Drug seekers

[Athena904]

I am almost out of nursing school to get my ADN and be an RN. I was curious for those of you who work in a hospital/clinic setting of how often patients are only seeking admission to fuel their drug addictions. My concern is that when health care is "FREE" that they will overwhelm the system with their addictive behaviors and tax payers will foot the bill.

Would love to hear your viewpoints on this.

Thank you!

[Athena904]

Still wondering where you're getting your information on the new healthcare laws.

That being said ... it would also be interesting to know why you would assume that there would be a flood of "drug seekers" over and above what we are already experiencing.

We have already voiced the opinions you asked about ... I'm curious as to whether you have searched the site and your reactions to what you've read.

Yes, it did resolve my question. I am honestly enlightened by the responses and have a more in depth picture on what is happening with health care and patients. I didn't realize that the number of people who intentionally abuse the system wouldn't rise when Obama's health care reform takes effect because they already are. I just was thinking that more and more people would start doing it because of the population who doesn't qualify for medicare/medicaid/etc. would have more access/temptation to get drugs without paying the bill. The new health care laws I am assuming from the media and reports that EVERYONE will be covered by health care and not just the patients who are limited in income. My thinking was that the new health care would be giving a potential rise for people who want drugs for their own pleasure instead of true physiological conditions. Now I see that drawing the line between physiological conditions and drug addictions is not a good method. VERY VERY grateful for the experienced advice. I am learning :)

I hope I did not come across as being too judgemental or harsh in the question. Plain old curiosity drove me. Thank you again!

[mrstookielpn]

Drug seekers? How many drug seekers are addicts, and how many have uncontrolled or minimally controlled pain? What constitutes a "drug seeker"? Do you think people who abuse the system now are footing their own bills? Do you think all abusers of the system are "drug seekers?" What sort of free health care are you speaking of? Medicare? Medicaid? VA benefits? The poor who use the ED as a primary provider? Taxpayers and people with insurance always have and always will foot the bill for those who cannot or will not pay. Nothing new there.

Addictive behaviors are your job security. I'd wager food and nicotine addictions count for more admissions on my floor than drug addictions. If people didn't smoke and weren't fat, we'd have far fewer nursing positions. I honestly don't see many drug addicts. I see many people with chronic pain. I see a whole slew of COPDers, most of whom smoked until diagnosis, some of whom continue to smoke. I see a lot of diabetics and heart failure pts who continue to be noncompliant with diet and/or behaviors such as smoking and exercise, resulting in repeated admissions. Shrug. It's human nature, and the nature of your chosen profession. Humans are complex animals, and it's difficult to be so judgmental when so few of us are perfect creatures.

Good luck in your future profession. I hope you continue with the critical thinking and dialogue, but lose some of the judgmental ideas, or at least develop an appreciation for the complexity of treating pain as well as addictions.

Very well said.

[Aeterna, BSN, RN]

I am not well versed in the complexities of the changing American health care system but, living in Canada, we have "free" health care. Reading some the posts on this forum, I'm getting the feeling that the health care situations are roughly the same-ish. We are all frustrated with being overworked, underpaid, stressed, working with increasingly complex patients, not being heard by upper management, etc.

That being said, yes, we do see our drug addicts come in and out of the hospital. I don't work in ER so I imagine many of them show up there, but on the floor, we do see them occasionally. However, whenever they do get on our floor, they are referred to our social worker who will work with them to discuss addictions services and whatnot. Still, I don't think they overwhelm the system. the vast majority of patients we see have real medical problems. And there have been times where they've had real medical problems but were turned away because hospital staff thought they were drug seekers.

For example, we had a patient admitted to our floor with a pathological hip fracture due to metastasized lung cancer. She had visited the ER several times to seek treatment for her pain, but they assumed she just wanted narcotics and sent her home. Little did they know that she actually had a malignant cancer spreading to her bones and brain.

[EmergencyNrse]

There are no such things as drug-seekers...

