Drug seekers

Published

I'm sure this has been posted before and I would appreciate any links to good threads on the topic. I am a new nurse and struggle with giving strong opiates like Dilaudid, etc to people who are clearly pain seeking. I feel dirty. Yesterday I had a gentleman who was ordered 1mg Q6. He was a clock watcher. As soon as that six hours was up, he was on the light. The reason he was getting this is because during the previous shift he threw such a fit yelling, screaming etc to have it the physician ordered it. Looking through his history, this is his pattern. Usually in the ER he yells and screams and demands IV Dilaudid. In this country there are a lot of people addicted to opiates because they are often over prescribed and these types of things feeds into that. As a nurse, one of our responsibilities is to encourage health and I feel more like I am contributing to a societal problem than helping a patient in situations such as this.

I don't want this to be a "pain is what the patient says it is" argument. I am talking about the rare instances where someone is clearly a drug-seeker.

Specializes in Med-Surg, Oncology, Neurology, Rehab.

I wish one day some nurses would stop passing judgement on patients that State " they are in pain". I don't understand how a nurse can feel "dirty" by giving pain medication as ordered. The legislature has pass the law years ago to treat patients,for their pain,how did this come about because a doctor was treating a terminal cancer patient and ordered tylenol because he did not want the patient to become ADDICTED to pain medicine! So lets stop passing judgement about whether a patient is in pain or not.

Remember when you point one finger three are pointing back at you.!

Blessings to all!

Up Vote Up Vote ×

I hurt my back 24 years ago so I am aware of chronic pain. I also am an adult NP, and all my chronic pain pts are under opioid contract. You get a rx for X Percocet or Norco per month, I can call you for random urine any time I want, there cannot be any ETOH ot illicit substances in your urine, no ER visits or "Dr. hopping," no after hours calls for refills. I still get calls: my 3-year-old daughter dumped my (2-day-old) Rx of my month's Percocet in the toilet, can I get a refill?" Sure, after I call CPS for you having your Rx in your daughter's reach. "Never mind, she really didn't." "I had just gotten my Rx filled, and was eating in a restaurant and my purse got picked." Okay, I will refill your antihypertensives, etc. "Oh, no, they only stole my Percocet." Really? You were eating with others and they did not notice someone going through your purse reading all the med labels?!?! I can go on and on but you get the idea. I am not stupid enough to believe all the stories people try to "feed us." And yes, I am in pain 24/7/365, but I am still not stupid and gullible. "I take my meds JUST AS PRESCRIBED," yet there are none in your urine and there is ETOH and heroin. I NEVER prescribed you heroin. So you are selling your Percocet and buying heroin. Nice!

Up Vote Up Vote ×
Oh good grief. Anyone who says giving ordered 1mg Dilaudid q 6 (with a freaking percocet for good measure) to a patient with a horrible chronic and painful disease makes him feel "dirty" is being JUDGMENTAL. Talk about "shame throwing!"

This is why nurses, especially new ones, leave the profession in droves. Many times, it's because of the treatment they receive at the hands of other nurses.

Up Vote Up Vote ×
Specializes in Hospice.

Sorry, but if they are upset at being held professionally responsible for the quality of their care, they should leave.

Up Vote Up Vote ×
Specializes in Cardiac, ER.

To the OP I understand your frustration. As an ED nurse these patients wear me out! I do want to clarify that I am talking about the extreme patients. I am not talking about our frequent flyer chronic pain patients that I see twice a month. I am talking about the patient I see 4 times in a 12 hour shift! The patient that comes in by ambulance and EMS explains that they picked him up from the parking lot of another hospital and he still has a name bracelet on! I am talking about the patient who is so drunk/high that he has urinated all over himself and falls asleep mid sentence but still finds time to yell and swear about his chest/leg/back pain. I am not exaggerating, I can think of 10 of these patients right off the top of my head!

It is these patients that make me feel like an enabler. I am supposed to believe that "pain is what the patient says it is" and cater to these patients. It insults my intelligence to have to 'play along" with these patients. I do feel very sorry for these people and I agree with others who would much rather have some one tell me they are withdrawing from A, B or C than to lie, get rude and make up stories to come back in 3 hours. It is a HUGE waste of resources and pulls me away from patients that are genuinely wanting my help.

Up Vote Up Vote ×
Specializes in PACU, ED.

OP, I don't worry about whether someone has pain or is just trying to get stoned or to stave off withdrawal. I don't work in a rehab. No matter how little narcotics I give, there is no way we can cure addiction in my area. We have a different focus; life, safety, comfort.

Treat your patients with kindness and with meds as ordered.

Up Vote Up Vote ×

If it's ordered and there are no contraindications I just give it. At times I will annoyed by obvious drug seeking but oh well that's life. Nothing I say or do is going to change the fact that they are addicted and can't cope with life.It's pathetic really.

However, I draw the line when they start berating or harassing me. I am not kind when that happens.

Up Vote Up Vote ×

No panties here. I go commando.

Up Vote Up Vote ×
No panties here. I go commando.

Hahhahaha! Is this in response to don't get your panties in a wad? 'Cause that's pretty funny.

Up Vote Up Vote ×
This is why nurses, especially new ones, leave the profession in droves. Many times, it's because of the treatment they receive at the hands of other nurses.

Which has absolutely NOTHING to do with the subject at hand. That's a total straw man if I ever saw one. So everyone should totally agree with what someone posts or else they are guilty of driving that poster out of the profession? Really, read what you just wrote again. It's just nonsense. Expecting everyone to validate anything one writes is completely unreasonable. Agree with me or you are being mean! Sorry, if you post on this forum, you must expect to get feedback, not all of it agreeing with your premise. People who cannot tolerate a differing opinion have no business posting threads on widely read message boards that are designed with this premise that members may disagree.

Up Vote Up Vote ×
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Yes, I've sent patients home with no scripts from the doctor, after they were just taken off 3 weeks of round the clock I.V. meds, switched to p.o. for 2 days, then the doctor refuses to write them a script for pain. Wonder what these people do?

There's a woman selling oxycodone in the parking lot of my local grocery store.

Up Vote Up Vote ×
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
A small warning - "MI" in the context of this thread will be read as Mental Illness, even if you did mention earlier in your post that you're talking about motivational interviewing.

And here I was thinking "myocardial infarction."

Up Vote Up Vote ×
+ Join the Discussion