Addicts in the ED

[amyjm333]

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?

[babychickens]

Unfortunately my shift ended before I learned whether she had one or not.

[babychickens]

Thanks. Good to know!!

[JKL33]

JackRusselGirl - I hope I didn't undermine the telling of your excellent observation; if so it was unintentional. I was just having an internal "moment" of pondering the big job of triage and some of the factors that sometimes make it difficult. I didn't mean to take away from your story. There is no excuse for not doing a quick, appropriate, and focused triage assessment. I won't say more since it's incredibly difficult to judge someone else's triage process without being there to see it (for me, anyway).

Now, this admittedly is nitpicky - I never "dismiss" anyone. Never. But I may "determine" that they do not have an emergent need, or maybe that they don't have even an urgent need. Sometimes, I "determine" that they don't really need to be there at all. Dismissing is done with inappropriate judgments - and it does happen. So there's another concept for you to observe and think about going forward in your education: Determining vs. Dismissing. Determining should be done with care and astute observation, and dismissing is not okay. :)

[babychickens]

Hi amzyRN. I didn't take it that way at all. For what it's worth, I feel encouraged by the communication I've been having in this forum with so many RNs. I work as hard at learning how to communicate with my future fellows as I do on learning the knowledge. I appreciate the insight you all have given. :)

[Cola89]

I didnt really like the er I was working in bc the main doc always prescribed dilaudid and a ct for any small pain almost. We started ivs and gave fluids on almost everyone who came through our doors... not a thorough dr assessment, he just ordered iv blood work dilaudid or morphine ekg and ct on nearly everyone.