What do the drug seekers coming into your ER ask for most? In our ER it seems to be Vicodin or oxycontin.
What is their usual complaint? In our ER it usually is back pain with pain radiating down the leg. Sometimes they will limp.
Do you have ANY ER Doctors with the Balls to order a non Narcotic? We do. Its cut down on our repeat offenders! Can lead to some very entertaining and loud discussions behind those pt curtains....
Ever have a repeat offender that went really bad? We did. Came in as an overdose after a year of weekly visit for refills of Vicodin for uncontrolable back pain and spasms. Died. Found out later his main income was reselling his pills to those in the area and online. Family sued the Dr and facility for allowing him to become addicted..... and won.
Hoop_Jumper.....I hope you do not make a mistake about a patient because of the abuse you had taken by the fakers.....remember it is your license and it only takes one call.
Have a great evening and day.
Buttons
I ain't worried. When you get some real word experience come talk to me.
Hoop_Jumper.....I hope you do not make a mistake about a patient because of the abuse you had taken by the fakers.....remember it is your license and it only takes one call.
Have a great evening and day.
Buttons
I ain't worried. When you get some real word experience come talk to me.
HOOP JUMPER,
I have experience and I have conducted a research about high stressful areas which effect nurses. I know you believe that you are the almighty nurse that knows all and no one can reflect their opinion about any issue you are discussing. I will not argue with you or be negative. I can say that nurses are very important to our society and their feelings should be taken into account. Every voice should be heard and to find solutions for the issues that is controversial and negative. Everyone should be heard and listen too no matter how one feel's abot another post.
Have a great evening Hoop...dinner awaits for my arrival....
I have a sister with fibromyalgia and a "bulging" disc who is in excruitiating pain. Today she was complaining to me how no one will treat her pain. She is very angry. She is on ultram, (wants prednisone again, says lortabs help but they won't give them to her...excuse my spelling!). I don't know enough to give her any good advice (I am an aide, don't even know what these drugs are!) I did ask her if the doctor suggested surgery to repair the disc, and she said NO WAY would she ever do that. It is so hard for her to function, and I am not sure what kind of physician she should see for help.
I ain't worried. When you get some real word experience come talk to me.
HOOP JUMPER,
I have experience and I have conducted a research about high stressful areas which effect nurses. I know you believe that you are the almighty nurse that knows all and no one can reflect their opinion about any issue you are discussing. I will not argue with you or be negative. I can say that nurses are very important to our society and their feelings should be taken into account. Every voice should be heard and to find solutions for the issues that is controversial and negative. Everyone should be heard and listen too no matter how one feel's abot another post.
Have a great evening Hoop...dinner awaits for my arrival....
Buttons
Hoop,
I am a person that has chronic pain. I have fibromyalgia and spinal stenosis with pinched nerves. I know and have encountered nurses and doctors that are hardened against anyone who needs something "strong" for pain. Unfortunately I am allergic to NSAIDS and have to have something else for pain. What are people supposed to do? How would someone exhibit their pain in a way that would show a "hardened" person that they ARE in pain? I have been unable to walk, sit, or lay down without extreme pain and it does radiate down my leg. Do I have to sit and cry in order to "prove" I am in pain? I know I could not sit and eat HOHO's or be comfortable when I am in pain. I know there are abusers, but what about those that really are in pain? what does it take to show one that it is not "faked"?? I am interested in what HOOP JUMPER has to say regarding this.. Thanks....bonjo
Hoop_Jumper.....I hope you do not make a mistake about a patient because of the abuse you had taken by the fakers.....remember it is your license and it only takes one call.
Have a great evening and day.
Buttons
I ain't worried. When you get some real word experience come talk to me.
Well, from what I am able to ascertain from this reply is depressing. This, unfortunately, is most often the majority voice of the 'real world'. Sure makes me proud to be in the profession...
I have a crazy story, last year I developed RLQ pain with fever as high as 104 degrees. I went to the ER at the hosp where I used to work and the ER doc did tests, WBC was 24,000, rebound tenderness, what is everyone thinking? RIGHT. Well, a urine pregnancy test came back positive, despite being on BCP, I was pretty sure that I was NOT pregnant (you have to be exposed, right) the ER doc started looking for etopic pregnancy, ultrasound was negative. SO she sent me home and told me I was just pregnant and to follow up with an OB GYN. About two hours later a nurse that worked in the ER called me, she was a friend of mine, and told me my blood pregnancy test came back totally negative (beta HCG). I called a surgeon friend, he ordered a CT scan which showed appendicitis, DUH. He put me in the hosp and took my appendix out emergently. The next day he came back in an the path report showed a carcinoid tumor in my appendix!!!! Holy Crap! Anyway, the whole point is I was given Dilaudid 2mg as soon as they could get an IV in and it made me so sick, I know everyone is different, but that is what the "seekers" in my area seem to want.
As an ER nurse two things bug me about our seekers:
1. The $ we spend doing test after test every time one of our seekers comes in looking for a fix
2. The truely ill people left sitting in the waiting room for hours while all these tests are done
Point well made... I think we all got off track just a little. We all know (or should) that there are patients that are absolutely needing pain medication.. the ones we are talking about are the seekers. And they do tie up resources for the really needy ones.....
