Drug Seeking Behaviors?

mattsmom81 · Apr 12, 2004

I suggest that instead of going to the ER for emergency pain treatment you speak with your primary care physician. If he can't help you ask for a referral to someone who can. If your injuries are causing you this much pain I question the wisdom in your choice of nursing as a career. Have you researched the job description? Heavy lifting is involved. Your doctor should know this and I'm surprised he is supporting your career choice with what you have told us. Plus preemployment physicals are done where you may need to prove you can lift safely without injuring yourself. Can you safely lift 75-100 # 6 times from floor to chest level? (many nurses job descriptions call for this..mine did)

Not trying to discourage you but you need to be realistic, IMO. And most people who choose to run to the ER foir painkillers instead of getting regular MD office care DO risk possibility of being labeled a drug seeker. Maybe not fair but this is how things are. This is how drug seekers can operate, unfortunately.

Take care of yourself and find out why you are hurting, get proper treatment, and find a job you can do without hurting yourself further is my advice. Good luck.

I have severely injured my back and now have arthritis from over 20 yrs of being a nurse. No way would I choose this field if I had a bad back going in. Its the only back I got. Just being honest. The pain can get a lot worse, believe me. Take care.

jbro · Apr 12, 2004

have you seen a neurosurgeon, i hurt my back at work and required surgery, that was over two years ago and i haven't had any real problems with it since, besides ocasional aches and pains, but you should see a speacialist for pain management and treatment

Okay, here's the problem.
I recently began nursing school. I previously was a waitress, and severly injured my back. This was (is) a worker's comp. injury, and the proper tests were not done to determine the extent of the injury. Although my doctor has told me this will never heal, and I will most likely be in some form of pain, moderate to severe, for my entire life, he has classified this injury as a sprain.
I can not get relief for this pain. I am on diclofenac 75mg and skelaxen 400mg, along with an untold amount of Motrin.
I have been to the emergency room several times, complaining of the same problem. They, of course, have labelled me as "drug-seeking", and each time I leave the ER with a rx for Naprosyn.
Is there any possible way to change the ER staff's opinion of me? Although, yes, I am a drug-seeking patient, I am seeking these medications for a legitimate reason...
I am so frustrated. I don't work at all right now, and I am so depressed by all of this that I find it difficult to just go to classes, let alone do the huge amount of work required of me. I desprately need help here.

2ndCareerRN · Apr 12, 2004

What has already been said.

Go to your primary care physician for your pain management. The ER is NOT the place that should be accessed for the management of chronic pain.

bob

**canoehead, BSN, RN** · Apr 13, 2004

I agree, you need to find a doc that will work with you to get ongoing pain relief.

manna, BSN, RN · Apr 13, 2004

The other replies hit the nail on the head with this one. The ER is not the place you need to be seeking treatment. Get a referral to a pain management specialist if need be.

My brother is an ER doc who says when there is any question about pain seeking behavior, he usually gives the patient a non-narcotic and tells them to see their PCP or specialist the next day.

JLN1129 · Apr 14, 2004

I appreciate everyone's candor and advice. I know I need to get into pain management, unfortunately, being a worker's comp case, there's the question of what is "reasonable care". What I think is reasonable..ie getting me out of pain, is not what they think is reasonable...ie throwing medication at the problem.

the ER is my last ditch resort for those really really bad days...the days where I would drink dirty ditch water if it would make me feel better.

My PCP tends to lean towards the side of caution as well. He only sees me every 6 weeks, and occassionally...those appointments where I'm crying in the waiting room...he gives me 15 soma...which don't help the pain. They just make me sleep.

I really just needed to vent. It's good to feel like someone out there is on my side. No one in the healthcare industry really seems to be.

As far as nursing as a career for me...it may kill me...it may put me in traction one day soon...but if I can do it at all, I'm going to do it. There has never been a question in my mind about what I wanted to do with my life. I decided this when I was 6. When the boys played war, I played Army Nurse.

But, I have considered having a "back up" plan. I may not be hireable. Who knows what the future will hold, but again, thanks to everyone.

walterrn · Apr 16, 2004

For those of you that are going to slam me for bringing this up, let me just say that I'm tossing out one of many alternatives to chronic pain.

"Methadone". Many people enjoy life, free of pain with this med. There is a slight problem though. It is highly addicting and like all opiates, has no ceiling. Which means, that although it will work for awhile, tolerance sets in and you end up needing more medication to get the same relief. And since there is really no ceiling (a maximum amount of drug to take before respiratory depression or cardiac arrest sets in), you could end up taking large quantities daily. I've seen clients on 250mg QD walking around stating, "Oh my aching back."

And methadone is a real fun drug to detox off of. I've heard it described as taking little vises, putting them on every bone in your body, and tightening to the point of excruciating pain. That little scenario gets to last from 1-3 weeks, followed by 2-3 months of intense psychological w/d.

The warnings stated, I can say that it helps many people with chronic pain. The doctor will start you out with a 10mg dose QD. After about 3-4 weeks, it'll have to be increased to get the same relief (tolerance sets in quick with methadone). Once you hit 100mg QD (8-12 months later), find a nice little detox center for a methadone takedown, get back down to zero (going through the pain of the paragragh above) and start the process all over again.

Walter the Nurse

Tweety, BSN, RN · Apr 16, 2004

Walter, while I agree that narcotics are best for pain control. It might not be an option for nurses. Here in Florida we are not allowed to take narcs and work.

To the original poster. Why would you consider nursing if you already have severe back pain? You are not physically cable of performing the job duties required of a nursing student. This concerns me. You could injure your back even more. What about repiratory therepy, speech therepy, or something that isn't so demanding on your back. Sure there are areas of nursing that you can get into with an injured back, but first you have to get through nursing school.

Good luck. Sorry it's so bad for you.

rjflyn, ASN, RN · Apr 16, 2004

You say its a workers comp injury. One question and I ask this as my wife is a legal assistant for a personal injury law firm. Have you hired an attorney. If you are still dealing with the employer and the doctors they want you to see they have their best interests in mind and not nessessarily yours. Your next response may be I can't afford a lawyer, but most the time firms take these cases on a contingency basis, no money unless you get money.

Rj

RainbowSkye · Apr 16, 2004

I agree with most of the other posters, but wanted to add a couple of other things.

You have a lot of decisions to make. Depending on what area of nursing you choose, it can be brutal on your back. Many facilities will ask on your application if you've ever had a worker's comp case for a back injury, and although they probably don't advertise it, you won't be getting the job if you answer yes. (And you'll lose the job if you answer no and they find out.)

Worker's comp generally has a structured process you must participate in if you want them to pay your bills. It usually means seeing the doc they assign, and not using the ER. The ER is very expensive, and the worker's comp people want to save as much as possible.

Plus you get absolutely crummy chronic pain care in an ER. Trust me on this on, I've worked in ERs for over 25 years.

Also, please be careful with Soma. It can be quite sedating, and used with certain other drugs becomes pretty addictive. You probably should not be using it while on duty.

Take some time to educate yourself on back injuries to find out the newest treatments, and if and where they're available for you. Medications really are only a part of the therapy.

Good luck!

smk1, LPN · Apr 16, 2004

i would suggest preparing yourself now for a "non-clinical" path in nursing or at least low impact as far as lifting etc..... (school nursing, workers comp, dr. office, management, pharmeceuticals etc) hospital nursing and LTC may be too stressful on that injury.