Crazy things pt's do for pain meds.

Nurses Relations

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Specializes in M/S, Travel Nursing, Pulmonary.

I have two stories actually, not sure which is worse.

1. I was working the floor, doing crazy OT, switching between this and that shift to help out (doing all three shifts the same week) and I was dead on my feet. Short on patience for the booing and hooing.

Had a woman who was an obvious drug seeker. She couldn't get enough. She tried all the tricks........asking for it right at shift end, waiting for the next nurse to come on and asking for it again.........everything. She put her light on, and when I got there, she proceeded to explain to me that she had called her doctor in NY (I am in PA) and it was OK with him for her to get 4mg dilaudid instead of 2mg and that he ordered a "now" dose also. She then went on to let me know I did not need to call him, she would NEVER lie about such an important thing, and that he was on his way to surgery and would not be available for me to talk to.

I explained to her that I could not take a verbal order from a doctor who does not round at the facility. She got upset, insisted I could, she had seen it done a thousand times. She was convinced the doctor had given me an order, and the only reason I would not respect is was because I didn't believe her and I didn't like her (yes, I made sure I did not deny that I did not like her, I didn't confirm it, but I didn't deny it either). She told me to "Go to Hell."

2. Had a pt. sharing his semi-private room with an older gentleman who had Parkinson's. He was the type always asking for his med early. And yelled and screamed at his nurses to call the doctor and demand more for him. After one such incident with me, I informed him the doctors had left instructions that no calls for pain meds were to be made (and they had......wrote it as an order) and he had to discuss it with them when the rounded.

So, I'm preparing insulin for another pt, different room, and I hear a loud bang from his room. At first I think it is his roomate, who frequently drops his food try onto the floor. As I go towards the room, I see the seeker putting the clock back on the wall then running and laying back in bed.

I go in, ask if everyone is ok and what the bang was.

Pt: "I didn't hear anything, must have been another room. BTW, I have been due my pain meds for 15 min. now and I told you a long time ago I wanted them. So march out there and get them or I will be contacting your supervisor. NOW".

Now, I knew he was not due for awhile. So I look at the clock on the wall. :eek:According to it (I knew right away), he WAS 15 min. past due. Yep, you guessed it. He changed the clock on his wall to make himself due. It now also had a large crack on the face and......well, didn't work at all anymore. Problem for him was, these clocks didn't have the little knob on the outside for you to adjust the time with. You had to open them with a screwdriver to change the time. So, he had to crack it open to do this time change of his.

I gave the clock to my DON, and she was :angryfire. Had him D/C'd an hour later. I never saw her flex her muscles like that before. She even put the clock in his belongings bag. According to her, he had bought it.

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Specializes in Sub Acute Rehab/ Oncology Med-Surg.

I've had similar situations with the first story, not the clock one. That- I must say- is original!! :jester:

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Those are pretty awesome stories....my personal favorite. Had a patient go into the bathroom and sprinkles water on her IV site. Then she throws a hissy fit that her IV was "leaking" and she was not getting her PCA delaudid. So I tell her I am going to have to restart her IV in a different site if that site is leaking. (I checked it, I flushed it....it was not leaking) All the fluid was on top of the tegaderm...no fluid accumulated under the tegaderm. She again goes nuts and insists that the IV site is fine.....she just needs an additional dose. Some people's reasoning skills are just awesome.

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Specializes in Addictions, Acute Psychiatry.

I had the clock thing done...by a nun (knowing what I know now, clergy is down there on my ok list).

I've had them say "can you slam it"? Excuse me? "Can you push it really fast and I promise I won't bug you again" funny thing is he really didn't for nurses who would slam his meds and for those who didn't he'd bug over and over.

I learned for those seeking just to give whatever since pain is subjective and once I'm maxed, I'm maxed. (long as I get a pain scale interview and chart).

Problem with addicted patients/drug tolerant one's is the pain and perceived pain is greater and perceived pain is pain so I hit em till the order says don't. If it's ordered, I definitely want them calm and cool. Acute stays aren't the time to wean; that's why God made addiction facilities!

Hey, don't you like the hall screamers and the dramatic one's?

this would be good for the addictions specialty area, too!

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Specializes in ER/ICU/Flight.

I knew a guy who used to dislocate his hip. Did it 3-5 times each week for several months and showed up at the ER by ambulance wanting Demerol ("75mg because 50mg didn't quite do it").

One of the orthopods got ****** off and reduced his hip without any meds at all and, miraculously, he never had anymore problems.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

found a patient's family member once trying to remove dilaudid from the pca. from the roommate's pca. when i caught him in the act, he assured me that he had been "trying to help because i know how busy you girls are."

another patient's husband brought in a hack saw and sawed open the needle box so he could get all the needles and wasted narcotics. (we used to just take the ordered dose out of the tubex and throw the rest into the needle box when we wasted it.) when i informed him that it wasn't just his wife's needles in the box, but every patient that had been in that room for the past week, he was horrified. wanted to know what was wrong with all of those patients and threatened to sue for "exposing him to hiv." he threw such a fit that security had to remove him.

and then there was the patient (an md, of course) who would reprogram his pca to get more drugs. he insisted that i had done it and forgotten about it. so i'd change it back, get another nurse to doublecheck and co-sign and he'd change it again as soon as i left the room. then i got the bright idea of standing in the next room with the lights off and watching through the window as he reprogrammed his pca. only this time i had his doctor standing there with me. no more pca for this guy! he was mighty unhappy with me and tried to tell me that since he was a doctor, he could order his own pain meds. when i didn't fall for that one, he used his cellphone to call the desk and try to leave a verbal order for more pain meds. (his doctor just happened to be sitting there when the phone rang, and i handed the phone to him.) after a little "come to jesus talk" with the head of his department, he behaved much better while he was in our unit, but i heard he was even more difficult when he went to the floor.

