abusers and losers. Can you top this one?

[Uptoherern]

Last monday, I had a lady come into triage with a godawful, pity-me limp. She proceeded to tell me that she had terrible pain from her low back radiating into her left leg. She offered up that maybe she had "over done it at her family picnic" the morning before. Then she said, "I think it might be sciatica!" (stage limp = 1st red flag, medical jargon from non-medical person = 2nd red flag). For some unknown reason, she felt she needed to share that she had had an MRI the previous thursday, but her Dr. didn't have the results yet. Now I am confused beyond reason....why did she have the MRI thursday, when the pain started Sunday am? (red flag #3). I simply told her that since it was now Monday, I would place her in a room, and call her PCP for the MRI results. Looking a bit nervous, she allowed me to place her in a room. I told her to get into a gown, and the Dr. would be in to see her shortly. She did get into the gown, then opened the door and laid back onto the cart. I called her PCP, and they said they would get back to me. A few minutes later, one of the nurses said, "Diane, you have a phone call from dr. so and so's office regarding the lady in bed #3". As I go to answer the phone, the patient appears on the other side of the desk, fully clothed (nt having seen the er dr yet), and proceeds into this tearful tyrant about her PCP having "washed his hands of me!" boo, hoo. As I am looking at her, her dr.'s office informs me that this lady did indeed have an MRI in April, however it was in 2002. I thank them, and hang up. Then the pt. tell me that her "othopedist" (red flag #45) "told me that if EVERYBODY in the world was taking oxycontin, then who would be left to govern the world?!!!" boo, hoo, hoo. I tell her, she hasn't even yet seen the ER dr. Would she like to return to her room to see him? She sniffs a few times, and goes into the room, only to return to the nurses desk a minute later, saying "I want to sign out AMA!" (another one of those medical jargon red flags". So, we sign her out...and upon cleaning the room, discover that the code cart key is broken, and the pre-filled valium syringes are gone. Great. BTW, another thing she had said in triage was "My co-worker dropped me off during my lunch break and will pick me up when I'm done" I hadn't even asked her how she got to the ER. She obviously Knew enough to say that, so that if she got narcs, we would think she had a ride. When she signed out AMA, she had her car keys in her hand.

Call me....MS suspicious

I shoulda been a cop

[Scis]

erdiane:

If only these types (of which there are many) would use their brain power for the greater good imagine what a world we would have! It never ceases to amaze me how ignorant they think we all are! Patty :roll

[RNPD]

. My seekers are usually allergic to toradol, motrin, and tylenol. I had a women once, in again for migraine, 3rd time in one day, anyway, doc told her she would get demerol shot, ordered toradol, Patient left without any allergic symptoms and no pain 10 minutes after the IM toradol.

debi87021

Sounds like an extremely dangerous, unprofessional game to play. What if the woman was truly allergic, and had an anaphylactic rx? Then both the prescriber and yourself would be in a lot of legal troubles-that is malpractice!

I don't think our job should include "busting the liars". As others have stated, we can't rehab them in an ER visit.

I think it is up to the ER docs to decide what to do on an individual basis. I think it is up to the nurse to carry out those orders if they feel they are safe and appropriate for that moment. If not, tell the doc, the sup, whatever. But don't judge. Even addicts have pain.

That said, I know it is extrememly frustrating to have to deal with people who are obviously lying & drug seeking. But that is part of their illness, as well. Who are we to say what s/s are acceptable to us for rx and what s/s are suspicious so we will refuse to rx?

[JOY LEE]

ERDIANE, WHAT I DON'T UNDERSTAND IS ....DO THEY THINK WE ARE THAT DUMB? THESE PEOPLE ARE SO SAD AND THEY TAKE UP OUR TIME FOR THE PEOPLE WHO ARE REALY IN NEED OF THE ER...GREAT STORY, AND OHHH SO TRUE.:roll :roll

[Uptoherern, RN]

re:teeituptom, etc. I figure...why should I let the docs give these people rx's, when I know that they are wasting MY time! I don't over extend myself being super "nurse-cop", but I do consider it time well spent, when in a few seconds I can deduce that a patient has been seen in a sister facility recently. AND, having visited that facility has recieved narcotics that should have sustained them for longer than...oh, say one or two days!... I will not put up with the people who abuse the system!!! If the only thing that I accomplish is that they know better than to come to MY er, then so be it.................... they can waste some other nurses time. At another facility. .........................I rather enjoy it.

[AZEMS]

diane

i work in phoenix and feel your anguish. I like you give everyone a equal chance to tell their story and get treated as if family. But out here its horrible. People abuse and use ER's like I've never seen. Its time nurses take the upper arm and make patients establish TRUST. If they expect the same then we should from them. Good job I think many times we feel like cops. With the need to investigate the WHY they are here and the objective facts for their needs

[teeituptom, BSN, RN]

Hi yalll

The trouble now ERdiane is that any facility that gives you such info is in violation of HIPPA. When other ERs call us about known drug abusers we cant offer any information about even if they had been seen here. Sad but true. HIPPA protects the abusers of the system very much so.

[Medic946RN]

HI All!

First post on this board, stumbled upon it by accident, but what a nice accident! I have been a paramedic for 24 yrs and now am a baby ER nurse. I was absolutely stunned by the amount of drug seekers that come into my small community ED. There's a couple of them who come into the ER three and four times in a 24hr period, now that's dedication. One of ths doc's I work with has taken to giving the identified regular seekers Haldol. And it works! The patients state they feel better and leave happy. Pretty amazing huh!

I also run into the pt's who are allergic to every pain med but their drug of choice which is usually dilaudid or oxcycontin. I even tested one seeker one night when she asked me what was in the syringe, I told her hydromorphone. She got real upset stating the MD promised her dilaudid for her pain. Once I explained it was the same thing she calmed down. Did I mention that she had been in twice earlier that day, strangely her visits seemed to coincide with the physcian's shift changes. What were the odds?

[Uptoherern, RN]

teeituptom: We have a computer link between our hospital and our two sister facilities. One has a similar name, the other is completely different. I'm able to access pt.'s visits, and am able to determine reason for visit. I think since all three hospitals are owned in the same area by one owner, it is not a hippa violation. I don't actually talk to anyone....I can easily get info out of the computer.