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.
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.
Best wishes,
Claire x
Hello, Clair
I understood why you were upset because the lack of my communication about a specific group of ER nurses. I am sorry as well for not making my point clear and percise about the small group of er nurses. In addition, I want to improve the areas of high stressful as well as to find resolutions to the problem and not making the problem bigger.
Thank you for your reply and hope to read more from you as well as others.
Specializes in CVICU, PICU, ER,TRAUMA ICU, HEMODIALYSIS.
I am afraid you are failing in your attempt to educate. The only way to educate is to change the way that students are taught about acute and chronic pain management and what drug addiction is all about. Research has shown that most programs devote three hours to pain management and it is mainly focused on acute. Not only requiring that patients be assessed properly but also that all nurses undergo re-education would be a step in the right direction. Do I think it will happen------no but I can hope.
Like you, I am a chronic pain sufferer. I avoid going to the ER for the same reason you do. And I think that it is a shame that you and I have to put up with such things. I sometime wonder how those who judge, would like being judged, if they found themselves in our shoes.
Grannynurse :balloons:
In 2001 I was working as a weekend supervisor when I severely injured my knee; because my insurance did not take effect for 3 months, I hobbled around using heat, ice packs, the knee stabilizers etc. because I KNEW that because of the degree of swelling and pain that I would probably require surgery. I could not see an MD because it would be considered a pre-existing condition. Needless to say, I made an appointment with an internist to have as a PCP so I could be referred to an orthopod ASAP. Prior to this appointment I had had no visits to the ER for any reason, and I had had no narcotics scripts since my hysterectomy 6 years prior. By the time I was examined by this MD, my knee was swollen to twice its normal size and my entire leg was swollen to my foot with pitting. I could neither bend nor straighten my leg to its normal degree. The doctor ordered an xray but when I told him that because of a very sensitive stomach, I have an intolerance to most medications including Erythromycin, Macrodantin, ASA, naproxen, zyban, darvon, morphine, demerol, codeine, vicodin and nearly all NSAIDS with the exception of small widely spaced doses of ibuprofen which I can tolerate if I take it with additional doses of pepcid which I take twice daily along with omeprazole for previous gastric ulcers, he asked me what can I take and I told him truthfully that the only pain med that I can take without adverse reaction is percocet. He refused to give it to me saying that my injury was not severe enough to warrant such a strong medication. I left angry and livid that he was inferring that I was drug seeking. He had never laid eyes on me before that day, had no history on me, yet he had the nerve to write in my chart that he strongly suspected that I was a drug abuser and a drug seeking nurse; that I probably went from doctor to doctor asking for narcotics since he was my new PCP and that I probably was a frequenter of every ER in the Tucson area. I found this out after I went to see another PCP one year later and he asked me about the record which he had requested from my most recently seen previous PCP. (In the interim, I went to an ER where the doctor after an xray and exam of my leg asked me if I wanted an injection of Morphine which I of course declined and explained my history of drug intolerances to him. This doctor was more objective and let his powers of observation and examination of the injured part help him decide that I was INDEED IN ENORMOUS PAIN AND HAD BEEN FOR MORE THAN 3 MONTHS. HE GAVE ME 2 PERCOCET THERE AND A SCRIPT FOR 20 TO LAST ME UNTIL I GOT IN TO SEE THE ORTHOPEDIC surgeon 2 weeks later. The ortho was so alarmed by the degree of swelling that he had not only an MRI done to rule out a possible concommitant fracture, but also a doppler to rule out a DVT before he would do surgery. I finally had surgery 6 weeks after seeing the original PCP for badly torn cartilage; I had one script for 30 percocet prior to surgery and one afterwards. I have had no narcotic prescriptions since. But I made the mistake of writing the opiod-phobe MD a very irate letter regarding his labelling me a drug seeker and he in turn reported me to the Arizona board of Nursing; after a year of investigation