Addicts in the ED

Specialties Emergency

Published

I am a new graduate nurse and have begun working in the ED. The other night, we had a patient (not my patient) who was a frequent flier and was seeking pain meds. The patient's nurse (who is also new to the unit, but not a new nurse) was about to discharge the patient and asked an experienced nurse if they give referrals or if we even had any pamphlets or information to provide this patient who obviously needs help. The answer was no, we have nothing. We provide nothing. I have pretty tough skin, but my heart sunk for this patient. I have wondered many times since that day what I MYSELF will do when presented with an addict of the obvious or admitted sort....

So here is my question...what do you all do? Do you have a policy regarding this? Do you provide information of your own to your patients?

Specializes in Psych, Addictions, SOL (Student of Life).

As my son the man cub would say "I gotcha lobster!" I don't actually know what that means but he says it's a sign you have someone's back.

Hppy

Specializes in Emergency Dept. Trauma. Pediatrics.
As my son the man cub would say "I gotcha lobster!" I don't actually know what that means but he says it's a sign you have someone's back.

Hppy

hahaha I have no idea either. Not even urban dictionary heard of it. That's cute though! Kids can be hilarious, my barely 10 year old overheard me on the phone the other day. She didn't know what was going on but could tell it was important. She says "Mom I want you to know that I will always be here for you and have your back. If you need to talk, I'm here. You can always count on me no matter what"

Not what a 10 year old would say (she is nothing like a 10 year old though anyway) but I smile and laugh and ask her where she got that from and she says "It's what you tell me when I am having a rough day"

Much like patients, I suppose they to sometimes have to remind us why we love what we do. ;)

Specializes in Hospital medicine; NP precepting; staff education.

Hppy and mi Vida Loca have some sweet babies!

Specializes in Emergency Dept. Trauma. Pediatrics.
Hppy and mi Vida Loca have some sweet babies!

She's alright! lol Actually I am very proud of her. We just hosted our first dinner Thursday at that recovery house I was talking about. She was a little social butterfly mingling and joking with the veterans. She knows they used to be homeless and she knows they are in recovery from drug and alcohol addictions and have been in war and might have mental illness, she didn't show a hint of worry or fear or treat them any type of way. They said having her there mingling with them so young and innocent meant so much more to them then anything. Reminded them of what they are fighting for in their recovery as many of them have children and the fact that because kids are so innocent (unless they are taught to treat people a certain type of way) that it was nice having someone not looking at them like they were broken people!

I can't wait for our BBQ there tomorrow!

Specializes in ER, ICU.

At my ED we are just embarking on a new project to decrease narcotic use in the ED. Safe injection and needle exchanges are a part of the program. There is ethically no way to withhold advocacy for reduction in harm to our patients. A culture change that addiction is a disease and not a personal failing needs to take place. It does not help that these patients don't tend to be very much fun, but this is our job.

I think we, as nurses, SHOULD debate.

So, not all EDs have 24/7 social workers, check. It's not ethical NOT to help out a patient with a substance abuse problem, check. Both good discussion points.

Mine: I don't think it's ethical to use drugs or waste hospitals'/nurses'/doctors' time seeking, and I have absolutely nothing but disdain for drunks and dope fiends and make near zero effort to "assist" them.

My prayer is that you find yourself in their shoes some day soon so that you will develop some compassion for them.

Specializes in Medsurg/ICU, Mental Health, Home Health.
My prayer is that you find yourself in their shoes some day soon so that you will develop some compassion for them.

While I get where you're coming from here, I hope you really don't mean that you hope this person ends up addicted.

I will say this, folks...if substance abuse has not touched you personally via yourself, friends or family, you are blessed.

My prayer is that you find yourself in their shoes some day soon so that you will develop some compassion for them.

I find that interesting, given that I pray no one experiences it despite my hardened sentiment.

Specializes in Emergency Dept. Trauma. Pediatrics.
I find that interesting, given that I pray no one experiences it despite my hardened sentiment.

If you're a man of prayer, I find it interesting that you are willing to pray that no one falls victim to addiction, but so easily cast aside anyone that does and show so much disdain for them.

If you're a man of prayer, I find it interesting that you are willing to pray that no one falls victim to addiction, but so easily cast aside anyone that does and show so much disdain for them.

I don't pray, just a turn about of Kooky's post. I hope it never happens to anyone, but more often than not, it's poor personal choices that lead people down that road. My sympathy runs pretty low when you're a victim of your own stupid decisions. It's also pretty easy to hate on addicts in the throes of their disease because of their reprehensible behavior: lying, cheating, stealing, murdering.

Again, I'll help those seeking help but if you're trying to throw resources at someone whose literally just seeking a drug fix, you're tying up precious ED time, space and staff. Or is this the touchy-feely rehab forum and I'm turned around?

Specializes in ED, Cardiac-step down, tele, med surg.

I hear you, it's really annoying when some malingering junkie is draining resources. I get really pissed off, but I usually fall back on an inkling of compassion that carries me though in order to still attempt to do something positive. I think cutting off the narcotis and/or providing follow up and boundary setting, i.e. care palns and such for possible future visits is necessary. I agree that poor personal choices are definitely at play, I do think that there is a biological component to addiction, so that at a certain point people are no longer making choices. Perhaps there is a small amount of will power and nurses and health care providers can harness that small amount to possibly save their life. Unless I have "walked a mile" in someones shoes, I make every attempt to refrain from judgment. Once we start making judgments and assumptions we miss things and that's not good for an ER nurse.

Specializes in Emergency Dept. Trauma. Pediatrics.
I don't pray, just a turn about of Kooky's post. I hope it never happens to anyone, but more often than not, it's poor personal choices that lead people down that road. My sympathy runs pretty low when you're a victim of your own stupid decisions. It's also pretty easy to hate on addicts in the throes of their disease because of their reprehensible behavior: lying, cheating, stealing, murdering.

Again, I'll help those seeking help but if you're trying to throw resources at someone whose literally just seeking a drug fix, you're tying up precious ED time, space and staff. Or is this the touchy-feely rehab forum and I'm turned around?

Oh I missed the part of that you were lying about praying. Got it!

The bolded part is a clear indication that as a health care professional, especially in the ER, you need more education regarding addiction. I would expect something like that said from an ill informed person off the street. Not from what should be an educated professional.

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