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.
Specializes in Med-Surg, Geriatric, Behavioral Health.
I can see that things are getting quite heated here. It is a topic that tends to flair opinions and maybe even tempers. So please, let's be considerate in our posts.
I can see that things are getting quite heated here. It is a topic that tends to flair opinions and maybe even tempers. So please, let's be considerate in our posts.
Thanks.
Ok if I have been out of line I apologise, and I will refrain for future postings in this thread because it annoys me to distraction :)
I think I'm glad we don't have Demerol or Dilaudid in the Uk... infact, I've no idea what our alternatives are :)
Actually you do, but you call it Pethidine. The generic is still meperidine. The generic Dilaudid is hydormorphone, and I'm pretty sure you've got that under a trade name, also.
Here in the southwest, the frequent flyers like intractable migraine even more than back pain.
The only way to identify frequent flyers and separate them from people with legitimate complaints who do need short term opiate pain control from an ER is to track them. Prescribing NSAIDs and undertreating pain for legitimately hurting patients as well as frequent flyers is not the answer.
Yeah, someone pointed that out earlier. Actually, of all our controlled drugs, Pethadine is the least used of the lot, apart from Ketamine which we seem to have stopped using.
For migraines, the strongest thing I've ever seen presecribed is IM Codine Phos and that is very rare, its usually an anti emetic then 20 minutes later oral codine and a dark room.... they don't tend to reattend either :)
Actually you do, but you call it Pethidine. The generic is still meperidine. The generic Dilaudid is hydormorphone, and I'm pretty sure you've got that under a trade name, also.
Here in the southwest, the frequent flyers like intractable migraine even more than back pain.
The only way to identify frequent flyers and separate them from people with legitimate complaints who do need short term opiate pain control from an ER is to track them. Prescribing NSAIDs and undertreating pain for legitimately hurting patients as well as frequent flyers is not the answer.
Yeah, someone pointed that out earlier. Actually, of all our controlled drugs, Pethadine is the least used of the lot, apart from Ketamine which we seem to have stopped using.
For migraines, the strongest thing I've ever seen presecribed is IM Codine Phos and that is very rare, its usually an anti emetic then 20 minutes later oral codine and a dark room.... they don't tend to reattend either :)
Not everyone who attends the ER for migraines is a drug seeker. I have had migraines for >50 yrs. Demerol/Morphine etc DO NOT help my migraines. They will put me to sleep and when I awaken, the migraine is still there. When I go to the ER, it is because when I have visual auras with them, I have
I have never thought or implied that a migraine sufferer is a drug seeker, although others in the thread have said that is a common presenting complaint.
I myself suffer from Classic Migraines, with auras and photophobia, therefore I for one completely understand and encourage the way we treat migraine sufferers... dark room, antiemetic and then followed by oral codine or similar.
I'm glad you have had nothing but good experiences. I personally, thankfully, have not yet had to attend the ER for my migraines, but I hope I'd get as good a service as you have :)
Not everyone who attends the ER for migraines is a drug seeker. I have had migraines for >50 yrs. Demerol/Morphine etc DO NOT help my migraines. They will put me to sleep and when I awaken, the migraine is still there. When I go to the ER, it is because when I have visual auras with them, I have
I don't work in an ER, but i do work at an in patient behavioral health facility, and we see people coming in who just want pain medication. the most common is lortab, but usually they would take any narcotic if the doctor would perscribe it. I have noticed that if they have say the have pain then they will be given something for pain, just not always what they request.
Hello!!!!!!!!! pretty new to the site and worked 3yrs in Med/Surg, I always wanted to go into the ER area of nursing, but Instructors instill in me to start in med/surg, and so I did. Med/Surg is a challenging area of nursing, good learning experience for me. My intentions is to relocate to albuquerque, NM and find a good Hospital that will take me under there wing, maybe like a fellowship program to enter into. I have 3 years experience, with only a bls, I am currently back home in tulsa, okla and hate it. If there is anyone that what in albuquerque, NM could recommend me some hospital that I could notify would be nice. Thanks, Mary
I am appalled at your opinion of pain management in the ER! You won't go there so long as you can breathe or your heart beats? Well, I hope you never utter that to an ER nurse who may have the misfortune of treating you.
You believe taking your prescriptions to the ER wouldn't change things? On the contrary, if someone can show me they are usually on, say Dihydrocodine, I'll make sure they get the next drug up on the opiate level if they come in complaining of pain.
Your attitude, to be frank, brings down the reputation of emergency nurses and with it every other nurse in the hospital. If you can't trust a nurse, who can? Are you sure you are cut out to be a nurse?
I know 100% that I strive to do my best for each and every patient - even if it means sticking my neck out infront of the doctors.
I feel very sorry for you and hope you find a way of getting over this very strange barrier you have. Perhaps you have had a bad experience in the past, but PLEASE do not tar every emergency nurse with the same brush, its only more likely to get peoples backs up and make them seem resentful to you.
Best of luck.
