pain in the ed - page 12

by MAGIK GIRL 24,661 Views | 189 Comments

i am wondering if a percocet or an oxycontin drive thru right in the waiting room would be the answer. then perhaps, we would have the time to give quality care to our patients who are really sick. our er uses the pixis and... Read More


  1. 0
    Originally posted by Erin RN
    I am with Tom on this one although when I was in the ED I probably would have been with Magik girl or some of the others..The seekers really aggravated me...looking back, it took too much of my energy and time and if I ever return to the ER I will probably do the "roll over" as well.

    Give them what they want since the MD orders it anyways and get thm gone so you can get the other pts that have been in the waiting room for 2 plus hours back.

    I used to wonder about the MDs..they seemed to be as frustrated as us but many would just give the med and b*** about it the whole time. I would guess that there is a fear that a complaint would be filed and that they would have to answer to it? We had one new doc that refused pain meds all the time the fisrt yr or so then he became like the rest.."rolled over" probably decided the battle wasn't worth fighting?

    Erin
    erin, you are wise! what is up with the docs anyway? there was one thread post where someone worked with a doc who treated the seekers with more meds than the appy's or the obstructions! i am glad that i am not an md. too much pressure!
  2. 0
    No wonder you can't win. I guess I'm lucker than I thought, being able to work in such a supportive environment. Our docs are all on the same page with this problem. NONE of our docs order narcs for "seekers".
  3. 0
    Some of our doc's are non-chalant about this. They give the narcs just to get them out of here. I once saw a doc write the pt's med order as they were being brought back to a room. He knew what the pt was there for. The pt was medicated and gone in under twenty minutes. (Talk about Fast Track!) So we freed up a room, the problem was when the pt came back and another doc refused narcs then the screaming fit, "I gonna sue you!" stuff ensued, so it doesn't pay either way.

    What's strange is that our PA's seem to be stricter than the Doc's. They are concerned with being percieved as "candy man" When we get these pt's who come in the ED day after day w/ back pn, HA, neck pn, etc. The PA usually looks up the hx and last visit rx in our computer. If a pt was given 6 percocet in a take home pack and an RX for 20 more and they're back within a 1-2 day period, then that pt gets a Naprosyn and referral to a pain clinic.
  4. 0
    I understand that there is a huge lack of knowledge concerning pain management. Things like addiction physical and psychological, physical dependence, tolerance, psuedo addiction are all things that are not well understood. Wouldnt it make more sense to educate yourself on these things so that we can truely be the compassionate and caring advocates for our patients that we are meant to be instead of insulting those seeking our help? Is it just me or has alot of the care gone out of health care?
  5. 0
    You are right Angelbear.

    Care went out of Healthcare right about the time we started labeling patients as seekers. Right about the time we stopped admitting patients into LTC becasue they were on the "poision Methadone". Right about the time we decided patients taking Oxycontin were on "Hilbilly Heroin". At the same time, "CARE" was thrown to the wolves, when long time nurses decided to throw all those years of research and teaching to the wind... and profess that they knew a seeker and a fraud, forget about basing care on the patients statement of pain.

    I am just thankful that where I practice, we still have nurses who know just what the CARE in HealthCARE is. And that they apply it to every area of medicine, including ailments which will require controlled subtances.

    Dave
  6. 0
    Dave please hold that job for me it is giving me incentive to study.
  7. 0
    You guys, I think we need to meet somewhere in the middle. Prescription drug abuse is an enormous problem in this country, ruining many, many lives. Please don't think that those of us who believe there are people who are addicted to prescription drugs and will do just about anything to get them are uncaring. You could not be farther from the truth. I do not want patients to be in pain, and I fight to make sure that patients receive the pain medication they need on a daily basis.

    However, please take a moment to check out these resources:

    http://www.drugabuse.gov/ResearchRep...cription5.html

    http://www.prescriptiondrugaddiction.com/default.asp

    I don't think that treating one problem while ignoring another (or denying it exists) is true patient caring. One nurse's opinion only.
  8. 0
    I agree and I dont think any of us want to create or enable addiction it is just that that is its own area of medicine and we have no business in it. In those cases we need to referr for either adequet pain tx or addiction tx
  9. 0
    Originally posted by hogan4736
    I disagree

    Let's just give the shoplifter the merchandise he wants in the store then...
    Or the arsonist a pack of matches, and a can full of gasoline.
  10. 0
    A patient on methadone needs inpatient detox, NOT a LTC...

    I turned down an admission to my LTC last week. A 28 y/o female that was on IV Demerol q3h for intractable back pain...

    She needs inpatient detox (w/ possibly a course of methadone), NOT A LTC!!!!!!


    I will not endanger my elderly patients. And please, before you say "how dare you label the 28 y/o," I'll just say:

    PLEASE! A nursing home is not the place for an IV opiate addict!


    sean


Top