for surgery to remove a 6mm kidney stone. i feel like they believed i was just drug seeking because i complained of toradol not retracting my pain levels. i was discharged with script for antibiotics and peridiem. i felt so degraded, as though they thought i shouldn't have wasted their time. my first thought was to make a complain, but i am not the type of person who likes to do things like that, but i would like to understand why they seemed so indifferent towards my very real pain. just the thought of them thinking of me in this matter just breaks my heart. (yes i am a little over sensitive to how people perceive me) does this sound like they didn't believe me or is this "normal protocol" i am just a cna at this time and have started nursing school so i don't quite understand the physicians actions or lack of quite yet. my nurse who did my cath was very compassionate and kept rubbing my hand as i was tearing up so at least she seemed to understand my situation. when i graduate i truly hope i never have to treat a patient in this manner because of a physicians attitude/beliefs. i would appreciate any feedback. if i was in the wrong i would like to know. thank you.
    i was treated like that by my primary physician of 10 years, who misdiagnosed me twice. i eventually renamed him and then fired him. i now have a wonderful pcp who does believe me, and has managed to stabilize me. he knows i'm not a nut nor am i a drug seeker. those kind should not be docs imho. they are not nice people.:angryfire
  3. by   ssouthernyankee
    Thank you for your advice. I have gone to my pcp already and he gave me pain meds and antibiotics, my urologist can't get me in until next week(there is only 1 urologist in this area and extremely busy) No the ER did not send me home with a pain script, peridium and macrobid. They gave me 1 pain pill @ ER after I complained Toradol didn't relieve my pain an hour after it was given. That's why I felt they thought I was just seeking. I am going to get taken care of I have a great pcp that knows me well and realizes that I usually have a high pain tolerance and very seldom have asked for any type of pain meds. I do understand why they are concerned about having a driver but they had given me IV phenergen which I have always believed made a pt unable to drive themselves home, and they had seen my friend bring me in and stay until I was settled in a room, I am just confused as to why they sent me out of there without anything for pain control when it was a Sat. and I wouldn't be able to see my pcp until Monday. Sorry I am just frustrated with my employer at this time.
  4. by   ssouthernyankee
    As far as my labs all I know is that I had +3 blood, elevated protien, and wbc's. I have had a kidney stone in the past and a couple infections, the kidney stone almost 2 years ago was the only other time I was in ER. I wasn't told what blood work showed. My pcp has asked for copies to be sent over to him so I should find out soon, I am suppose to follow up again with him on Thurs.
  5. by   ecnav
    I'm thinking about 'evidence based medicine'. Why not employ polygraphs -lie detectors- in the pain assessment. Like bispectral analysis used in anesthesia, polygraph science might help identify factitious complaints. Like bispectral, it wouldn't be the sole determinant, just another source of information leading to more complete patient assessment.

    :typing
  6. by   KarenGeorgeBSRN
    Hi ecnav,

    Would you be one to submit to this, and why would you not believe a client?

    Karen G.

    Quote from ecnav
    I'm thinking about 'evidence based medicine'. Why not employ polygraphs -lie detectors- in the pain assessment. Like bispectral analysis used in anesthesia, polygraph science might help identify factitious complaints. Like bispectral, it wouldn't be the sole determinant, just another source of information leading to more complete patient assessment.

    :typing
  7. by   ssouthernyankee
    Quote from KarenGeorgeBSRN
    Hi ecnav,

    Would you be one to submit to this, and why would you not believe a client?

    Karen G.
    Are you refering to my situation? Either way I think it's sad when nurses feel lie detectors are needed for patients who state pain. Think about this for a moment..if you came in ED in alot of pain how would it make you feel to be subjected to thinking like this? To be strapped to a machine first.
  8. by   KarenGeorgeBSRN
    Honey (Yankee),

    I think it is pathetic that is why I asked her if she'd submit to one!!

    Karen G.