What do the drug seekers coming into your ER ask for most? In our ER it seems to be Vicodin or oxycontin.
What is their usual complaint? In our ER it usually is back pain with pain radiating down the leg. Sometimes they will limp.
Do you have ANY ER Doctors with the Balls to order a non Narcotic? We do. Its cut down on our repeat offenders! Can lead to some very entertaining and loud discussions behind those pt curtains....
Ever have a repeat offender that went really bad? We did. Came in as an overdose after a year of weekly visit for refills of Vicodin for uncontrolable back pain and spasms. Died. Found out later his main income was reselling his pills to those in the area and online. Family sued the Dr and facility for allowing him to become addicted..... and won.
drug of choice in my ER has always been vicodin.....however I have a few patients who come in with "backpain" and say...nope, that med wont work..I need 30mg of toradol followed with 2 mg of...yada yada yada...ya know what those patients get from me??? TYLENOL!!!! heheb
"The ER Doctor came in and said to me in front of my husband that he gave me enough valium to knock out a horse and in his opinion I was just trying to get narcotics from him and he was not falling for it?????" from Patma
Sorry, I got on this thread a little late. Sounds like this Doctor needs to go back to veterinary school. :) As a vet. tech. I can tell you that 10mg of valium won't make a horse stagger. It will stop seizures a small dog (20lbs) and sedate a medium dog (30lbs) but for horses, usually 100mg might make a horse weave a bit but it will remain standing. In most cases diazepam is mixed with other drugs including ketamine, acepromozine, xylazine, and guaifensin. So Patma, the next time a doctor tells you this nonsense, ask to see his DVM/VMD license. :chuckle
Pain management is a big deal on the veterinary side of medicine also. Our patients (animals) are not generally drug seeking but I think that some of our clients (people) might be. Thankfully we haven't had much problem in our area yet and I hope that it doesn't come to that.
I am a person that has chronic pain. I have fibromyalgia and spinal stenosis with pinched nerves. I know and have encountered nurses and doctors that are hardened against anyone who needs something "strong" for pain. Unfortunately I am allergic to NSAIDS and have to have something else for pain. What are people supposed to do?
Who made this statement? Don't say things about me I have not said. I see lots of people who truly need pain control and they get it. I also see alot of fakers and seekers out there who are constantly coming in for pain meds and when we cal other ERs low and behold they were there earlier. If you have chronic pain needs then you need a primary care practitioner period. The ER is not the place to come to constantly for pain control or for primary patient care period, and if you do you are coming in constantly you are gonna be suspect; as you should be.
Specializes in ER, ICU, Infusion, peds, informatics.
point well made... i think we all got off track just a little. we all know (or should) that there are patients that are absolutely needing pain medication.. the ones we are talking about are the seekers. and they do tie up resources for the really needy ones.....
just a thought... :chair:
agreed.
sigh.....if only there were some truley reliable way to determine if someone was really in pain or just wanted the narcs. unfortunatly, there isn't. the best thing we have is the pain scale (which i personally detest), and some highly-fallable physical parameters. even more unfortunate, the people who tend most to be labeled as "seekers," the chronic pain patients, are the least likely to show physical signs of pain since they live with it all the time. one of the reasons i stopped working in the er full time is that several of the docs i worked with would never give anything stronger than toradol unless you could prove to them you were in pain (positive ct scan, positive pancreatic enzymes....) it was so frustrating to be begged for pain meds from patients and get nothing from the docs.
the bottom line is that until they invent the perfect lie-detector test (pain-detector test?), we will end up doing one of two things: not treating some of those who are in pain, or giving narcs to some who are seeking. i would rather err on the side of medicating the seekers, and i would hope that most nurses feel the same, though i understand how jaded one can get.
that being said, the drugs of choice in our er seeems to be lortab and demerol.
to whitecaps:
i tried to imagine myself as the triage nurse when your husband came in with the dilaudid rx, and how i and the er where i work occasionally would have responded. while i would never treat you/your husband as a "seeker" for this request, i don't think you would have gotten that script changed in our er very easily. not because any of the docs there would have assumeded you were seeking narcs, but just because it isn't good practice. none of those doctors had worked him up/treated him. he may have had a valid script, but the er doc who would have been writing the new script didn't have a threapeutic relationship with your husband. not a good idea for any medicine, but especially narcs. and it is very unfortunate that things are that way. good practice would dictate that your doctor would have had someone covering for him while he was out of town, and that is who should have changed the script. i'm not sure, though, why the pharmacy couldn't substitute the correct amount of dilaudid from what they had on hand, but then i know that dea regs are complex and strict. anyway, i'm so sorry you and your husband were treated so poorly.
William_SRNA
173 Posts
Hoop_Jumper.....I hope you do not make a mistake about a patient because of the abuse you had taken by the fakers.....remember it is your license and it only takes one call.
Have a great evening and day.
Buttons
I ain't worried. When you get some real word experience come talk to me.