Just came here to blow some steam off. I just put in a three day stretch with a chronic pain patient assigned to me that was a royal pain in the behind to take care of. This patient was on our floor for a ORIF of her knee. She also had a hx of fibermyalgia and was on all kinds of pain meds and narcs and junk to keep her zoned out most of the time. I tried my best for the three days I had her as my patient to take very good care of her and meet her needs, but for the most time she was very rude and nasty to me. It did not matter what I did, I could never do enough nor could I do it right.
Here is the question I would like to put out there: Why do these docs keep ordering all of these highly addictive substances for these folks? I know that when I go see my doc he is very conservative about pain killers and does not want folks to become addicted to them. He will give you something for pain, but he won't keep ordering it over and over again for you. He also looks for alternative medicines to give to you that will do the same thing but are not addictive.
Another question to throw out there: Why are most chronic pain patients "nasty" to deal with? They always have "attitudes" with the nursing staff. Most are downright rude to everyone who takes care of them. Many do not know the words "thank you" and are very demanding and critical of your care to them.
Sorry if I sound like I am not compassionate. I really am. I just came here because this is a safe place to sound off about these issues. If anyone out there has some answers, please, please post them.
I just want to understand better why these people act the way they do. Thanks.
I would like to try and give at least a little bit of insight into this situation from a chronic pain patients point of view...and one who is also extremely sensitive to all NSAIDS, cannot take any Aspirin based medications to due reactions with Asthma and has a past HX of Heroin addiction.
As a chronic pain patient, who also has the above mentioned added conditions, there are still times when I need relief from acute pain (for example after falling through a ceiling and injuring my back). As a Chronic Pain patient as well I am very familiar with what does and does not work for me, how much of any drug I will probably need and what I can't take or what is going to be a complete waste of time. So when I present to the ER needing relief from acute pain and I say something like "Tramadol is going to be a waste of time, I believe Fentanyl is more appropriate for me", I am not "drug seeking" just to get a Narcotic I am trying to save the ER staff a lot of wasted time and effort. Instead of just not saying anything and then having the staff only end up having to reassess and change medications and so on if I haven't received what I need for pain relief, thus ending up spending more time in the ER taking up a valuable bed that another patient could be using, I figure it is in everyone's best interests for me to try and make it easier by just stating straight out what is and isn't going to work for me.
I will always try and be as polite and cordial as possible to all ER staff as well; however, if I can sense (usually because their muttering under the breath, rolling their eyes and generally looking at me like I'm the worst kind of scum they've ever seen) that any staff member is being judgemental towards me then I can get a little defensive. I will still try not to be rude but I will try and advocate for myself and be very assertive in letting the person know that their assumptions are very wrong. Unfortunately I know that as soon as I open my mouth and say that I can't take NSAIDS or Aspirin based medicines and they also see the trackmark scar on my arm (I am always upfront and honest about my past history of heroin addiction and I will offer to take a urine or blood test if they want to check what drugs I have in my system) I am likely to be labelled a Drug seeker and that can tend to make me a little defensive and more likely to react negatively to even the slightest hint of not being believed, although like I said I do still try to be nice and polite with everyone.
Specializes in icu, er, transplant, case management, ps.
I would like to try and give at least a little bit of insight into this situation from a chronic pain patients point of view...and one who is also extremely sensitive to all NSAIDS, cannot take any Aspirin based medications to due reactions with Asthma and has a past HX of Heroin addiction.
As a chronic pain patient, who also has the above mentioned added conditions, there are still times when I need relief from acute pain (for example after falling through a ceiling and injuring my back). As a Chronic Pain patient as well I am very familiar with what does and does not work for me, how much of any drug I will probably need and what I can't take or what is going to be a complete waste of time. So when I present to the ER needing relief from acute pain and I say something like "Tramadol is going to be a waste of time, I believe Fentanyl is more appropriate for me", I am not "drug seeking" just to get a Narcotic I am trying to save the ER staff a lot of wasted time and effort. Instead of just not saying anything and then having the staff only end up having to reassess and change medications and so on if I haven't received what I need for pain relief, thus ending up spending more time in the ER taking up a valuable bed that another patient could be using, I figure it is in everyone's best interests for me to try and make it easier by just stating straight out what is and isn't going to work for me.