    Quote from ssouthernyankee
    Are you refering to my situation? Either way I think it's sad when nurses feel lie detectors are needed for patients who state pain. Think about this for a moment..if you came in ED in alot of pain how would it make you feel to be subjected to thinking like this? To be strapped to a machine first.
  9. by   mahjia
    well, we cant judge our patient regarding pain issues noh coz pain indeed is unique to every individual. what we'll just ought to do is to make them feel we are concerned and that we care. drug-seeking patients (as u describe them) need not only pain relievers or need not depend on drugs. we can give them the natural mechanisms to dec the pain. its up to us, nurses, use our compassionate attitude and to build rapport to our patients. yet, we cant appease or satissfy them and caught our self losin our patience.... find another nurse to help you :icon_roll
  10. by   krisssy
    Last July, I was admitted through the ER for a blockage which required emergency surgery. The ER Doc and the ER nurse gave me quick IV pain meds and continued to do this after a diagnosis was made. I was moved up to a floor to wait for surgery. The floor nurse refused to give me pain meds and told me that the papers from the ER said that they gave me no pain relief in the ER, and that papers don't lie. I knew two things-I was in excrutiating pain, and I was receiving IV pain meds from 5AM-6PM in the ER. When my husband arrived, I told him, and he started screaming at the nurse. She said she was on her rounds and would get to it when she came to me. After he had a tirade, she came in the room and stabbed me so hard in my arm that I was black and blue for months.

    After surgery, my surgeon told me he had prescribed pain meds while I was on the floor awaiting surgery, and that bowel obstruction is one horrible painful condition. That nurse knew I had a bowel obstruction. My husband went to the Supt. of Nursing who had her written up, went to her manager and came to me to apologize. She said that when a nurse gets written up a certain amt. of times, she is fired, and they will keep an eye on this nurse. I also refused to go back to that particular floor after being in ICU for a few days. When I got back my evaluation form, to be sure I reiterated what this nurse had done.

    As patients, we do not have to put up with nurses who show no compassion and do not use proper judgement in treating patients. It is up to us as nurses to use our critical thinking skills when pain management is going on. This nurse treated a patient with a diagnosed bowel obstructipn who was awaiting emergency surgery like I was seeking drugs. Give me a break! How stupid can one be???

