Drug Seekers

Editorial Team / Moderator · May 18, 2014

I find humor in just about everything.. But drug seeking is not one of them.. But that's me. It's frustrating, pressing resources, the situation almost always ends up chaotic.

I feel the same way ... it's just not constructive conversation to me. I derive no real amusement from this population because I feel like it's just become lose-lose. If they get what they want, we all lose. If they don't get what they want, we all lose. It's sad and not something I like to dwell on, if that makes sense.

BrooklynRN11201 · Jun 15, 2014

I see a ton of drug seekers in my ED and it is sad, but it is also extremely frustrating and a burden on the whole system. I don't see anything wrong with making fun or talking about these people behind their backs - we do that to plenty of other patients, it makes the job a little easier to harbor a sense of humor about certain situations.

I think the OP was curious about specific stories so I'll give him/her exactly that:

Out of the umpteen sickle cell crisis patients I've seen come through the ED so far, only ONE was actually in a sickle cell crisis. They always know exactly what they need - dilaudid. Some of them walk around, talk on their cell phones, even go outside for something to eat while their waiting. And we can't do much because "pain is what the patient says it is" - then, when the Dr (rightfully) doesn't want to order anything but oxygen, fluids and maybe one dose of morphine until we get labs back, these people absolutely flip out from threatening to sue to threatening to kill to taking their "business" to another hospital. And I'm sure they do - it's not uncommon for a drug seeker to come in with multiple other hospital bracelets on - so out of it they don't even notice.

And don't get me started on the blatant liars! "I'm alergic to ASA, Tylenol and Motrin... they gave me, oh what's that drug called, mor... morph..." yeah right. Or the ones who come in with elaborate stories about how they just had some surgery they can't remember the name of, and they don't even realize we have access to ALL their previous visits and can see how many times they came in for pain in the last month."

I've actually had my life threatened before by one of these patients and now am looking over my shoulder when I enter/exit the building and carrying pepper spray. So yeah, these patients and their addictions are VERY sad, but the ER isn't a place to come to get high, and I have no problem making fun and sharing my frustrations about these people.

TheGooch · Jun 15, 2014

I see a ton of drug seekers in my ED and it is sad, but it is also extremely frustrating and a burden on the whole system. I don't see anything wrong with making fun or talking about these people behind their backs - we do that to plenty of other patients

Wow, that's just sad that you think it's excusable to laugh and make fun of sick people who have put their health in your hands.

Just sad............................................................

OrganizedChaos, LVN · Jun 15, 2014

I don't work in the ER but I heard this lovely convo.

So I went into the ER with n/v x 3 days & 36 weeks pregnant. I fill out the paperwork & wait for the triage nurse to get me & send me up to L&D. Well he comes out & asks who hasn't been seen yet. I raise my hand & the woman across from me says,"I haven't & I was here first!" If I wasn't so sick I would've said something.

So the man calls report to L&D & I'm waiting in a w/c to go up when he's triaging the woman. He asks her, "If we give you pain meds again, you're not gonna disappear are you? Her to him, "No, no!". I felt bad for him.

CaptKris · Jun 19, 2014

Ever have a patient start flooding the sinks in the ED because dilaudid is not prescribed...

other great responses

I'm not an alcoholic but someone has been spiking my gatorade with vodka

I don't know where that 1.75L bottle of vodka came from but I didn't drink it

Nahh man I'm just seeing if toilet paper is really flammable.

Don't you have IV xanax? If my roommate can melt it down and shoot it up then you think some drug company would make it.

This hospital morphine is crap, my street morphine is way better and push it faster or I don't get the rush.

I could do this all night...

BrooklynRN11201 · Jun 19, 2014

Wow, that's just sad that you think it's excusable to laugh and make fun of sick people who have put their health in your hands.
Just sad............................................................

sure, okay, spin it like that.

meanwhile, I think it's entirely closed minded and unrealistic to expect to be mother superior to everything that walks through the door. did you get licensed to care for the sick or did you get licensed to help get drug abusers high and then to babysit them to make sure they're still breathing? how on earth is medicating a drug seeker "helping" them?

talk to them, educate them, refer them to programs, call social work to assist, etc. - I do that all the time. but the ones who don't want help, who come to the ED to get high for free, who are nasty manipulative liars? yeah, I get that this is their coping mechanism, but I also don't have to be played by them and I believe I can laugh about the sadness of the situation every now and then.

aeris99 · Jun 19, 2014

sure, I believe I can laugh about the sadness of the situation every now and then.

I truly hope that you or someone you love never gets caught up in an addiction. That's an awful thing to joke about.

emtb2rn, BSN, RN, EMT-B · Jun 19, 2014

I truly hope that you or someone you love never gets caught up in an addiction. That's an awful thing to joke about.

Have relatives with substance abuse issues. And yeah, I laugh at some of the seekers that come through. From your posts, I see that you don't have ER experience. Come work with us for a few years, see if your outlook changes.

And I'm not laughing at them per se, it's more about the performance art and audacity of the seeker.

Guests · Jun 19, 2014

Part of how many ED docs and nurses (not to mention cops, firefighters, and EMS) avoid burnout is to laugh at some of the goofy and even tragic stuff that people do to themselves.

And some of the stuff that people do and say - particularly around narcotics - is just ridiculous

toomuchbaloney · Jun 19, 2014

In my view dealing with drunks and substance abusers is part of working in the ED. When people get too caught up in that drama and begin experiencing negative emotions about those patients it might be a sign that burn out or other issue is at play. Those patients are, have been, and will continue to be a staple group of frequent fliers for the ED. Forever. No matter what you or I think.

If I can't find compassion for young unmarried women in labor I shouldn't work in L&D,

If I can't handle crying and screaming children I shouldn't work in pediatrics,

If I can't tolerate walking into a cluttered filthy home to provide nursing care I shouldn't work in home health,

If I can't find compassion for those who suffer from addictions and substance abuse I probably shouldn't work in the ED.

LadyK,RN · Jun 19, 2014

While it is true that there are many people drug seeking, I urge you to remain compassionate and LISTEN to your patients before you judge them. I have a very dear friend who has been unable to keep a job and therefore insurance because she has a rare disorder called Sphincter of Oddi disease that has just been diagnosed now that she has insurance under the ACA after finally undergoing and ERCP. I mention her because of the countless times she has gone to the ER over the past several years in excruciating pain to be dubbed a drug seeker and under medicated and discharged. She has nearly died a couple of times due to dehydration and electrolyte imbalances related to vomiting and been septic due to undiagnosed pancreatitis. As an RN I am embarrassed when she relays the barriers she has received to care. We must be careful not to stereotype people, even the frequent flyers who drive us crazy, without ensuring that there isn't an underlying, legitimate cause to their pain. As her friend, I have instructed her to carry MD documented medical history/summary with her in hopes that any future episodes that she has are met with understanding and compassion.

aeris99 · Jun 20, 2014

From your posts, I see that you don't have ER experience.

You're correct that I don't have professional experience in ER. Just personal experiences that leave a sour taste in my mouth. Mother with Lupus who was labeled a drug seeker and hypochondriac for 10 years before finally being diagnosed. Also experience with my own round of inappropriate labels. I can see how it's easier to laugh but your OP still seems as though the patient is being ridiculed.

In any case I'll chalk it up to posts not expressing the correct inflection.