into my working past, having me seen by a psychiatrist, and casting suspicion on my reputation by talking to every manager I have had in the past 10 years and FINDING NO EVIDENCE WHATSOEVER OF ANY ABUSE INCLUDING 2 NEGATIVE RANDOM DRUG SCREENS AT 2 DIFFERENT PLACES OF EMPLOYMENT THAT WERE GIVEN TO ALL NURSES WORKING ONE SHIFT WHEN A NARC WAS MISSING . IN SPITE OF ALL THIS, THE BOARD WAS TOO INTIMIDATED TO TELL A DOCTOR THAT HE WAS ABSOLUTELY, POSITIVELY WRONG IN THIS CASE. SO INSTEAD OF DISMISSING HIS ACCUSATION, I WAS GIVEN A LETTER OF CONCERN WHICH THE BOARD TELLS ME IS NOT A PUNITIVE ACTION. What they did not tell me is that whenever a prospective employer calls to check on my license they are told that an investigation was done on me due to an accusation by an MD of suspected drug abuse. NOW WHAT WOULD YOU THINK?? My husband and I just filed for bankruptcy; I am tired of applying for and in some cases getting jobs only to be let go weeks to months after starting the job for ridiculous reasons. I was an excellent, highly educated professional who was well liked and highly regarded by my peers until this hateful human being used his power over nurses to ruin me. I strongly recommend that NO ONE GO INTO THE NURSING PROFESSION. WE ARE ALWAYS THE FALL GUY WHETHER IT IS AN MD, PHARMACIST, OR OTHER MEDICAL PROFESSIONAL WHO MAKES A MISTAKE. IF THERE IS A NURSE'S SIGNATURE SOMEWHERE ON THE CHART, THEY WILL FIND A WAY TO BLAME IT ON THE NURSE. I know that many will think that I have exaggerated the facts and that I am cynical; to the novice nurse and to those of you who have never had the bad fortune to have your future destroyed over something of which you are blameless I am sure that it is hard to believe. But believe this: I personally know of 4 other Arizona nurses who lost their licenses due to the mistakes of a pharmacist in one case, and a resident in another and cases similar to mine in anothere.
In 2001 I was working as a weekend supervisor when I severely injured my knee; because my insurance did not take effect for 3 months, I hobbled around using heat, ice packs, the knee stabilizers etc. because I KNEW that because of the degree of swelling and pain that I would probably require surgery. I could not see an MD because it would be considered a pre-existing condition. Needless to say, I made an appointment with an internist to have as a PCP so I could be referred to an orthopod ASAP. Prior to this appointment I had had no visits to the ER for any reason, and I had had no narcotics scripts since my hysterectomy 6 years prior. By the time I was examined by this MD, my knee was swollen to twice its normal size and my entire leg was swollen to my foot with pitting. I could neither bend nor straighten my leg to its normal degree. The doctor ordered an xray but when I told him that because of a very sensitive stomach, I have an intolerance to most medications including Erythromycin, Macrodantin, ASA, naproxen, zyban, darvon, morphine, demerol, codeine, vicodin and nearly all NSAIDS with the exception of small widely spaced doses of ibuprofen which I can tolerate if I take it with additional doses of pepcid which I take twice daily along with omeprazole for previous gastric ulcers, he asked me what can I take and I told him truthfully that the only pain med that I can take without adverse reaction is percocet. He refused to give it to me saying that my injury was not severe enough to warrant such a strong medication. I left angry and livid that he was inferring that I was drug seeking. He had never laid eyes on me before that day, had no history on me, yet he had the nerve to write in my chart that he strongly suspected that I was a drug abuser and a drug seeking nurse; that I probably went from doctor to doctor asking for narcotics since he was my new PCP and that I probably was a frequenter of every ER in the Tucson area. I found this out after I went to see another PCP one year later and he asked me about the record which he had requested from my most recently seen previous PCP. (In the interim, I went to an ER where the doctor after an xray and exam of my leg asked me if I wanted an injection of Morphine which I of course declined and explained my history of drug intolerances to him. This doctor was more objective and let his powers of observation and examination of the injured part help him decide that I was INDEED IN ENORMOUS PAIN AND HAD BEEN FOR MORE THAN 3 MONTHS. HE GAVE ME 2 PERCOCET THERE AND A SCRIPT FOR 20 TO LAST ME UNTIL I GOT IN TO SEE THE ORTHOPEDIC surgeon 2 weeks later. The ortho was so alarmed by the degree of swelling that he had not only an MRI done