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Specializes in M/S, Travel Nursing, Pulmonary.

Oh my, I thought I had seen it all. I don't think I'd have known what to do when an MD was the one playing games. And the water on the IV site......thats a new one to me too, but I'm surprised its not more common.

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Specializes in Developmental Disabilities, LTC.

Wow! All these stories are just nuts! I think I'll just stay in my lil' ole LTC - the most "deceitful" thing I have to deal with there is a 94 y.o. man who's only allowed to have two 1/2 oz of alcohol/day d/t liver disease, yet consistently tells the night nurse he hasn't had any drinks yet after she's already given him his 2.

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Specializes in Flight, ER, Transport, ICU/Critical Care.
found a patient's family member once trying to remove dilaudid from the pca. from the roommate's pca. when i caught him in the act, he assured me that he had been "trying to help because i know how busy you girls are."

another patient's husband brought in a hack saw and sawed open the needle box so he could get all the needles and wasted narcotics. (we used to just take the ordered dose out of the tubex and throw the rest into the needle box when we wasted it.) when i informed him that it wasn't just his wife's needles in the box, but every patient that had been in that room for the past week, he was horrified. wanted to know what was wrong with all of those patients and threatened to sue for "exposing him to hiv." he threw such a fit that security had to remove him.

and then there was the patient (an md, of course) who would reprogram his pca to get more drugs. he insisted that i had done it and forgotten about it. so i'd change it back, get another nurse to doublecheck and co-sign and he'd change it again as soon as i left the room. then i got the bright idea of standing in the next room with the lights off and watching through the window as he reprogrammed his pca. only this time i had his doctor standing there with me. no more pca for this guy! he was mighty unhappy with me and tried to tell me that since he was a doctor, he could order his own pain meds. when i didn't fall for that one, he used his cellphone to call the desk and try to leave a verbal order for more pain meds. (his doctor just happened to be sitting there when the phone rang, and i handed the phone to him.) after a little "come to jesus talk" with the head of his department, he behaved much better while he was in our unit, but i heard he was even more difficult when he went to the floor.

the amazing ruby vee - ;)

yep, i have had a box burglar too. the sharps boxes we used then were the larger ones with round hole in top - he took a gerber and pried the locking mechanism on the support cage off and shook the box contents out on the bed and pilfered them - i pulled the curtain and stood there speechless (doesn't happen often). i had two days of paperwork and he had an er visit for the possible exposure and then he went to jail.

i am pushed for time - but, i have seen some doozies -

i have seen several get their teeth pulled one at a time (pain, the toothache, no money - just pull it!) and show up in the ed after "running out" of pain meds. amazing isn't it.

i agree with giving 'em what it ordered - until i work in addiction - i'm just going with the flow. :)

practice safe!

;)

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Specializes in Telemetry, IMCU, s/p Open Heart surgery.

and then there was the patient (an md, of course) who would reprogram his pca to get more drugs. he insisted that i had done it and forgotten about it. so i'd change it back, get another nurse to doublecheck and co-sign and he'd change it again as soon as i left the room. then i got the bright idea of standing in the next room with the lights off and watching through the window as he reprogrammed his pca. only this time i had his doctor standing there with me. no more pca for this guy! he was mighty unhappy with me and tried to tell me that since he was a doctor, he could order his own pain meds. when i didn't fall for that one, he used his cellphone to call the desk and try to leave a verbal order for more pain meds. (his doctor just happened to be sitting there when the phone rang, and i handed the phone to him.) after a little "come to jesus talk" with the head of his department, he behaved much better while he was in our unit, but i heard he was even more difficult when he went to the floor.

how was he able to do this? our pca pumps require a key in order to make any changes (change the syringe, alter the dosing, lockout rates, etc)

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Specializes in ER, education, mgmt.

The trick that disgusts me the most are parents who insist their kids (young and adolescents alike) need pain meds for whatever problem they have. I am sorry, but unless you have a peritonsillar abscess or 4+ swelling you do NOT need lortab for a sore throat. And a knee lac with 4 stitches- gimme a break. Sprained ankles- motrin and ice. now get outta my er.

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I work hospice, and we actually had one who contacted our company, claimed to have stage IV breast cancer. She even shaved her head to look more authentic. She had addict friends who were nurse aides and/or nurses, and they 'vouched' for her by contacting us as well on her behalf. We admitted her to service before we actually got any medical records, which isn't unusual because sometimes our patients get admitted and die right away, so if we waited for records we wouldn't be able to get in there and help them. Anywho...once we started looking for records, there were none to be found.....I think we had her for a week, and she was able to get some meds from us, but was of course dropped immediately once we had our doc examine her and find no cancer or any other medical issues. Not sure why the company didn't press charges.

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