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...
When I talk about drug seekers in the ED, I am talking about those who purposefully shop around from ED to ED, lie about pain, or come in with a narcotic agenda, be it to feed their own addiction or to sell their spoils. With that being said: I give everyone the benefit of the doubt, until they lie to me or try to drive home wasted on Dilaudid; fool me once, shame on you, etc. I have more respect for people who come in and say, "Look, I just need a Percocet refill" than those who embroider some elaborate tale about falling down the steps and twisting an ankle, but whose story changes 17 times during the course of the ED visit.
I don't think anyone participating in this discussion falls under this category.
No, you didn't. You posted a "poor me, they thought I was a drug seeker" story, the type of which we have seen ad nauseum any time the topic of drug seekers in the ED comes up. These types of posts contribute nothing of value to the discussion, IMO, and only serve to distract from the actual discussion, hence the term "red herring". And, I haven't flamed you. I apologize if it appears that I have. You have every right to your own opinion. However, the topic is about drug seekers in the ED. Since you said yourself that you don't work in the ED, I don't think you have a dog in this fight.
First bolded sentence--If you really knew me, you would realize that I have zero interest in anyone's sympathy. Again, I was simply trying to add some perspective to the "discussion".
Second bolded sentence--I have no interest in fighting with you or anyone else. (Although, it seems as if you have been trying to turn this into a fight from the moment you read my first post.) You have made it abundantly clear that it is not possible to have any type of discussion on this matter; you are too busy trying to come up with a snappy comeback for every thing that I say. So, I will leave you keep beating this dead horse.
Hmm....OK. I'm not sure I'm following you on that one. The OP started a discussion about drug seekers, and how ER staff deal with them. In addition to sharing one of my own personal experiences with this very issue, I simply tried to give a different perspective in which to view seekers. I have my opinion on this matter, and you can flame me for it as much as you like; it will not change anything. And, as I stated previously, I was not referring to anyone in particular. If you have chosen to take what I have said personally, then that is on you.
Haven't noticed anyone calling you names or suggesting anything about you as a professional so I'm not sure why you think you are being flamed.
And I really didn't think you were referring to me, in particular, with your previous post. I do think you were addressing ER nurses collectively when you suggested that we treat patients "like trash." And that is what I take exception to.
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.
How does your hospital get by with letting people leave after getting narcs. Our policy states that someone must be there to sign you out who will be driving and be responsible for you after discharge.
First bolded sentence--If you really knew me, you would realize that I have zero interest in anyone's sympathy. Again, I was simply trying to add some perspective to the "discussion".
Second bolded sentence--I have no interest in fighting with you or anyone else. (Although, it seems as if you have been trying to turn this into a fight from the moment you read my first post.) You have made it abundantly clear that it is not possible to have any type of discussion on this matter; you are too busy trying to come up with a snappy comeback for every thing that I say. So, I will leave you keep beating this dead horse.
Again, such posts admonishing ED RNs to reserve judgment do not add perspective to the discussion.
I almost chose "you don't have a horse in this race", but went with the dog analogy. It's a figure of speech, not to be taken literally.
In an attempt to get back on topic, I agree that it's something that is not going to go away, and that developing humane and effective management strategies for this patient population is imperative. And I use the word "management" because that's really what we do. We manage them. We're not fixing them, curing them, helping them, or healing them. We simply manage them during their time in our EDs.
I think one of the biggest barriers in developing effective management strategies is the schism between the "pain is what the patient says it is" mentality, where there is no such thing as a "drug seeker", and the reality that yes, there are people that do this. We have to accept that it's a problem that does exist in reality, yet at the same time, take complaints of pain seriously and treat pain effectively. That's a tough line to walk.
Ladies and Gentlemen, enough already. Despite my earlier requests personal comments have continued, so this is my last request to stop making personal comments about other posters and keep on topic.
I don't want to see this thread closed but if you can't discuss the topic without making it personal then that's where it is heading
How does your hospital get by with letting people leave after getting narcs. Our policy states that someone must be there to sign you out who will be driving and be responsible for you after discharge.