to rule out a possible concommitant fracture, but also a doppler to rule out a DVT before he would do surgery. I finally had surgery 6 weeks after seeing the original PCP for badly torn cartilage; I had one script for 30 percocet prior to surgery and one afterwards. I have had no narcotic prescriptions since. But I made the mistake of writing the opiod-phobe MD a very irate letter regarding his labelling me a drug seeker and he in turn reported me to the Arizona board of Nursing; after a year of investigation into my working past, having me seen by a psychiatrist, and casting suspicion on my reputation by talking to every manager I have had in the past 10 years and FINDING NO EVIDENCE WHATSOEVER OF ANY ABUSE INCLUDING 2 NEGATIVE RANDOM DRUG SCREENS AT 2 DIFFERENT PLACES OF EMPLOYMENT THAT WERE GIVEN TO ALL NURSES WORKING ONE SHIFT WHEN A NARC WAS MISSING . IN SPITE OF ALL THIS, THE BOARD WAS TOO INTIMIDATED TO TELL A DOCTOR THAT HE WAS ABSOLUTELY, POSITIVELY WRONG IN THIS CASE. SO INSTEAD OF DISMISSING HIS ACCUSATION, I WAS GIVEN A LETTER OF CONCERN WHICH THE BOARD TELLS ME IS NOT A PUNITIVE ACTION. What they did not tell me is that whenever a prospective employer calls to check on my license they are told that an investigation was done on me due to an accusation by an MD of suspected drug abuse. NOW WHAT WOULD YOU THINK?? My husband and I just filed for bankruptcy; I am tired of applying for and in some cases getting jobs only to be let go weeks to months after starting the job for ridiculous reasons. I was an excellent, highly educated professional who was well liked and highly regarded by my peers until this hateful human being used his power over nurses to ruin me. I strongly recommend that NO ONE GO INTO THE NURSING PROFESSION. WE ARE ALWAYS THE FALL GUY WHETHER IT IS AN MD, PHARMACIST, OR OTHER MEDICAL PROFESSIONAL WHO MAKES A MISTAKE. IF THERE IS A NURSE'S SIGNATURE SOMEWHERE ON THE CHART, THEY WILL FIND A WAY TO BLAME IT ON THE NURSE. I know that many will think that I have exaggerated the facts and that I am cynical; to the novice nurse and to those of you who have never had the bad fortune to have your future destroyed over something of which you are blameless I am sure that it is hard to believe. But believe this: I personally know of 4 other Arizona nurses who lost their licenses due to the mistakes of a pharmacist in one case, and a resident in another and cases similar to mine in anothere.
Hello, Celeste
Have you consider to file a lawsuit against the physician who was incorrect? In addition, Have you consider to have a meeting about with the BON and your lawyer about the incident?
I would not sit back on this what so ever. It may cost you a job in the future. I would seek advice about the incident and see if anything could be done in your behalf.
Shaking my head, in disbelief about the incident that occurred with you. I know there are two other sides to the story here and I should not make a judgement at all. I would advise you to seek legal council about this incident.
I am very sorry this incident occurred and it is a hard lesson to learn about how other medical professionals treat their own.
I would not quit the profession and I would fight for my rights as a person/nurse . I would show them that I count and I will not turn my back on this incident without a fight in the court of Law. However, that is me and how I would handle the incident and reap the win in numerous ways. For example, to show this dr that it is not appropriate to label someone who gives them a honest answer. In addition, he could have ask you who was the last dr who treated you and called him/her about you. Which this action is appropriate and backs up your story about the medication. End of story....seek legal advice.
I think I'm glad we don't have Demerol or Dilaudid in the Uk... infact, I've no idea what our alternatives are :)
I had the opportunity or in some cases, misfortune, to become a patient in London when I passed a kidney stone. I was offered an opium based pain medication which killed the pain most effectively. Morphine did not touch the pain what so ever.
How sad for that patient and her family. Due to the ER staff's prejedices, she died. Seekers cause the medical staff to assume which clouds their judgement.
I, too, am a chronic pain patient. I've been to an ER exactly three (3) times in the last ten years for pain. I have a long history of nine Cerivial and Lumbar surgeries from a birth defect. I have no use of my left arm or hand; I can't stand for more than 3 minutes, I have foot drop on the left and of course, unrelenting pain which is at a 3/4 level with medication.
