Drug Seeker Stories

Well I had one of those lovely drug seekers the other night. Patient said she had a kidney and was peeing prue blood. Well, I had her get a CC urine. When I went back to get her urine, I noticed her finger was bleeding and some blood spots on the sheet. And her urine was a weird pink color. So I told the doc and he had me cath her....her urine was completely clear. Of course, she tried to make up a story about how sometimes she pees blood but sometimes pees clear too. Whatever...sent her out the door...

Also had someone come in 3 times in one week who used a new name everytime. Turns out he was going to ER after ER in my city using differents names for drugs...sent him out the door and to jail.

Unusual occurence here. Got a call from the supervisor last night warning any nurses going outside the hospital to be on the lookout for a guy who was approaching people asking for needles and drugs. Drug seeker..mmm...ya think?

"At the ER, we(nurses,doctors) say that "we're not going to care anymore about you than you care about youself" (to the patients)."

Does that "hard line" tactic really work?

How realistic is that?

I know you have to get hard at some point, maybe with a pt you see all the time but would you treat a new "user"/"seeker" like that?

A "user" or "drug seeker" is an addict, doesn't matter how long they've been doing it.

I have offered on numerous occasions to get these pt.s set up with Rehab, Chronic Pain Management Clinic, Counseling services, etc.,. In 13 years of nursing, I've never had any of them take up my offer. However, each time , I've had contact with them, I continue to offer them the same services and let them know that I'm willing to help them whenever, they are ready. However, I let them know that they need to take the first step and ask for help.

AMEN hipab4hands!!

No one who works in ER is going to stay there, unless they want to help people. True with any nursing job. Once again, the fact that we vent about the users we do see does not mean that we dont help or give the benefit of the doubt to other pts. I see drug seekers a few times a month (until they make their rounds to another hospital). I know who they are. These are not pts that come in 2-3 times with an acute problem; pts Ive never seen before.

Those of you who are being critical - do you or have you worked in a state or county funded hospital er? Just for the record, any time a Doc orders 2-4mg of mophine - I always give the max dose. I dont like to be threatened by pts either. Lets put a little responsibility on the Doctors. Also, I got so tired of coveing for Docs - I QUIT covering for them.

If a pt asks to speak to the Doc and he wont, I tell the pt, "I told Doctor SO and SO. He says that he doesnt have time or whatever" Im just honest. Our Doctors room is right next to the nsg desk. I stand at the door and say "pt wants to talk to you". It puts them on the spot. I get so tired of Docs making us do thei dirty work.But, thats another post.

As for drug seekers, yes, there are those that seek drugs and there are those that are legitimate about their pain. My experience has been that those that whine, yell or moan about their pain and ask for pain meds before the doc even sees them, are usually the ones that are in the least amount of pain. It's those folks that don't complain that you have to watch out for cause those are the ones that are being tough guys and trying not to be babies about their pain. These are the ones that are usually in enough pain to put a horse down, but won't ask for pain med or more pain med because they don't want to bother anyone.
I agree with you that this is often the case, with one caveat - someone might read the above and think that the only really sick patients are the ones that are too sick or too stoic to complain. The ones that complain of pain that AREN'T drug seekers get shafted. If, for instance, I was a patient in the ER, I would verbalize my pain if I was capable of it, and I'd probably be pretty stubborn about getting adequate relief because I'm a nurse and I KNOW that better pain relief is possible. I'm an RN, clean-cut looking married house-owning 20-something-y-o, and the only thing you might find in my urine is the Ativan I'm prescribed for occasional anxiety/insomnia. I hope I wouldn't get branded a drug seeker or just a PITA for insisting on better pain control, but I know it could happen.

Bottom Line imho:

You will end up treating some drug seekers with narcs to treat people truly in pain.

Big deal.

We all know what they are like, and how slimy it can feel.

The only ones I refuse are the obvious very manipulative types that I have personally treated in the past. Even then, an open mind is important.

But in the end, I sleep better knowing no one left my care in pain when it was in my power to alleviate that pain.

I agree with TraumaIntheSlot. Alcoholism is not a disease - its a "character flaw". We all have genetic tendencies - but we dont act on them. I have many alcoholics in my family. One of which is on Disability!! So, me and other tax payers are getting the bill. Disease is a condition that you have no control over (except to be compliant with treatment). Alcoholism is a choice that we make.

