pain in the ed - page 12

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. ... Read More

  1. by   Dave ARNP
    I have never done this. It takes alot, and I do mean ALOT to peeve me off (deeply) but I have honestly reached my limit.

    To those of you with your labels. Make them. That's fine.
    Go on about the abuse and misuse and addiction. Thats fine.
    You practice nursing the way you see fit. That's fine.

    Just keep it out my practice.

    Because let me say this. If one of you were to come and express these views on any patient I am treating, I'm going to tell you this. (And I have never said it, but I beleive now the time has come).

    Understand that you are the nurse. I am the Practitioner who has evaluated this patient and making a treatment plan. I will order the medication/s that I see fit. As the nurse, you will admister them. If you choose not to, then I will admister them myself, but understand I will also be relieveing you of your duties to this patient, and me as the Practitioner.

    Call it pulling rank, call it a power trip. However a nurse with the kind of feelings posted in this thread will be useless to me, and will prevent me from doing MY job. And as the Practitioner, I will not allow that.

    Good day to you all. For those nurses who are compassionate and caring enough to understand that patients complaints of pain need to be taken seriously, this is very much not meant towards you. I would be privilaged to work with any one of you.

    Dave, who is hanging his hat up on this thread. I will not be responding to any other posts. I have nothing else to say. Explaining things again is waste of my time.
  2. by   fab4fan
    Darn, where is that clapping smilie when you need it!

    Thank you, Dave.
  3. by   angelbear
    Well said dave sometimes these things just need to be said.
  4. by   fab4fan
    If you get into a serious accident, and "need" 4-6 percocets/day during your recovery, there is a HUGE possibility you may need some help getting off them after your recovery, especially if you are an alcoholic/addict, or have the addict gene
    This is patently false, and has been proven so by research.

    Think I need to take a page from Dave..some people are just never going to be convinced, no matter how much info. they are given.

    Wonder if anyone out there still thinks the Earth is flat.
  5. by   Spidey's mom
    Thank you Dave.

  6. by   caroladybelle
    Originally posted by stevielynn
    Thank you Dave.
    I second that!!!!!!!
  7. by   hogan4736
    Originally posted by fab4fan
    This is patently false, and has been proven so by research.

    Think I need to take a page from Dave..some people are just never going to be convinced, no matter how much info. they are given.

    Wonder if anyone out there still thinks the Earth is flat.
    I know of much research about an addiction gene and how it can lead to a propensity toward alcohol and drugs...Giving narcs to this person could do more harm than good...

    at least give them a look:

    Last edit by hogan4736 on Jan 14, '04
  8. by   ERKev
    Yes... This has gotten quite heated. And I think it's important for all to understand that our areas of practice differ, so our experiences differ. I, myself, work in a number or Detroit area EDs. We have a DEFINATE problem with SEEKERS!!! And I use the term NOT as an epithet, but as a very good descriptor. On some evenings as many as 30% of the people I see are there simply for pain drugs. At one particular ED I work at there are about 4 other EDs within the city that are all conected by the same computer system. We see the records of all of their visits! These people (not all, but many) make the rounds from ED to ED. In a perfect world, we could refer them to help and they might very well take us up on the help. But, most simply get peeved and split for the next ED.

    Now, you can look down on me and my usage of the term "seeker" and call me uncaring, but I am there, in the trenches, night after night with no breaks and no relief. Then, enter the seekers. They don't even stick with the same stories from one visit to the next, often only a few hours apart! They swear they haven't been treated before! They also (as previously mentioned by on of those nasty people using the term "seeker") threaten our lives and actually DO wait around and watch for you to leave. I have a close friend (ED nurse) that had a pistol held to her head in the parking lot by a SEEKER.

    I've cried more times than I can even recall over the people I've had under my care. And, further, I'll be the first one to push for proper pain control! But, there are seekers. They do cost us a great amount in time and resources. They do detract from the legitimate pain patients who get lumped into the same category. THEY ARE THERE....

  9. by   hogan4736
    Indeed they are there Kev, which is why I filled in my ER trench and went on to another endeavor...


    Nice post

    A good thread on both sides...
  10. by   athomas91
    i see that everyone has made very good and valid points...there are those who are indeed in great pain - and there are those who really just want the meds...i think it would be ridiculous to argue otherwise....

    i am however going to back up some statements made my reading her post - i interpret what she is saying NOT to mean that those in pain should live in pain that affects their ADL's - but that when all pain is obliterated - that one increases the chance of re-injury....for example....a post-op pt who is 100% pain controlled HAS THE POTENTIAL to over-exert and injury that site....... in reading her post she states that there is pain "for a reason" - perhaps she is speaking of our bodies having the opportunity to tell us when enough is enough.....

    i also think it is important not to judge another's post right away - perhaps asking what exactly is meant by certain statements would be the more intellectual way to approach a discussion...

    i do happen to work in an area that has alot of i am not labeling - i fully agree that those in physical pain should be treated w/ appropriate medications - as a nurse w/ extensive ER experience in many area, and as a nurse who is in the process of APN education - i would expect that the other nurses in this arena would take into consideration that perhaps in statements i am speaking of certain individuals that I have encountered - and that just perhaps i am right.....perhaps you have had the fortune NOT to deal w/ these types of are lucky...

    i agree fully that those in pain need medication - but some are medicating psychological/emotional pain via physical means, and this is where I as a nurse need to decide where the line is between help and harm...

    another thought - when being tx for pain - for instance w/ oxycontin - when you discontinue and perhaps have w/d symptoms - these also cause severe, are the medications making it more difficult for those who no longer need them to discontinue?!?!
  11. by   MAGIK GIRL
    Originally posted by angelbear
    I hardly think I am the only one who thinks you were implying that people should suck it up since you do. I know you did not say that I do however believe that is what you were implying. I dont know if you are aware of it or not but this forum is intended to educate on pain management and support those who deal with it it was not intended to be a forum to insult addicts and seekers.
    ok. i tried. you are going to think what you want no matter what i say. applolgy still stands but that's all.
  12. by   MAGIK GIRL
    Originally posted by fab4fan
    You obviously don't read a lot of what I post. Whatever.

    BTW: You've made some pretty personal attacks on me in several posts. Guess I should be offended. :stone
    perhaps (i can recall only 2) but you should look at post numbers 1-8 and you will find a judgemental attitude from yourself. i was not offended then and am not now. i am just wondering why we all just can't get along anyway. this was just for fun so please stop judging me and i won't judge you. ok?
  13. by   ERKev
    Also, Folks.... This thread's title says a lot: "pain in the ed"

    We're not talking about anyplace else in this thread. I think, perhaps to a degree, this is why this discussion may become heated at times. I, myself, come solely from an ED perspective. In reading these other posts again, it is quite obvious that most others do not. ED is particularly different from most other nursing contacts for pain control. It is usually in the form of acute pain control, not chronic, that pain is treated. And the ED/EMS is abused in a wide variety of ways - not just seekers. I have seen in the past year alone, people using the EMS to get from one side of town to the other - no real medical problems for which treatment is desired. Just a "free" way to get to another crack house across town.