pain in the ed

Specialties Pain

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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 computerized mar's. the doc orders a drug, you have to wait, wait, wait, and then go to the pixis, get a witness for a waste (if you don't need all of the pre measured dose), and then give the pain patient his dose. never mind the fact that on the way to the pixis you have 6 other things that suddenly need to be done and that pain patient has sent each of his 6 visitors individually at 5 minuet intervals to complain that the 2 hour er stay is rediculous and that he missed his dinner and wants you to fix him something to eat.

by the time you get to the patient, the award winning draumatic preformance is simply breath taking!

now i know that some pain is true. but if i have a kidney stone, an acute appendix, labor pains, or chest pain, the er nurse shouldn't have to come out to the smoking area, tell me to put out my cigarrette, put down my big mac and accompany her to a room where my vs are 120/80 - 70 - 16!

thanks for allowing a "newbw" to vent!

jeez....what is this 2nd grade?!?!? noone should ever have to apologize for their opinion, or their personal experience...Magikgirl - there is no need to apologize - you have a right to your thoughts just as others do....where has mutual respect gone?!?!

i may not agree w/ certain posts - some may even be offensive - i however attempt to take them w/ the consideration that others have had different experiences from mine -

Originally posted 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....

ERKev

:) excellent post!

Originally posted by athomas91

jeez....what is this 2nd grade?!?!? noone should ever have to apologize for their opinion, or their personal experience...Magikgirl - there is no need to apologize - you have a right to your thoughts just as others do....where has mutual respect gone?!?!

i may not agree w/ certain posts - some may even be offensive - i however attempt to take them w/ the consideration that others have had different experiences from mine -

thanks athomas91. i thought i was in another reality for a moment - being chastized and scolded for my opinions.;)

Originally posted by MAGIK GIRL

:) excellent post!

Thank you, MAGIK GIRL...

As I said before in this thread, I am very impressed by all the posts here! I makes me proud of our profession! Even though some posts seem a little condescending, the writers obviously care deeply about those in their charge. We are truely a caring profession, thus the passion in our posts. I am truly proud of you all...:D

ERKev

Originally posted by MAGIK GIRL

thanks athomas91. i thought i was in another reality for a moment - being chastized and scolded for my opinions.;)

And I felt like I was being mocked for posting what I have learned from years of clinical exp. and personal mentoring from pain mgmt. specialists. You are entitled to your opinions. Having worked in the ED, and having also worked with pts with chronic and terminal pain, I have a different take. Having also suffered with chronic pain for most of my life, I have had to deal with people who were less than compassionate. It is a shame when someone feels like going to an ED for a pain exacerbation is only slightly better than taking a gun and blowing his/her head off.

We will have to agree to disagree. If you were offended by my posts, then I apologize.

And now that really is all I am saying on this thread.

Originally posted by fab4fan

And I felt like I was being mocked for posting what I have learned from years of clinical exp. and personal mentoring from pain mgmt. specialists. You are entitled to your opinions. Having worked in the ED, and having also worked with pts with chronic and terminal pain, I have a different take. Having also suffered with chronic pain for most of my life, I have had to deal with people who were less than compassionate. It is a shame when someone feels like going to an ED for a pain exacerbation is only slightly better than taking a gun and blowing his/her head off.

We will have to agree to disagree. If you were offended by my posts, then I apologize.

And now that really is all I am saying on this thread.

thank you. i am truley sorry for your pain. as the originator of this thread, i assure you that those with true medical conditions are not the subject matter here.

i will agree to disagree with you.

magik girl:)

Just letting you know that this 2nd grader appreciates your apology. I realize this can be a heated topic. I am just saying as someone who has a legit chronic and painful illness lets try to be a bit more careful when it comes to labeling someone a drug seeker. As I have said before I am fully aware that there are those who are truely only after the high. Just please take the time to check something out before you label someone. I agree we are all caring people here and may just need to agree to disagree on this. I too hope I have not offended but you see I speak from personal experience having been wrongly labeled and badly treated.

Originally posted by angelbear

Just letting you know that this 2nd grader appreciates your apology. I realize this can be a heated topic. I am just saying as someone who has a legit chronic and painful illness lets try to be a bit more careful when it comes to labeling someone a drug seeker. As I have said before I am fully aware that there are those who are truely only after the high. Just please take the time to check something out before you label someone. I agree we are all caring people here and may just need to agree to disagree on this. I too hope I have not offended but you see I speak from personal experience having been wrongly labeled and badly treated.

i accept you appology also. i need to say though that I have neither labeled you nor treated you badly.

agian i will say that those with legitimit chronic (and or acute) pain conditions are not the subject matter of this thread. i am sorry for your pain as well as others on this bb and i am never talking about ligit pain pts.:)

I know you were not personally labeling me. I have just had a very bad experience and would like to think I can somehow prevent it from happening to someone else. I dont know if those who work in ER realize it but reading about all their drug seekers make those of us legit afraid to seek their help. Thanks for responding.

Originally posted by angelbear

I know you were not personally labeling me. I have just had a very bad experience and would like to think I can somehow prevent it from happening to someone else. I dont know if those who work in ER realize it but reading about all their drug seekers make those of us legit afraid to seek their help. Thanks for responding.

You may rest assured that I would NEVER label you that way. After many years of emergency nursing, I have a BIG problem with pain patients being undermedicated and poorly treated. I have had many a heated discussion with physicians and PAs reguarding undermedicating and unjustly labeling a pt as a seeker. I feel confident in having NEVER been the cause of anyone being labeled a seeker when they have had a legitimate complaint of pain.

I think many ED nurses will tell you the same thing. After a while, you get to know the seekers. Some times I may get fooled by a seeker, but I have NEVER withheld or encouraged the withholding of pain meds to an ED patient that was even POSSIBLY a seeker. I prefer to err on the side of compassion... Many ED nurses will say the same. I would further like to apologize to those of you who have had a negative experience in the ED seeking treatment for pain. Pain IS a very subjective experience. I, myself, am a big baby when it comes to pain. Thank Goddess I do not have a chronic problem with it.

ERKev

Originally posted by ERKev

You may rest assured that I would NEVER label you that way. After many years of emergency nursing, I have a BIG problem with pain patients being undermedicated and poorly treated. I have had many a heated discussion with physicians and PAs reguarding undermedicating and unjustly labeling a pt as a seeker. I feel confident in having NEVER been the cause of anyone being labeled a seeker when they have had a legitimate complaint of pain.

I think many ED nurses will tell you the same thing. After a while, you get to know the seekers. Some times I may get fooled by a seeker, but I have NEVER withheld or encouraged the withholding of pain meds to an ED patient that was even POSSIBLY a seeker. I prefer to err on the side of compassion... Many ED nurses will say the same. I would further like to apologize to those of you who have had a negative experience in the ED seeking treatment for pain. Pain IS a very subjective experience. I, myself, am a big baby when it comes to pain. Thank Goddess I do not have a chronic problem with it.

ERKev

well said.

i myself have a problem with the md's that say "they are seekers (the well known ones) and we have to give them what they want or they will sue..." and then that same doc medicates a male kidney stone pt who weighs 240lbs with only 1/2 mg of dilaudid!

i have occasionally been fooled by seekers also. :eek:

Originally posted by MD Terminator

Do your docs not write out the # and refills in LETTERS?

I would never let a patient walk out with a narc that I wrote that didn't have it SPELLED out for them. Not even my mother (She lost a MS Contin 60mg TID script one day). Things happen, and we don't need to feed the habbit.

Dave

But what if they NEED the medicine b/c of TRUE pain...And how do you know it's a "habit"

:p

sean

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