Hello, Claire
I do respect all nurses regardless of a few bad apples. I feel when people become thicked skinned and emotionless toward their patients. Then that is a problem. I feel desensitivity is needed for those nurses, to help to find a resolution to the problem and not adding to the emotional and physical stress of coming into the ER. Therefore, it is far and inbetween to find a nurse who can understand your illness/disease and the reason of the visit to the ER.
Yes, I did have six personal run ins at the ER. Each time I went into the ER I was treated as a drug seeker and they assumed I was faking. One time I almost died and they almost cost me my life by their assumptions. Sorrys did not healed the emotional wounds and I became fearful of the the ERs.
I had develop a blood clot in my left leg, the clot filled all my arteries and veins in the leg and it was four times larger than my right. The leg was black and pain when moving the leg. I never complained once in the er and I had on sweats and a T-shirt. I heard the nurses say there is another drug seeker in room 7 and she is faking so do not rush in to see her at all. She will wait till we get the other patients done before her and I wish she would leave cause she is taking time away from us to finish the poll. Guess what? I got up, told the nurses ...I will take you up in the offer and I will leave on your request. I left went back to my friend's house and called my family dr. and told them what had happen. He told me to get back there or I will die. I told him then I will die with my friends around me than those asshole nurses who wanted me to leave so they can finish their polls. The police were called I was section 302 and returned to the hospital under police escort. Heck it was Christmas of 1992 and santa deliver me a hell of a gift. Upon my arrival, the doctors were apologic to me and told me the nurses will be taken care of by them. I has tests and x-rays and it was a major clot that was going into my heart. Those nurses may an assumption and deny the medical attention to me for their darn poll. The doctors did not know I had arrived the first time because they told them I went ama. My doctor spoken to them and told them what had happen. I was place intensive care because of the clot and I was in the hospital for two months. I was so upset about the nurses and the treatment that it left a scare. Therefore, I vowed to be a nurse to change attitudes like those nurses who did not give a crap about me, just their dam poll.
I had worked in an er and saw people dropping likfe flies and mismanage by the triage nurses and medical staff. Using a profile is not correct because it only takes one to slip away. I hate the profiling and the nasty attitudes by the staff. We are here to do a job and help those who are in need of medical attention, regarless of, it is physical and/or emotional. I felt that I was not going to become an emotionaless or profiling the patients or become a negative nurse. I tried to change the attitudes of the staff and it was rejected. One example, a triage nurse made the wrong called and place a patient into the "4" grouping (which is last to be seen). After, 42 hours in the ER she finally came into the room. The triage nurse wrote on the chart patient is drunk and slurring words and could not understand why she was there. Guess what? I had the patient and did the work up. The patient was having a major stroke and missed the time for the clot blusters. I had called the physician into the room and said we need neuro right away. We worked on that patient for five hours and she was in critical state. She did have side effects that resulted from the stoke. I felt like chit and the triage nurse (who triage her the hours prior to it) stated "oh, well she was not drunk" and walked away. I wanted to kick her butt. Therefore, that is only one of numerous tragedies and how the emotionalless of some nurses react.
It is a reality that nurses become thick skinned over a period of time. It is ashame because it just cause more problems. I am not saying all nurses treat everyone negatively and profiling patients as they come into the er and/or to the unit. The treatment of the medical staff is the first criteria a patient evalulate a hospital. And if it is not good....than evaluation will travel faster than an airplane. Everyone will know how the treatment of a hospital is bad and make up a name for it. Although, it may/not be true, I wish we all can drop the emotionalless and the profiling and treat each patient as individual.
There will be abuse by several patients of seeking medical attention, shelter, food and warmth and most, likely there is an underline medical problem. Can the problem ever be resolve? Who knows but er can try to resolve it. In addition, I understand er nurses choose the unit to thelp those who have true trauma, illness, disease, and injuries. Unfortunately, society has created the problem by the increase of medical insurance cost, high prices of apartments, less medical personnel, inflation and the reduction of employment. Therefore, we all have to figure out more solutions to have effective care for all.
I am a very good nurse according to my patients and I have a high rating score from them and my superviser. I am trying to find a way to improve the situation for everyone (nurses and patients) and reduce the negativity. I know that thick skinned is needed when you see things occurr each day and night. I know if you allow it to eat you up than you become less productive. Therefore, resolutions are needed to reduce everyone's stress levels and those who are not being true about their medical conditions.
Having read the reasoning for why you won't visit the ED, I can completely understand! What a horrible experience you were put through.
It reinforces the initial instruction we are given to all patients in our ED (in majors anyhow), first expose the patient (ie change into gown), that way, your severe and life threatening problem would have been solved immediately
I'm sorry if my initial post seemed like a personal attack, but as I am what I concider a good ED nurse and triage nurse, I was upset at what seemed like a blanket damning of ED nurses, having read your stories, I know it not to be true!
I hope if you ever go to the ED again that the nurses listen to you on face value and you don't have the prior experiences reoccur.
Thank you for your story, I'm sure it will make many people think twice before writing people off.... I think this is very important.
Thunderwolf, MSN, RN
3 Articles; 6,621 Posts
I can see that things are getting quite heated here. It is a topic that tends to flair opinions and maybe even tempers. So please, let's be considerate in our posts.
Thanks.