    Krisssy RN MA
  11. by   ssouthernyankee
    thank you karen g. once i graduate nursing school i only pray that i never get so hardened that i start to treat my pts as criminals. although i suppose i can sort of see how frustration could set in especially being an ed nurse when there is such a problem with drug seekers, it's just a shame that many "innocent" and honest patients get the raw end of the deal so often.
  12. by   sociostudent
    Dear whoever,
    I'm a 25 year old female and have had a history of recurrent kidney stones since age 17 (at least 3 per year ; 2 cystoscopies for obstruction so far) and ovarian cysts (dermoid and functional ; had a laparoscopy in 2005 to excise/test a dermoid cyst that wouldn't go away), which has sent me to the ER many, many times. I went to 4 different hospitals (not at the same time--my husband had to keep moving for work, and apparently, documentation for CT scans isn't required. The pain medication was usually either withheld completely (toradol, instead) or not given until after a CT "confirmed" a source of pain. I would estimate that I've had at least 30 CT scans of the abdomen (many with oral and IV contrast), but it could be even more. I really don't know. Of course, b/c of my preexisting conditions, I can't get health insurance. I found an OB-Gyn that would take me without it, so I paid the $200 and found out that I've developed a complex 4 cm cyst in my left ovary that will need an exploratory laparoscopy for excision/pathology to determine if it's malignant, as well as reduced kidney function (GFR = 69). Apparently, the doctors at the hospital ED don't look at previous admissions/radiological studies until the damage has already been done. I was doing ok until January, when I started having abdominal/joint/flank pain, went to the usual ED, who diagnosed the cyst, as well as another stone. I've had a low-grade fever for the last month or so, weight loss (from 110 pounds to 95 in 3 months), fatigue, and now, my hair is falling out. And I don't mean a few strands at a time, I mean CLUMPS of hair are falling out without even brushing it. I saw a rheumatologist back in '02 who said he thought I had either lupus or a connective-tissue disease (arachnodactyly, hypermobility, dual-positive ANA with homogenous and speckled patterns with titers of 1:320 and 1:160, respectfully), so I'm thinking it's either autoimmune, medullary sponge kidney, or cancer. Labs have been abnormal (only slightly, but chronically). metabolic panel shows high levels of calcium, albumin, total protein, low ALP, Sodium, and Potassium, and BUN/Creatinine ratio (been tracking for 3 years). CBC shows only high MCH and MPV, rest is normal (from past year). UA's, however, are all screwed up: cloudy urine, alkaline, moderate proteinuria at 1 g/dl, chronic, intermittent hematuria (on/off for almost 5 years), and occult amorphous crystals.
    I don't know what all of this means, but I do know that I AM sick, I just don't know what with. Can't get medicaid (we make $100 too much per month) and insurance doesn't kick in til January 1. So what should I do when I'm bleeding out my rectum and nose and am having severe abdominal pain? What would you ED nurses want me to do? Stay home, possibly worsen and die of infection, or come in, put up with the nurses' snide remarks, eye-rolling, paternalistism, and refusal to even give me toradol after the doctor specifically said that I was going to receive pain medication? I'm not looking for opioids, I'm looking for relief until I can get to a nephrologist! What would ya'll do?
  13. by   allaboutthefamily
    Quote from sociostudent
    Dear whoever,
    I'm a 25 year old female and have had a history of recurrent kidney stones since age 17 (at least 3 per year ; 2 cystoscopies for obstruction so far) and ovarian cysts (dermoid and functional ; had a laparoscopy in 2005 to excise/test a dermoid cyst that wouldn't go away), which has sent me to the ER many, many times. I went to 4 different hospitals (not at the same time--my husband had to keep moving for work, and apparently, documentation for CT scans isn't required. The pain medication was usually either withheld completely (toradol, instead) or not given until after a CT "confirmed" a source of pain. I would estimate that I've had at least 30 CT scans of the abdomen (many with oral and IV contrast), but it could be even more. I really don't know. Of course, b/c of my preexisting conditions, I can't get health insurance. I found an OB-Gyn that would take me without it, so I paid the $200 and found out that I've developed a complex 4 cm cyst in my left ovary that will need an exploratory laparoscopy for excision/pathology to determine if it's malignant, as well as reduced kidney function (GFR = 69). Apparently, the doctors at the hospital ED don't look at previous admissions/radiological studies until the damage has already been done. I was doing ok until January, when I started having abdominal/joint/flank pain, went to the usual ED, who diagnosed the cyst, as well as another stone. I've had a low-grade fever for the last month or so, weight loss (from 110 pounds to 95 in 3 months), fatigue, and now, my hair is falling out. And I don't mean a few strands at a time, I mean CLUMPS of hair are falling out without even brushing it. I saw a rheumatologist back in '02 who said he thought I had either lupus or a connective-tissue disease (arachnodactyly, hypermobility, dual-positive ANA with homogenous and speckled patterns with titers of 1:320 and 1:160, respectfully), so I'm thinking it's either autoimmune, medullary sponge kidney, or cancer. Labs have been abnormal (only slightly, but chronically). metabolic panel shows high levels of calcium, albumin, total protein, low ALP, Sodium, and Potassium, and BUN/Creatinine ratio (been tracking for 3 years). CBC shows only high MCH and MPV, rest is normal (from past year). UA's, however, are all screwed up: cloudy urine, alkaline, moderate proteinuria at 1 g/dl, chronic, intermittent hematuria (on/off for almost 5 years), and occult amorphous crystals.
    I don't know what all of this means, but I do know that I AM sick, I just don't know what with. Can't get medicaid (we make $100 too much per month) and insurance doesn't kick in til January 1. So what should I do when I'm bleeding out my rectum and nose and am having severe abdominal pain? What would you ED nurses want me to do? Stay home, possibly worsen and die of infection, or come in, put up with the nurses' snide remarks, eye-rolling, paternalistism, and refusal to even give me toradol after the doctor specifically said that I was going to receive pain medication? I'm not looking for opioids, I'm looking for relief until I can get to a nephrologist! What would ya'll do?
    I have thought about situations like this, especially being that I am a full time student (meaning when I begin work full time my insurance will not cover "preexisting conditions" in the US. If I were to develop cancer or the like now, all I would leave my family with would be bills and fond memories. I am not reccomending this, but I told myself if this did ever happen to me I would move to canada (hopefully with my family) so I could get free healthcare. You need treatment, and to be honest palliative care such as opiods will only make your kidneys worse in the long run. I am not trying to diagnose you or tell you what to do, I am just saying what I would do in a similar situation. My heart goes out to you, and I wish you the best.

    Nurses who refuse to give pts meds because of thier own feelings should lose thier license to practice. Evidenced based practice, as well as common sense, tells us that the patient is the only one who knows thier own pain. Even the pain of withdrawl is pain that needs to be treated, albeit what we really need is stricter treatment programs for drug users.

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