Chronic Pain (as an RN)

I try to avoid telling anyone at the ER I am a nurse and when I worked at the ER I never treated any healthcare provider differently than someone else.

The ER is still not the place for pain management. If your neurosurgeon isn't willing to fix the problem it is probably worth a second opinion. If you continue with conservative treatment and your physician won't go higher with your pain medication then a referral to pain management is in order.

I hope you get relief from your symptoms

I don't triage based upon whether you are a nurse or not. I assign acuity based upon chief compliant, VS, presence or absence of high risk situation, etc.

As described, your chief complaint would be "back pain" and your ESI acuity level would be 4 (1 is a resuscitation, 5 is the very lowest acuity).

That means you will wait until everyone with a higher acuity level has been roomed.

You might sense a lack of urgency- not necessarily due to lack of compassion, but because your condition is not emergent, and you've already been living with it for some time, so you can wait.

As others have stated, the ER is not a good place to manage chronic pain. You need to follow up with your pain management specialist, and if you're not satisfied with their response, seek a second opinion.

Most likely, we would give you something IM and send you on your way (after a potentially very long wait, when you could be at home in your own bed taking your ibuprofen and Norco and alternating heat and ice instead of waiting in the ER lobby), but since you already have a script for Norco, we wouldn't be prescribing anything except maybe a muscle relaxer (in a very limited quantity), and advising you follow up with your PCP.

Just wanted to add that if the ER you go to has a dedicated Fast Track, or is not very busy at the time you go, you could get in and out pretty quickly. But this would have nothing to do with your being an RN. Patients are triaged and seen based on acuity and the needs of the department.

I jdischargeant that it was sad an RN has to be scared to go to the ER because of the staff attitudes. I don't expect to get in faster because I'm a nurse, I never even told them that I was.

Actually when I went I was given a stat MRI due to the fact that the cyst on my spinal cord is filled with CSF and the intensity of the pain combined with the loss of sensation on one leg made them weary of a potential rupture or need for immediate surged on it. I was put in the main ER (not fast track) and given IV fluids as I had eaten in over a day, and am diabetic, along with IV Dilaudid after they reviewed the previous and new MRIs.

As i said, I would never go to the ER for just pain, but with the type of condition I have, combined with being diabetic, they told me I was smart to go in. If CSF leaks into your body, it can become very serious, even life threatening. The sudden onset of new, intractable pain with other symptoms signal to me that something has changed. After paging my doctor through his office more than once. I had to do something. Not to mention that as a diabetic, my blood sugar levels were all over the place.

On discharge, my dx was not 'back pain' but symptomatic sacral meningeal cyst.

I also can only take Tylenol, not NSAIDS because I take another medication that interacts. They also did give me some valium IV.

We cant give medical advice but consider a second opinion. Based on the size and symptoms you describe a second set of eyes wouldn't hurt.

Thanks. The flareup is subsiding slowly, and I am on the list to schedule surgery with one of three top Drs in the nation who treat this rare condition, I just got really scared that night when the pain intensified so sharply and I lost feeling in my thigh. But I was afraid to go to the ER even though I was really scared. But it turned out. Pray that I get my surgery scheduled within the month!