I will always try and be as polite and cordial as possible to all ER staff as well; however, if I can sense (usually because their muttering under the breath, rolling their eyes and generally looking at me like I'm the worst kind of scum they've ever seen) that any staff member is being judgemental towards me then I can get a little defensive. I will still try not to be rude but I will try and advocate for myself and be very assertive in letting the person know that their assumptions are very wrong. Unfortunately I know that as soon as I open my mouth and say that I can't take NSAIDS or Aspirin based medicines and they also see the trackmark scar on my arm (I am always upfront and honest about my past history of heroin addiction and I will offer to take a urine or blood test if they want to check what drugs I have in my system) I am likely to be labelled a Drug seeker and that can tend to make me a little defensive and more likely to react negatively to even the slightest hint of not being believed, although like I said I do still try to be nice and polite with everyone.
I am not a former drug addict but I do suffer from chronic pain. I hate going to the ER when my doctor is not available. I am tired of the label and the knowing glances. Knowing glances that are in complete error, I might add. I love reading about how, we as nurses, should not judge any patient who comes into an ER for pain relief. I love the reading because it is rarely carried thru to the patient.
The only time I can remember not being pre-judged was last July, when I spent twenty-one days in ICU. The nurses medicated me when ever I requested medication. And the reason for my stay was acute renal failure and sepsis.
I would like to request of my peers, that you not pre-judge anyone, even a drug seeker. They also need help. And giving them a placebo is not providing them the help they need.:angryfire
I would like to request of my peers, that you not pre-judge anyone, even a drug seeker. They also need help. And giving them a placebo is not providing them the help they need.:angryfire
Woody:balloons:
it would be a heck of alot easier to treat the drug addicts, if they admit they need help.
but until then, most will lie and manipulate to get what they want.
we are not helping them by enabling and supporting their habit.
there are many who need help.
i am quite confident that most of our criminals come from disadvantaged backgrounds.
aren't many of our child molesters, victims themselves?
this does not negate the severity of their actions.
unless one is deemed mentally insane, you are accountable for your actions.
i get so sick and tired of being told to show compassion, "they need help"...
the only way one can get help, is to admit that they need it.
no, we shouldn't be judgmental.
but we're human, and we respond accordingly to adverse behavior and actions.
many of us have had it tough in life.
many.
do something about it:
deal with it.
get help for yourself.
be proactive.
love yourself enough to want something better.
but until then, don't expect me to coddle those who choose illegal, immoral and contemptible lifestyles.
too many have turned their lives around.
i refuse to support those who choose the road to self-destruction.
I would like to request of my peers, that you not pre-judge anyone, even a drug seeker. They also need help. And giving them a placebo is not providing them the help they need.
When a placebo works that tells me they are getting exactly what they need.
Specializes in icu, er, transplant, case management, ps.
I would like to request of my peers that you not yell with big, bold writting. That's exactly how it comes across.
When a placebo works that tells me they are getting exactly what they need.
I am sorry but this is the way that I post. And the response of the three of you, lets me and other chronic pain suffers, as well as addicts, just where you stand. We should not clutter up your ERs because either our pain is just an attention seeking device or we are drug addicts. And you wouldn't do a thing to help a drug addict. would you.
And when the placebo doesn't work, what conclusion do you jump to next? I thought this type of thinking was on the way out back in the 90s, when students were taught not to judge their patients. I guess the message flew over some's collective heads. When I was actively practicing, I never judge a patient. If they said they had pain, I believed them. And I medicated them. I'm sure there must have been one or two who was faking but that wasn't up to me to judge. Some are so busy disbelieving their patients, they fail to met the needs of those patients. But they can be proud that they never medicated anyone they didn't think had real pain.
I am sorry but this is the way that I post. And the response of the three of you, lets me and other chronic pain suffers, as well as addicts, just where you stand. We should not clutter up your ERs because either our pain is just an attention seeking device or we are drug addicts. And you wouldn't do a thing to help a drug addict. would you.
And when the placebo doesn't work, what conclusion do you jump to next? I thought this type of thinking was on the way out back in the 90s, when students were taught not to judge their patients. I guess the message flew over some's collective heads. When I was actively practicing, I never judge a patient. If they said they had pain, I believed them. And I medicated them. I'm sure there must have been one or two who was faking but that wasn't up to me to judge. Some are so busy disbelieving their patients, they fail to met the needs of those patients. But they can be proud that they never medicated anyone they didn't think had real pain.
Woody:balloons:
I think your experiences with nurses is causing to judge us all. You're reading a lot of judgement in posters you're referring to in this thread when there isn't any. You're taking someone's post and expanding them into ideas that we are uncaring of our patients needs. You're presuming all nurses look askance at chronic pain patients not believing them.
Give some of us some credit here and don't let your bitter experiences cause you to judge us.
