Bipolar does not mean "druggie"

[aslaten08]

I just want to put this issue out for others to read...A majority of the time, when a patient is in the hospital, regardless as to why, and they have a history of bipolar, depression, anxiety, etc., they are almost ALWAYS sterotyped into being a "druggie", a "seeker", a bad person, etc. Now in saying this, when a patient is in pain, as nurses, we are supposed to take their words as to the intensity of their pain. But if the patient is in pain AND is bipolar, has depression,etc, most nurses automatically would say, "That pt only wants pain meds to get high" or whatever....ARE YOU SERIOUS??? When someone is in pain, of course they are going to be requesting their pain meds around the clock, but for some reason, if they have a hx of bipolar, they are automatically almost looked down upon or something. I am just so sick of other nurses questioning these patients and their requests for pain meds. Sorry...I just thought I would get some input and see if anyone else has seen this issue where they work..

[mpccrn, BSN, RN]

no! sorry, i haven't run across that....ever. that's horrible.

[Thornbird]

Sadly medical professionals are highly judgmental of persons with psych dx. Although many psych patients are "dual diagnosis", many are not. But those who are not do not get the benefit of the doubt. This prejudice is one of the big reasons people don't seek help for mental illness, don't take meds and deny the problem. If a pt admits to being on psych meds or a bipolar dx, even when seeking treatment for something entirely unrelated, the attitude changes and whatever their complaint is gets trivialized or denied. When they go for treament for mental illness, the groups focus on finding Jesus, getting/staying sober and then work on the psych issue. No matter if sobriety is not an issue, then the "denial" has to be worked on first.

[ladylikeRN]

I agree, I have seen a lot of health professionals like myself cast judgment on others because of pain medication usage. I have no problem giving scheduled pain medications. I also have no problem with seeking an increase in dosage for a patient that is having no relief. It's all about being a patient advocate, not a person to cast judgment on others. Pain is a personal perception.

[shelly304]

Recently, I spent a month at an oncology med office. (I work agency) I was disgusted by the attitude of the other nurses, who constantly made quips about the patients meds. One patient was having a flare-up of her migraines and requested a refill on her Imitrex (obviously not a narcotic). The RN glared at her and spewed, "Try Tylenol." Most of the narc prescriptions had to be picked-up, not called in. They had a small file box at the front desk with each prescription in it's own envelope, waiting for the pt to pick-up. They had labled it "The get high legally box." They nasty comments about patients meds and pain levels were daily conversation. I was ashamed of my fellow nurses and the attitudes they had. I, too, have been conned by "turkeys". I know substance abuse is rampant in our society. But judgement without walking in anothers shoes is akin to playing judge and jury. Someone elses suffering is not for me to make light of.

I am glad someone else has had their eyes opened to this and is speaking out about it. I had my agency take me off the list to work there after the office requested me several times. I wrote the office manager a letter of my reasons last week. I am interested to see if I get a response.

[Xbox Live Addict]

There's still an ugly stigma on psychiatric illness, and so many people continue to display the same ignorant attitudes towards people struggling with it that were common in the 19th century.

I've heard it said time and again by more compassionate physicians and nurses that having major depression, bipolar disorder, PTSD, etc, is a medical condition no different than having diabetes.

While I wish these attitudes were the norm rather than the exception, in reality, that's a load of absolute bull#&$@. Diabetics can get jobs. Diabetics aren't red-flagged by employers and colleges the way people with psychiatric disorders are, even those who are employed. Diabetics don't have to hide their illness lest they be shunned by society and have to hear constant derogatory remarks about them and their families. And diabetics don't receive the same inhumane care that people with mental illnesses get, whether living on the streets, being locked up in decrepit psychiatric hospitals whose conditions would never be tolerated at any city medical center, or being jailed just because society can't figure out any other place to put them, and forcibly given medications like Haldol that have permanent, disfiguring side effects, with little energy spent on safer alternatives. Even the new-generation drugs are still dangerous. And I've seen these attitudes even in physicians and nurses, who should know better.

Until attitudes like these change towards people with mental illnesses, little progress will ever be made in treating them.

[wonderbee, BSN, RN]

We do see a lot of drug seeking patients and we are able to tell what they're about fairly quickly, but their mental health diagnosis has nothing to do with it unless it's a substance abuse dx.

[KarafromPhilly]

In my experience, it's not just pain issues, but other things too. I can't count the number of times I've heard, "(S)he has a psych history." with a roll of the eyes, as if that explains everything from persistent vomiting to anxiety/concern before a major procedure.

[queenjean]

Sorry, Kara, but in my experience, psych history--particularly one that has resulted in multiple hospitalizations--*does* have something to do with certain diagnoses and problems. Not everyone with a psych history has problems--but it is as significant to certain diagnoses as saying "He has a history of hypertension" on a stroke pt.

I don't see pts with bipolar automatically described as drug seeking. Maybe it's because I work in a small community, so we know the drug seekers and the people who have uncontrolled mental illnesses. Maybe it's because we have a couple of bipolar nurses on our floor who control their disease as well as the three diabetic nurses on our floor, or the nurse with htn.

To me, bipolar is as big of a deal as depression or anxiety--not much. In my experience, bipolar pts are no more likely to be drug seeking as diabetic pts. I think maybe our frequent bipolar pts who do not for whatever reason take their meds seem to be more likely to abuse alcohol.

I don't think I've ever seen a nurse assume that because a pt has a history of bipolar, they are drug seeking. To me, those aren't logical assumptions. I mean, there are so many other diagnoses that are more common with drug seekers--abdominal pain tops the list in my experience.

[FireStarterRN, BSN, RN]

I haven't personally seen this happen specifically with bipolar patients. They are usually on various psychotrophics, not narcotics, unless they have chronic pain. Some bipolar people have other substance abuse problems. That's not surprising since they suffer from extreme mood swings, but I haven't noticed this tendency to specifically label bipolar people as 'druggies'.

[KaroSnowQueen, RN]

'One patient was having a flare-up of her migraines and requested a refill on her Imitrex (obviously not a narcotic). The RN glared at her and spewed, "Try Tylenol." '

That is so wrong on so many levels. As a person who is on a good sized dose of antidepressant, and as one has had chronic pain for over ten years, I just feel so wronged by that attitude. I too have seen people who are "seeking", but there are so many of us who just want to feel NORMAL, not high, just comfortable.

[shellsgogreen]

the people that cast judgmental remarks about bipolar people being druggies probably make the same narrow minded remarks about all patients.

:uhoh21: