Drug-Seekers

[inteRN]

Do most ER's (Im sure they do) have this overwhelming problem???

I've only been a RN for 9 mos and I'm so tired of the same people coming in with BS excuses to get their fix. Then, treat us like crap if they don't get the drug of their choice.

It's been a struggle to be compassionate, even though I put on a good front...

I guess it's a personal thing because I've struggled with a few family members who were horrible prescription drug addicts and screwed me over to get money for drugs, etc. I guess I can't help it.

Anyway, do doctors in other ER's always just give in to get them what they want or do they ever try to get them help??

We had a girl come in yesterday, (who always comes in) saying her ovarian cysts is killing her and she's allergic to everything but dilaudid. She brought her husband in too so he could get his "toothache" looked at. Of course, he got his norco script and was pressuring us to hurry up with her care so he could get it filled I guess.

I told the doc about it and he said, "yep, I know she's here for the dilaudid, but watch-- the one time out of 27 visits this year I don't do a CT of her abdomen, she'll have an appendicitis"

Its sad... the money, the time...I feel sorry for the docs! They're scared to death of losing their license b/c these patients have them by the balls! I just had to vent. Something has to be done to stop this problem and no one seems to try and help these people the right way...

[BrnEyedGirl, BSN, MSN, RN, APRN]

NurseGloria, it sounds like you had a bad experience with the ER,.sorry to hear that,..but we can't treat all our "ducks" like "zebra's",..will we get a Zebra from time to time? You bet,.but we can't assume all zebra's are ducks just because a few people have bad experiences . If you come to my ER and tell me that you have L sided chest pain after being hit on the L side with a baseball bat during your companies softball game,..I'm not going order a cardiac work up and suggest you stay over night for a stress test,.just in case your chest pain is unrelated to the obvious injury and you are really having angina! Could it happen? Of course,..but how likely is it? We can't afford to do the $40,000 work up on every person that walks through the doors and it wouldn't be in the pt's best interest even if we could!

People seem to forget that the ER isn't a free clinic. I completely understand that there are people without health insurance who will be forced to come to the ER for strep throat, gastroenteritis et other non emergent illnesses. We will see all those people,.but that isn't' why we are there,.it isn't what we are trained to do, it isn't what we are staffed to do and to be honest with you,..for some of the minor illnesses and most chronic illnesses you receive much better care by seeing a PCP who knows you and is trained to diagnose, treat and manage these illnesses!

The ER is designed, staffed and trained to care for emergencies! We are trained to keep you alive until you get to cath lab, OR etc. We are here to rule out anything that might kill you or severely change you quality of life if not fixed today,..everything else needs a PCP.

Anyone who has ever worked any amount of time in the ER knows how frustrating it is to have a full ER, 30 in the waiting room and have someone c/o the wait when they are here for a toothache, belly pain that has already been diagnosed as GB dx,.or a HA that is chronic for you but you are out of meds! Will we see those people?,.you bet,..but they aren't medical emergencies and will wait to be seen after all the the true emergencies in the department! Please forgive me if I sound a bit snippy the 4th time you ask me about the wait and again explain to me that your "reg doctor" is out of town and "he always just calls in a script for oxycontin",.and I again explain that we will get to you as soon as we can.

Okay,....I'll step off my soapbox,...I truly love my job and I do care for my pts.

[Scooty Puff Jr]

Nurse Gloria, to quote the fantabulous movie Stripes, "lighten up Francis." Explaining this is most likely a futile effort, but I work in an ER, I am well versed in futility. This is called venting, you come here to this site, vent, go to work all giddy because you were able to get a few laughs with people who walk a mile in your shoes.

[XB9S, BSN, MSN, EdD, RN, APN]

screamin mimi,

we need a single payer universal health care system so that the eds are not full of people with undiagnosed pain or treatable addiction.

!

unfortunately in the uk we would appear to have similar problems to you over in the us. so i don't believe healthcare reform in the us is going to help this particular issue

[NurseGloria]

rn-cardiac,

i have worked in ers. i have seen persons with every indication of having an mi sent home who have no insurance. later, they were urgently called to return to the hospital because the labs showed they had a major mi.

i have seen patients that could be an mi or indigestion admitted to the ccu because they had cadillac insurance when their complaint turned out to be heartburn.

are you saying that we should treat every patient like a duck because of the expense of considering that the patient may be a zebra? maybe every patient should have a primary doctor because that would save health care dollars.

but wait! everybody doesn't have a primary care doctor because they don't have insurance and can't afford one. they may be trying to pay their mortgage and feed their children. they may be living paycheck to paycheck and making payments on their emergency room bills.

nurses need to be nurses. that means you are patient advocates. that means you should fight for universal health care; not for universal health insurance. health insurance does not guarantee that you will get health care. we nurses know that.

[NurseGloria]

scooty puff jr, there is nothing funny about being a patient who can't get care. maybe it's funny to you...............

i have a sense of humor, but this isn't funny.

[NurseGloria]

sharrie,

We would need to compare the stats. What you see as the same problem may be a lesser problem in your country.

[BrnEyedGirl, BSN, MSN, RN, APRN]

NurseGloria I think perhaps you've worked in some really bad hospitals! I don't even know who has insurance and who doesn't and I really don't care. I'm a nurse,..I'm there to care for pts, and I get paid the same insurance or not. I can honestly say I've NEVER seen a pt even discharged before all the labs are back,.being sent home with a positive troponin wouldn't happen,.period.

I think the point of the OP is the same even with universal health care (which I think is a horrible idea,.but that's another post),...even if you have the "Cadillac" of insurance you shouldn't be allowed to go from place to place with multiple c/o pain just to get a script for your fix!

[XB9S, BSN, MSN, EdD, RN, APN]

MODERATOR REQUEST:

Please discuss the subject at hand, which is drug seekers in the Emergency Room, please do not resort to personal attacks as they will be removed. It is clear that there are very strong feelings about this subject, and it is possible to debate and discuss the subject at hand professionally, and without being rude and disagreeable. I strongly suggest that posters remember this before they click the "submit reply" button.

Further off topic posts and personal attacks will be removed.

Thank you in anticipation for your co-operation

[Scooty Puff Jr]

Apologies for straying off topic.

[screamin mimi]

scooty puff jr, there is nothing funny about being a patient who can't get care. maybe it's funny to you...............

i have a sense of humor, but this isn't funny.

is it that you just do not accept that there are any people who misuse the er for narcotics?

also, i thought you were funny scooty puff jr.

as a general rule, to the original poster, treat all your patients with respect but feel free to laugh, joke and curse when you need to. there is nothing wrong or even unusual about occasionally feeling resentful of the people who take your time from those you feel truly need it. at the same time, never let that patient feel your resentment, because you never know what someone else is going through.

i only have one "frequent flyer" i will not tolerate and that is because he gets in his car and drives after i give him im dilaudid (no, not with the largest bore needle i can find after wiping it down with alcohol) self-destruction is one thing, but i don't want to help him kill some innocent family out for a sunday drive.

[NurseGloria]

rn-cardiac,

you are assuming that some of your patients are "allowed to go from place to place with multiple c/o pain just to get a script for your fix!" how do you know who those patients are?

[NurseGloria]

good for you screamin mimi. don't let somebody drive after a narc shot. do what you can to protect potential innocent victims.