But, sometimes, something goes wrong, very wrong and the pain is intolerable and the meds I have will not help. You are at a point where you can't quit screaming from the pain, so your only choice is to go to your hospital's emergency room for help and care. I'll never go again except on a stretcher and half dead. The staff treat you like an addict and a drug seeker; they humiliate you; they ignore you; and if the Doctor believes you, the nurse will give you the least amount of pain relief possible because she/he can. They'll do whatever it takes so you'll never go back. Well, I haven't as well as many of my Doctor's patients who absolutely refuse to go to the ER.
Today, while in my Doctor's office he was seeing his patients with the Head of the ER at the hospital and he wanted me to tell this Doctor why none of my Doctor's patients would not go to his ER.
Well, I was as about as direct as I could be. I told him all the horror stories that I had experienced as well as other patients that I personally know about. In my experience, it wasn't the ER Doctor as much as it was the support staff who treated me with no respect, no kindness, no caring, and were very aggressive in their feelings that I was just a "drug seeking addict" that they had no time for. I've actually been called that in front of others within hearing range and I was so humilated by that remark because others had heard what that nurse had said. But, at that point, I was in so much pain, the kind of pain that you can't even close your eyes, you can't breathe, you pray to die and then I have a nurse that labels me. She even said, you might be able to fool the Doctor, but SHE knew I was a liar and making it up. I just cried in pain and in humiliation because my family was standing right there to hear this. God only knows what she documented on my chart. Her notes will be reviewed at some time during my future care and they will lead those medical personnel to "assume" the same thing before I even have a chance to be examined. Her incorrect charting will destroy my chances of ever getting proper care or kindness in the future, so why would I subject myself to that again?
So, there you have it. Will I ever go to another ER, ABSOLUTELY NOT! Like I said, only on a stretcher and probably knocked out and when I awakened, I'd limp like hell out of there with my walker never to be seen again......
I hope what I've written will open some eyes. I do know it must be very difficult to try to figure out who is really in pain and who is not. A nurse on this site put it very clearly, she said, "A patient's pain is what they say it is", and you go on from there. God bless her, I wish she was my nurse many times over. As matter of fact, many nurses on this site have been kind and caring because they lived up to their oath to care for the sick and people who are in pain.
So please, when a chronic pain patient appears in your ER, and I mean those that show up rarely, not every day or every week, give them the benefit of the doubt before you immediately "assume and cast accusations" at them.
Your kindess goes a long way when someone is suffering.
This is a case of patient's crying wolf too many times only to actually have the wolf in the sheep's den
Have you consider to file a lawsuit against the physician who was incorrect? In addition, Have you consider to have a meeting about with the BON and your lawyer about the incident?
I would not sit back on this what so ever. It may cost you a job in the future. I would seek advice about the incident and see if anything could be done in your behalf.
Shaking my head, in disbelief about the incident that occurred with you. I know there are two other sides to the story here and I should not make a judgement at all. I would advise you to seek legal council about this incident.
I am very sorry this incident occurred and it is a hard lesson to learn about how other medical professionals treat their own.
I would not quit the profession and I would fight for my rights as a person/nurse . I would show them that I count and I will not turn my back on this incident without a fight in the court of Law. However, that is me and how I would handle the incident and reap the win in numerous ways. For example, to show this dr that it is not appropriate to label someone who gives them a honest answer. In addition, he could have ask you who was the last dr who treated you and called him/her about you. Which this action is appropriate and backs up your story about the medication. End of story....seek legal advice.
Good luck to you and your family.
Buttons
That's what came to my mind. I want you get some legal advisors and talk over the possibility of a lawsuit. You need to get your state record CLEAN so you can start over and shine like you're supposed to. God don't make no junk, so don't let this ***h*** turn you into junk!
Pain management, acute and chronic should be a seperate course in nursing school. It can be a complex issue involving assessment, pt. hx. dx., etc. In my opinion, potential for addiction for reasons other than quality of life and normal functioning could possibly be emphasized in such a course integrating what you've learned in abnormal, pharm, community, rural and mental health curriculum. Might be a good project for a masters or doctorate level thesis.