I always medicate according to doctors orders. It's not my job to decide who should and who should not get pain meds. I medicate on time and without rolling my eyes. I still have my opinions which I am safe to express here.
I work in medical imaging. We have an open MRI. Occasionally we get a claustrophobic patient. They get in there and you can see the sweat pop out and the pulse goes up. I sedate with Versed per the radiologists order. The patient must remain an hour after sedation and they sleep, when awakened they are still drowsy, they must have a driver with them before they can be sedated. They are taken to their car in a wheelchair.
Occasionally we get a patient who tells us, prior to see the MRI, that they are extremely claustrophobic, so much so that they can't be in an elevator. "I need sedation, I need Versed". I give the Versed then it's not enough, "I'm still claustophobic", I give more and I say "ok now this is the most I can give you". They go in the MRI and as soon as it's over they are fully alert and orientated, walking, hungry, ready to go. Um sorry babe but you have to stay for an hour. "No I'm fine, I'm leaving", um no you can't.
I can definately tell the difference but sedate them both the same.
I only advocate placebo's for those patients who are frequent repeaters with no plausible diagnosis or those whose dogs keeping accidently eating their pills.
Never had my dogs eat my pills, but I went for two years without a 'plausible diagnosis' for my pain and symptoms before they found the ovarian tumor. I was lucky that my doc believed me, or maybe it was me swelling to the point of anasarca (hard to fake that I guess). I still didn't take much in the way of pain meds until just prior to the surgery, but I'm glad I wasn't judged a "seeker" or "faker". At least not to my face, anyway.
I'm curious as to how we'd give placebos. What do you say when the patient asks what you're giving them? Or the dosage?
Specializes in jack of all trades, master of none.
Soooo, I have CP, I truly AM allergic to morphine and I lie about my pain level. I always knock it down a notch, & I try to laugh, giggle & smile, talk on the phone. Whatever it takes to distract myself from the pain that I really am in.
What am I supposed to do... let everyone see me cry all the time? I'm too stubborn for that crap & my eyes get all red & puffy & it's way obvious that I've been crying.... so I fake it. I don't let people see me sweat.
I'm 2 months s/p spinal fusion....2nd back surgery in 3 yrs & I'm not even 40 yet!!
I won't tell my true pain rating to anyone. I need to get back to work & if I'm on pain meds, I've been told that I can't work ... Funny that nobody had a clue, except my doctor what I was taking BEFORE surgery & I was not impaired. I functioned the best that I had in years, b/c my pain was in CONTROL!
So, before anyone tries to classify me as a seeker, try walking a mile in my shoes.
WillowBrook
32 Posts
I would like to try and give at least a little bit of insight into this situation from a chronic pain patients point of view...and one who is also extremely sensitive to all NSAIDS, cannot take any Aspirin based medications to due reactions with Asthma and has a past HX of Heroin addiction.
As a chronic pain patient, who also has the above mentioned added conditions, there are still times when I need relief from acute pain (for example after falling through a ceiling and injuring my back). As a Chronic Pain patient as well I am very familiar with what does and does not work for me, how much of any drug I will probably need and what I can't take or what is going to be a complete waste of time. So when I present to the ER needing relief from acute pain and I say something like "Tramadol is going to be a waste of time, I believe Fentanyl is more appropriate for me", I am not "drug seeking" just to get a Narcotic I am trying to save the ER staff a lot of wasted time and effort. Instead of just not saying anything and then having the staff only end up having to reassess and change medications and so on if I haven't received what I need for pain relief, thus ending up spending more time in the ER taking up a valuable bed that another patient could be using, I figure it is in everyone's best interests for me to try and make it easier by just stating straight out what is and isn't going to work for me.
I will always try and be as polite and cordial as possible to all ER staff as well; however, if I can sense (usually because their muttering under the breath, rolling their eyes and generally looking at me like I'm the worst kind of scum they've ever seen) that any staff member is being judgemental towards me then I can get a little defensive. I will still try not to be rude but I will try and advocate for myself and be very assertive in letting the person know that their assumptions are very wrong. Unfortunately I know that as soon as I open my mouth and say that I can't take NSAIDS or Aspirin based medicines and they also see the trackmark scar on my arm (I am always upfront and honest about my past history of heroin addiction and I will offer to take a urine or blood test if they want to check what drugs I have in my system) I am likely to be labelled a Drug seeker and that can tend to make me a little defensive and more likely to react negatively to even the slightest hint of not being believed, although like I said I do still try to be nice and polite with everyone.