Drug seekers

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Sep 8, 2010

Amen, sister. It's just a shame that they can complain to management and the doc gets gigged for having unhappy patients. I guess all they see is that drug abusers dollars are the same color as those needing good legitimate care. All praise the almighty dollar.

PMFB-RN, RN · Sep 8, 2010

I can't help but get frustrated at the disrespect I get by pts who come in and don't get the dilaudid or the (30) 10mg norco script they demand...
Ive only been a RN for a year and this is out of control. Yesterday I got yelled at by a pt because she has chronic back pain, frequent flyer and was ****** she got 5mg norco this week instead of her usual 10mg, another one refused all meds but dilaudid and we had to call security because she became irate..
The last hospital I worked at, they stopped giving dilaudid and had signs posted up around the ER stating "we no longer administer dilaudid IV" Some dr's give in and some don't...but most do and that just makes the problem worse!
Just venting because I feel like they come in and walk all over us. We are just waitresses to them and all the hospital cares about is pt satisfaction. I dont care if drug addicts are satisfied or not...
UGGG so frustrated! Worst day yesterday!!!

*** Yes it can be frusterating but you can't let it get to you for your your own mental health. Don 't let anyone walk all over you. Stand up for yourself. If any patient gets out of control I call the cops. Yelling at me gets my back walking out the door.

pharmgirl · Sep 8, 2010

*sigh* I am a brand new RN in the ER and I am trying to come to grips with this every day as well. It's so frustrating on so many levels. Frequent flyers coming in and taking up beds that could be used for the truly sick. Irate because they can't get their meds. And the "act", some are such poor actors. I could go on and on. I feel your pain, I really do.

I'm so tired of being frustrated with it that I've decided that there has to be a better way for ME to react to maintain my sanity. I've even called my old instructor for advice and all she says is "Even drug addicts get sick". *sigh*. If you find a way to cope with this, let me know.

Editorial Team / Moderator · Sep 8, 2010

I just don't take it personally, period -- that's how I maintain my sanity. Emotional detachment (yay Vulcan, LOL). I learned a few years back (when I was an ER tech) that I cannot get emotionally invested in these types of patients AT ALL. They usually end up doing one of two things: dying of an overdose, or realizing that they're addicted. I've seen both happen to our frequent flyers (and it's nice when they get their lives turned around -- it doesn't happen often, but when it does, it's lovely to see). The meantime between death and the wake-up is tough to deal with, but I look at it like this: their lives must really, really suck. Seriously. Being an addict surely doesn't seem like a good time, and at least it isn't MY life. When a patient gets abusive, I tell them that I will not be spoken to in that manner, and walk away.

Orange Tree · Sep 8, 2010

The drug seekers don't bother me at all. I get more frustrated when I see patients with real needs being labeled as drug seekers by other nurses. A patient could have diverticulitis, kidney stones and a broken hip.....and someone would still call them a drug seeker because they asked for their PRN dilaudid as soon as they could have it. And now, back to your regular scheduled programming:D

georgianurse89 · Sep 8, 2010

I know what you mean...but try working in a LTC facility with drug seekers! It's much, much worse! At least at the ER you can treat and street. That's not an option here. I have a pt that came to us for anorexia/bulimia and b/c of her admitting dx she has lost almost all control of her life so to speak (we monitor her food, we monitor her trips to the BR, we go through her things once a week,...) so now she is turning to her pain meds to have some control. Although she receives Tylenol #4 regularly, she complains constantly that that is all she gets, shes on the call light constantly for us to call the doc to get a stronger med or to get another dose or that says "im gonna die if i dont get my pain med" But 5 min after telling us how unbearable and excruciating the pain is, she's asleep and snoring! How can you be in such pain and be asleep.

With that said, I'm a firm believer in pain control!! But, there are certain things us nurses notice that totally disprove your claims of pain. That's when I have a problem dealing out narcotic pain pills like m&ms.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Sep 8, 2010

*sigh* I am a brand new RN in the ER and I am trying to come to grips with this every day as well. It's so frustrating on so many levels. Frequent flyers coming in and taking up beds that could be used for the truly sick. Irate because they can't get their meds. And the "act", some are such poor actors. I could go on and on. I feel your pain, I really do.
I'm so tired of being frustrated with it that I've decided that there has to be a better way for ME to react to maintain my sanity. I've even called my old instructor for advice and all she says is "Even drug addicts get sick". *sigh*. If you find a way to cope with this, let me know.

From experience I know that those who see ER nursing as exciting do best, those who see it as stressful burn out, and me? I just enjoy the entertainment. Not many people are really ready for the moment when they find out what ER nursing is really like. I imagine it's probably the same in any nursing job. An ER doc once told me that of course the grass is always greener, but go over the fence and you end up stepping in what makes the grass greener. I hope you can find a niche in ER nursing. There are few absolutes about most nursing specialties, but in the ER you're going to see more chaos, more variety, more pathos and more joy, more injustice, all in one department. All nurses are a special breed, needing to find their own niche. I wish you a long, happy, rewarding career wherever you find your niche. I'm prejudiced to ER, if that isn't obvious. :up:

classicdame, MSN, EdD · Sep 8, 2010

it might help to think of the drug seekers as mental health patients. Your expectations would be different and that might lead to less disappointment. The situation is so bad in USA now and partly because there are few pain clinics available. Remember, pain in the brain, and so is emotional health. They may be suffering in both areas.

imintrouble, BSN, RN · Sep 8, 2010

It depends on the ER doc. There are some docs who won't order anything stronger than Toradol and Motrin. Hooray for them. Pts cruise the ER parking lot and know what car that doc drives and won't come in. (Very small hospital). Imagine what would happen if EVERY ER doc would stop giving out Dilaudid, Morphine and Demerol for subjective c/o pain in the ER.

itsmejuli · Sep 8, 2010

I know all about pain killer addicts on a personal level. My son and his girlfriend,at the time, were abusing pain killers for years. It all started with a car accident, a lawyer referred them to a pain clinic and next thing you know they were addicted. This led to doctor shopping and dealing, anything to get the next fix. They lost their jobs, their cars, their home, and in the end their child was taken away. My son almost lost his life and spent time in jail.

This addiction is evil, nobody knows who's going to get truly addicted to these pills. These lost souls often wind up shooting the drugs just like heroin. They lose themselves, their families, their friends...they lose everything for that high.

The relapse rate for those who try to get clean is over 80%.

Put the blame on the manufacturer, the drug reps and the pain clinic "doctors" who prescribe these meds.

Where are the drug rehab programs to help these people get their lives back? They don't exist.

Yeah, I don't like the drug seekers where I work either. But its not my job to judge whether they are truly drug seekers or if they have intolerable pain. At the end of the day I get to go home pain and addiction free. My life is far better than theirs.

scoochy · Sep 8, 2010

It depends on the ER doc. There are some docs who won't order anything stronger than Toradol and Motrin. Hooray for them. Pts cruise the ER parking lot and know what car that doc drives and won't come in. (Very small hospital). Imagine what would happen if EVERY ER doc would stop giving out Dilaudid, Morphine and Demerol for subjective c/o pain in the ER.

Ironically, downsizing in the ER might occur!