Do you ever feel like a licensed drug pusher?

Roy Fokker, BSN, RN · Jun 13, 2011

do you ever feel you are judging people who may have actual pain? Even addicts can hurt and may need additional doses. How do you know they are NOT in physical pain? Can you feel for them?

Because you hear them snoring as you approach their room, you walk by on your way to another patient's room, they hear your footsteps, awake from their slumber and instantly begin wailing "Oh my god! My back is killing me! Nurse! NURSE! NUUUUURSE! Oh MY BACK! Oh MY LORD! MY ******* BACK! NUUUURSE!"....

... because they prick their finger while in the restroom giving a specimen so that there will be 'blood in the urine'...

... because this is their 14th visit in the past 10 days for the same problem - despite being given narcotics in the ED AND a prescription that should last them at least 14 days...

... because this is the 11th time (in 12 months) EMS has brought the patient in for "overdose", and the first thing they ask for when we manage to save their life is "Can I have something for the pain! My stomach's killing me!"...

... because they are slurring their speech, no motor co-ordination worth a damn, have a BAL >560 (that's 5.6 on the legal scale), a systolic BP of 85 and still insist they are in 10/10 pain ....

... not to mention the obvious ones who swear they didn't "do any drugs" and their tox screen is positive for alcohol, opiates, cocaine, THC, amphetamines, benzos...

I could go on and on and on. I've treated traumatic amputations. Kids as young as 2 with 3rd degree burns. 90 year old grandma with a bad pelvic fracture (who tells me "Just give me some Tylenol dear"). Multiple gun shot wounds. The woman who came in with a meat cleaver stuck in her nearly severed arm.

Yes, pain is subjective. Absolutely. I get that. Not debating it.

There is a genuine difference between narcotic/drug dependence versus abusive. I have zero problems dealing with people who have chronic pain issues and/or drug dependence.

But I won't stand for the manipulative bahavior of the obvious drug seeking abusers. Especially the ones who have been advised to get HELP for their problem!

And you know what really burns me? It's not that there are drug seekers but how they affect my OTHER patients and how I take care of them. See, my personal philosophy is that "it's your body. Do what you want with it, so long as you accept the consequences of your actions".

But when their histrionics and tantrums and verbally/physically abusive behavior interferes with MY care and MY patients... that's where I draw the line.

The biggest 'drug problem' in the US today isn't marijuana, cocaine or heroin - it's prescription drug abuse.

And I refuse to be a part of that problem...

:twocents:

PS: Talk to any ex-ED nurse and ask them why they got out of it. See how often "manipulative drug seekers" and "chronic alcoholics/drunks" doesn't crop up...