We obviously need to change our policy. This was the 2nd time this patient did this. I knew of the first time(well documented) and informed the doc who required the patient call a cab. the patient called the cab and then walked right past it,got into his vehicle and left. I informed the doc and the police were called. Is this enough for us to stop his supply? I hope so but I'm not holding my breath!
Anyway, sorry, I know this is off topic but I am wondering what will happen to me if I refuse to medicate him the next time.
BTW-- this is person who has been in my ED more than once a week for many many months always for "chest pain" which, when he gets pulled back for his EKG is clarified as chest wall pain from "moving a piano" or some other trauma, so he avoids the cardiac workup while getting seen quickly, while everyone else waits.
Specializes in burn unit, ER, ICU-CCU, Education, LTC.
animal1993,
You made me feel so much better. Thank you for saying how it feels to be accused of going to the ED for narcotics instead of pain relief.
Because of your post, I was able to go swim at the health club, bake cookies with my grandchild, and feel that life is good.
It only took one sympathetic nurse to show me that all is not lost in our health care system. The system may take the souls of many nurses, but not all.
Before I read your post, I was pacing and crying due to the cruel things I was reading from ED nurses. How sad for them.
I think this argument is one that could be heard in many ERs across the nation. If you treat all people that come through the door the same you will never miss something you should have recognized. :)
I have been an ED nurse since 1995 in all sizes & levels of hospitals. Patients that abuse the ED for drugs really frustrate me also. However, please be careful about how you respond to said drug seekers. At one small community hospital I worked at, we had a 30-40 y/o woman coming in constantly for Demerol injections for Migraines. Then, one day I got called to the Med/Surg. floor to start an I.V. in a young girl with Cerebral Palsy & Spina Bifida. Lo & behold, this girl's mother was the lady always coming in for Demerol injections. An effective coping mechanism, no. However, it made me realize that I only see a small facet of a person's life & that I should not be so hasty to rush to judging said person.
At another hospital I worked at, A young mid-30's male kept coming to the ED for c/o rectal pain. As far as I am aware, the doctor never even examined his rectal area. He just wrote this gentleman off as a drug seeker,(I don't know about you but I've never had a drug seeker come in complaining of rectal pain.) Well, to make a long story short, about 6 months down the road the gentleman comes back in with a diagnosis of terminal rectal cancer & he was very angry that the ED doc had not listened to him & rightfully so.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Yay!! All that activity was the best thing you could have done for yourself! That's great, NurseGloria.
Some thought, sorry to be OT-It may sound to you as if this is a black and white area, or if a certain subset of people they are talking about applies to all people who seek pain relief in the ED. That is absolutely not true! You don't fall into that category, neither does Animal1993, or the man with bladder cancer. I'm sure that every one of the nurses here that have concerns about this subset of people, would give you dynamite care if they were with you. No way in the world are they saying that you fall into that category!!
To be honest with you, I think some of your reactions to these posts suggests you are taking their comments way too personally. No one has abandoned you, and it is disturbing that you are pacing and crying about what you are reading here. I've been reading posts by these nurses for months, and I believe I can safely say they probably would actually give you a group hug if you could stand it!!:)
It's obvious you've been through hellish experiences, and you seem to be saying that this thread is a confirmation of your deepest fears, that nurses really are cold-hearted people, whereas you merely suspected it to be true prior to this.
This isn't the venue to work out your issues, which are valid, but this thread was started by a relatively new nurse who came here with questions more than judgements, and she deserves to have us addressing her issue. I know you can understand that. I really hope you can attain a measure of peace about how you've been treated. Go hang out with your grandchild some more!! :)
Lunah, MSN, RN
14 Articles; 13,773 Posts
When I talk about drug seekers in the ED, I am talking about those who purposefully shop around from ED to ED, lie about pain, or come in with a narcotic agenda, be it to feed their own addiction or to sell their spoils. With that being said: I give everyone the benefit of the doubt, until they lie to me or try to drive home wasted on Dilaudid; fool me once, shame on you, etc. I have more respect for people who come in and say, "Look, I just need a Percocet refill" than those who embroider some elaborate tale about falling down the steps and twisting an ankle, but whose story changes 17 times during the course of the ED visit.
I don't think anyone participating in this discussion falls under this category.