That from the ENA. (I have witnesses) :sofahider:

[Been there,done that, ASN, RN]

Yikes! So many people agitated! I am not implying that it's my opinion the ER's would be overrun. That is why I'm asking YOU what you think because I don't know. I don't work in a hospital and was curious if some one could tell ME what they think would happen. LOL If I wanted to squabble back and forth about my intentions I'd go ask my nine year old child to go clean his room. LOL Sorry to have the focus steered on me and my mind rather than the question!

As you can see Athena, nurses eat their young, given any opportunity.

You simply stated an interesting thought, and the pecking began!

I feel if a reader does not want to respond to the content ,fine. But don't start criticizing the ideas /thoughts of the poster!

To respond to your INTENDED question... yes, I do see clients present for pain medication. Sometimes it is chronic pain that is not being controlled, sometimes it's in search of a buzz or to prevent withdrawal symptoms.

It would be the nurse's responsibility to assess the situation and attempt to obtain proper treatment.

Good luck, it's brutal out here.

[BabyLady, BSN, RN]

I am almost out of nursing school to get my ADN and be an RN. I was curious for those of you who work in a hospital/clinic setting of how often patients are only seeking admission to fuel their drug addictions. My concern is that when health care is "FREE" that they will overwhelm the system with their addictive behaviors and tax payers will foot the bill.

Would love to hear your viewpoints on this.

Thank you!

Most drug seekers don't pay for their care now.

So no, it won't make any difference. They get admitted using fake names, etc.

You cannot legally turn away someone in an acute need for medical care from an emergency room facility. You risk getting sued if you diagnosis the patient incorrectly. Physician's are not willing to take that chance...so they treat and discharge...the physician spends minimal time with these patients...therefore, minimal investment on his/her part..the hospital is the one that takes the real hit b/c they have provided the room, the nurse, the support staff and the drugs...and they don't get paid either.

[hiddencatRN, BSN, RN]

Thanks to EMTALA, people can already come to the ER for whatever regardless of their ability to pay. In principle I think it is good that emergency services are offered regardless of the person's insurance status or ability to pay. In practice, I see a TON of patients who should have just gone to their primary doctor instead of rushing to the ER (sometimes by ambulance) and we still treat them.

I don't see universal insurance increasing these numbers at all.

[Athena904]

Thank you for the encouragement. People are people whether nurses or not so I wouldn't expect anything differently as far as common decency. Glad for all the helpful comments though. Very interesting to one who has not entered into the reality of the "nursing" world yet. I will be sure to press through any obstacles :) No matter how brutal I hope it to be my pleasure to work as a nurse. Thank you again.

[BluegrassRN]

Oh for crying out loud, no one's "eating her". Give me a break. Disagreeing with someone, speaking plainly and bluntly does not constitute "eating one's young."

OP, you'll do just fine. You're naive and inexperienced, but you're thinking things through. Your initial post certainly seemed to contain some preconceived and in my opinion erroneous notions, but so what? A few months or years in the industry will give you a better understanding of the complexities of the issues.

[nursej22, MSN, RN]

In reading this link about the Affordable Care Act, I can't see any provision about handing out "free healthcare to anyone who needs it".

http://www.healthcare.gov/law/about/order/byyear.html

I see tax credits for small businesses, young adults being able to stay on their parents policies, help for seniors who reach the "donut hole", but nothing about "free healthcare".

What am I missing?

[tyloo]

I saw that you were truly sincere in your question but the context of it seemed judgmental. Healthcare is complex.

Drug addict hurts all especially the friends and family involved. Their behavior causes financial, physical, and mental devastation to the addict and the people on the receiving end of their actions. I don't think they will be breaking the financial bank going to the ER. Most addicts don't go to the hospital for a quick fix. They buy em' on the street or go doctor shopping. Narcotics are too readily accessible and you don't need to go to the ER to get them.

[JerseyBSN]

You'll have to treat the patient just like any other patient. It's the doctors call whether or not the patient gets pain medication. We can't judge patients.