It's too bad opioids are getting a bad rap because of all the intentional abuse. Personally, I have an ongoing script for lortab. I take 200mg Ketoprofen SR for chronic arthritis. It's about the only nsaid that doesn't churn my stomach, and I've tried most of them. For acute attacks, I have an ongoing script for Lortab. It's a godsend. If I need a little help, split one in half. For worse pain, take one and if things are unbearable, I can take two. It's the only pain killer that I can function with cognitively and the only one that never constipates me or upsets my stomach. I am a junior in nursing school with a 3.56 gpa.
G
What is taught in Nursing school is the eutopia--- what everyone thinks nursing is or should be in the hospital setting. Once out of school and on the floor, realization sets in and one cannot help identify repeat offenders of the medical system. Unfortunately, we as health care providers, cannot test each patient, with more than say five visits to the emergency room per year, with a tox screen or other identifying tests to see actually if the patient is a user or an legitimate patient....all patients should be considered legitimate. We also must remember our bodies do show other signs/symptoms of pain...Increased heart rate, diaphoresis, elevated BP.
That's what came to my mind. I want you get some legal advisors and talk over the possibility of a lawsuit. You need to get your state record CLEAN so you can start over and shine like you're supposed to. God don't make no junk, so don't let this ***h*** turn you into junk!
Actually, her successfully winning or even getting a suit, into court, are poor. Her attorney would have to show that it was a false and deliberate action, on the part of the physician, something that is extremely hard to do. She should speak to an attorney about what action she can take regarding her nursing record but I suspect there is very little that can be done. The harm has been done.
I am so apalled at what has happened to you. And what I have seen and experienced, I absolutely believe every thing you said. I can really see this happening.
There is an old adage that says we tend to want to demean those we have already injured. I guess instead of fessing up, folks like this doctor only increase their attack when the injured party sheds light on the damage they had done.
I have seen other nurses do this to other nurses and nursing assistants. It's scary as ****.
In my last place of employment, the supervisor carefully deconstructed my reputation. She had done something inappropriate herself, something I would never call her on, but I guess fear motivated her. I dont think she was a bad person so much, she was just emotionally imature. Some folk still live on the playground, what worked in third grade is what works for them now. Unfortunately, these tactics are devestating in the adult world.
In the case of this Doctor, the word narcissist springs to mind.
You and your husband have been through some awful hard stuff. Spend your energy on getting support for your emotional healing, and start a new life.....this could be a new beginning for you.
demerol in the ER hands down, percocet or vicoden at discharge. I don't think a doc in the ER would ever write for oxycontin. They would say that's for your primary to make a decision on. If it's that bad you need to be admitted.
In 2001 I was working as a weekend supervisor when I severely injured my knee; because my insurance did not take effect for 3 months
Just curious - how come this wasn't treated as a workman's comp injury so you could have received immediate treatment (and just maybe avoided all the obnoxiousness you had to endure)?
What a depressing thread. On one hand you have these poor souls who suffer from chronic pain. They truly suffer, so we help them... we give them medicine, opioids, to take away their pain. And it works, and they are so grateful. But the pain comes back, and so they come back, so we can make it better again. Before long, they're addicted. And now, to make matters worse - we don't believe their pain even exists. They are drug seekers. Addicts. Frequent flyers. Where we once listened empathetically, now we roll our eyes with contempt.
It's just sad.
I don't pretend to have all the answers. Certainly there are many people who are purely drug seekers visiting the ERs across the country in search of a fix. Thank goodness it's not my job to decide, I just couldn't do it. I've read research articles about the lived experience of those who experience chronic pain and the most important thing to them is feeling that others believed their pain. And so, I do... every time. The nifty part is I don't lose sleep over it, it's what I was trained to do.
In a perfect world, we would not continue to treat people with chronic pain in an acute fashion, but that's for another thread.
button2cute
233 Posts
Hello, Clair
I understood why you were upset because the lack of my communication about a specific group of ER nurses. I am sorry as well for not making my point clear and percise about the small group of er nurses. In addition, I want to improve the areas of high stressful as well as to find resolutions to the problem and not making the problem bigger.
Thank you for your reply and hope to read more from you as well as others.
Have a great evening and tomorrow.
Buttons