Don't like myself right now

DutchgirlRN, ASN, RN · Dec 30, 2004

The way I look at those drug seekers is that if they can get sick enough to be admitted and if they can convince the doctors to prescribe the meds for them then It's only my job to administer them. Those people will move from Dr. to Dr. and Hosp to Hosp. The majority will never change. You can only change yourself and how you think about it. The doctors I'm sure have their own ways of dealing with it. It's not just the nurses. I think swing shifts is asking for trouble. It's not good for your health. One or the other but not both. Good luck.

Nursebaby23 · Dec 30, 2004

Even though I have not cared for drug seekers in a hospital environment, I can speak from the other side of the fence. I have a mother who is a "frequent flier" to the ER who presents with high BP and headache or "back pain/hip pain" and requests morphine everytime. When she runs out of pain pills then she runs to the ER. This is so embarrasing. I say so because I am a nurse, and eventually I would like to work in the ER after I gain some experience. I know how medical staff look upon people like my mother. "I know what she's here for." And then she brags on me when she goes to the ER. I'm like, " I don't really know this woman":uhoh3: I love her nontheless, but it has changed my whole outlook on how patients should be medicated. You learn in school: "Pain is always subjective". But somehow, there is a small part of me that is suspicious when people c/o back pain and then are up bouncing on the walls. It must be hard to give into someone's addiction. I can think of myself in the situation. Just remember that there are plenty of other nursing environments to work in, where you don't have to be presented with this problem as often.

leslie :-D · Dec 31, 2004

i think what you're feeling is a natural phenomena amongst nurses.

afterall, we are allegedly the compassionate, gentle, merciful souls ( :rolleyes: ) and to feel agitated towards a patient goes against the whole image of nursing.

it doesn't matter if the patient is a med seeker, demanding, obnoxious, needy- we have all cared for these types and it's natural to feel irritation from time to time.

specific to the med seekers you speak of, i have learned to distance myself and just give them what is ordered. there is little else you can do in terms of what the doctors order for their patients.

but there are interventions for other acting out behaviors so we're not completely helpless, thank goodness.

but once you acknowledge there is little you can do re: ongoing requests or complaints of ineffective pain mgmt., just give them what the doctor ordered.

works for me.

leslie

Mystery5 · Dec 31, 2004

I feel guilty, also, about my attitude towards manipulative patients. My least favorite type of patient is an overweight one with chronic gastric/abdominal pain. They've learned to milk the system for all it's worth and I have a lot of trouble feeling sympathy for them. I know they are really suffering from mental/emotional problems and am really trying to become more sympathetic, but I really dislike going through the whole charade.

RN 2005 · Dec 31, 2004

I am set to graduate in 5 months and I am already becoming a bit disillusioned myself. I tech on a busy med-surg floor and am seeing the same frequent fliers over and over. Constantly on the call light. I see the nurses sometimes having to spend more time dealing with these patients then the ones that are dying and or seriously needing their help. I find it depressing as well. I have no answers for you......I just wanted to say you are not alone in your feelings. :)

z's playa · Dec 31, 2004

The way I look at those drug seekers is that if they can get sick enough to be admitted and if they can convince the doctors to prescribe the meds for them then It's only my job to administer them. Those people will move from Dr. to Dr. and Hosp to Hosp. The majority will never change. You can only change yourself and how you think about it. The doctors I'm sure have their own ways of dealing with it. It's not just the nurses. I think swing shifts is asking for trouble. It's not good for your health. One or the other but not both. Good luck.

Could you please explain how a drugseeker can actually make themselves sick to obtain drugs? (Not faking....sick) How do you know they're just not sick people in pain who "happen" to get admitted because they are just...welll....sick.!?!?! I'm so sick of hearing that term...drugseekers. If you were a diabetic...would you be called an insulin seeker? People in pain seek relief. Simple. I have faith that docs can see who to admit and who not to. To call someone a doctor admits...frequent flier or not...a drugseeker....I feel it's just wrong. But that's only my opinion. I'm sure to get raked over the coals on this one but you know what? My week can't get any worse.

shammy · Dec 31, 2004

I think dealing with chronic pain and people who are "drug seeking" is really difficult.