Another tell-tale sign of drug seekers is when the patient not only asks what you're giving, but wants to know what dose.

At the ER, we(nurses,doctors) say that "we're not going to care anymore about you than you care about youself" (to the patients).

I believe that seasoned nurses can tell the difference between real pain and faking/fudging pain.

From what I have seen alcoholism and drug abuse are many times symptoms of a bigger problem: depression. As someone who has suffered from depression since I was a child I know how debilitating depression can be. It isn't something you just snap out of. Nothing hurts me more than to hear someone flippantly tell people who are depressed to "get a grip." These kinds of statements are like a slap in the face to someone suffering from true depression and only add insult to injury.

People deal with depression in different ways. I hide away and eat (which has caught up with me, at 5'2" I weigh over 200 pounds.. while others may take drugs or drink alcohol. I don't think a doctor would be out of line to prescribe an antidepressant to drug seekers under certain circumstances. What could it hurt?

in older patients, it can increase the risk to bleed.

One of the ER Docs said we can't give this to patients who are allergic to ASA. So, is there ASA in it?

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
yes, i'm actually saying that some of us need to lighten up. i know, hard to believe. i can be pretty rabid on the subject of chronic pain, and proper management, but i can also laugh. this thread started off very amusing, but very quickly it turned into a debate about right and wrong. :lol2:

i agree! the first part of the thread was hilarious, and then some members started preaching . . . i think we all need a place where we can vent, and this place is a great place to do that. the debates about right and wrong don't belong in a humorous thread, and folks who haven't walked a mile in the shoes of an er nurse don't need to be criticizing those who do it daily! just my opinion. but hey, i'm an icu nurse -- but the icu threads aren't usually funny!

i agree! the first part of the thread was hilarious, and then some members started preaching . . . i think we all need a place where we can vent, and this place is a great place to do that. the debates about right and wrong don't belong in a humorous thread, and folks who haven't walked a mile in the shoes of an er nurse don't need to be criticizing those who do it daily! just my opinion. but hey, i'm an icu nurse -- but the icu threads aren't usually funny!

we have an interesting and effective way of dealing with these drug seeking, experienced consumers of healthcare services ( love that phrase!)

after we determine they don't have pathology...and treat them with the nsaid dijour, we look at their face sheet and if they (invariably) live more than ten miles away from our ed, we put their address into mapquest, print up a map, and put little red dots on the map to indicate the approximate location of all of the hospitals they passed on the way to our ed....

this, all done with the highest degree of compassion( with a straight face) and, with the hope that their future care is not delayed due to their being unaware of the resources available to them closer to their home.

Last year our hospital came up with a Narcotic Policy in that the ER MD's will not give narcotics for Chronic Pain. It is up to the pts PMD to manage their pain. They will give NSAIDS and suggest f/u with their PMD.....Now that is all well and good but you have those MD's who still give out Narcs and those who wont give anything. It has cut down the ##'s of seekers but not all.

Specializes in ER, ICU, Infusion, peds, informatics.
one of the er docs said we can't give this to patients who are allergic to asa. so, is there asa in it

no, there is no asa in toradol. but, like any other nsaid, people with a true allergy to asa can have a cross-reaction to toradol.

Maybe I am way out of order here, I am what you so ignorantly refer as a "migraine". I have been seen by neuro's, and a specialist in Illinois. My diagnosis? A small blood clot in the brain which may or not cause severe headaches. I have secure headaches now and then, so bad I feel life putting an icepack thru my brain. I seek help, usually thru the ER. The very second the words "Severe migraine" the eyes roll and the sigh begins" Note I never go to the ER, or not never but I have never been to tis hospital since the ae of 20 (many many 10's of years.) My neck with stiff and the doctor was so convinced I was drug seeking even though I was 100% honest about the meds I take and what works, no beating around the bush. He give me my med and let me go in 5 minutes, he never checked my neck even tho I told him all about it and he allowed me to go without even seeing if I was OK. The nurses were pretty good, I did complain about this doc and I am not done with him yet!! Would you consider me a seeker?

Please excuse my spelling I am really mad thinking about it and when I am mad I type too fast making may errors and I have to leave so no time for Spell check

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