When i was a new young brighted nurse wanting to change the world and "fix" everyones needs I would take it more personal. Like are they really in pain, do they need more companionship, maybe I'm missing a need they have.

But at my last job (now I'm in HH, and pt's medicate themselves) I would medicate them within parameters set by the MD, and then return to see if the med was effective then discuss alternatives, like relaxation, position changes, use of heat and cold if ordered, etc and if they wanted pain med right "on time" as ordered by MD then they got it. Because if the MD felt they needed it then they could have it and I did what they wanted.

I also always think of a friend of mine who has chronic back and leg pain from a car accident. She walks, and has a normal life but she also takes pain meds as needed to be comfortable. I would hate to think of some nurse passing judgement on her because she truly has chronic pain but still gets up and moves around.

NorthER,RN · Dec 31, 2004

I don't think that you're "whining" - I only read that you're trying to understand how to deal with people who know how the system works so that they get what they want. I work in a small ER, I'm new to the town (which means that I don't know the people who the other RN's describe as frequent fliers - among other rude terminologies)and come from a Critical Care background - I'm not new to drug seeking behaviour in patients - just new to the large number of people who show up in ER who want to self medicate. How the patients are cared for depends on how much I can do to provide comfort and care and what the docs will provide in the way of meds. I try to think about how I would deal with someone coming in between my diet coke and me on a night shift, and it makes me just a little more understanding. I had a guy come in who had fallen the week before - some serious problems, but he refused to come in to ER until the injury got out of hand as he had heard that the staff treated alcoholics and drug seekers very badly. Made me sad. I'm not going to change or cure anyone whose needs for drugs is overwhelming, but I'm still gonna be the person I prefer to be. Hopefully in 5 years I won't be rolling my eyes and calling patients names when they bring their repeat business back. I wish you all the best. Try to get off those swing shifts - and take care of yourself.

Lapa · Dec 31, 2004

I might try to explain to Z'Playa what real drugseeker is. Because my exhusbend was hooked on Soma + Codein. Since I lived with this person for number of years, i understand the problem better. First, i didn't know what the problem was and honestly beleived it was his chronic "back pain". When h used to passed out from overdose, i (fool) used to call for ambulance and delt with thousand dollar bills afterwards. He never stayed in a hospital for more than 1 night, though. We travelled a lot, and in EVERY state he managed to find a doctor who prescribed him Soma. YOu can not beleive, how easy it was for him. He showed up in doctor's office, c/o "chronic back pain", they asked what h usually taken, he said Soma, bum-bum -- he had got prescribtion. It is money for doctors, after all, he paid cash! He could cry in doctor's office because of "pain". But at home he was ok, no signs of pain, walking, talking. Then next minute he could passed out with food in his mouth (too many somas+codein). You can not do much, as a family member. You can not take away pills from him (they are prescribed -- legal). These people rarely seek for help -- well, drugs are legal, and not so expensive, if you have med insurance -- free. He has lost numerous jobs. He left the stove burning. He passed out driving a car.

Now, i deal with drug seekers in LTC. Elderly white females, mostly. Say, they had that hip replacement 3 months ago. For God's sake, why would they need that Oxyconti/Vicodin EVERY 4 hours (you can check time on them) after 3 months? Pain? Exuse me. It is just addiction -- pure and sipmle. What about Restoril/Ambien that are supposed to be given max for 7-10 days? They never got off their "sleeping pill".

I see the huge problem here. Dependance is real. Doctors tolerate it. Have you ever heard the doctor told the Pt in nursing home " this medication is addictive, i will prescribe it to you for several days just post-op to ease the pain, and that's it"? No way , Jose. They will get their Vicodin/Percocet/Oxycontin indefinetely. True?