my drug-seeking nurse patient

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Ok, do you guys remember the patient I had who crushed her percocet and pushed it thru her port-a-cath and occluded it? If not, here is a copy of the thread...

https://allnurses.com/forums/f8/getting-percocet-thru-port-cath-285794.html

Well, she is back and with a vengeance! :banghead: First thing as Im coming onto my shift, she rings the callbell 3 TIMES before I am able to get to her room...wanting pain medicine. She is a nurse who lost her license due to narcotic abuse. She knew it was change of shift, and as a fellow nurse she should have known not to act that way. We, as nurses, know not to act that way because we know and understand how shift change is hectic. :grn:Well later, she claimed she had a seizure. I walked into her room and she was awake, alert, watching tv, no signs of any seizure activity at all. She claimed she did though. :icon_roll She also claimed she had been vomitting, but keeps forgetting to save it...flushes it everytime. She claims there is blood in her urine, but refuses to show us any of her urine. She refused to give a urine sample in the ER until they threatened her with an I/O cath to obtain a sample..then all of a sudden she could pee...no blood in it by the way. All this after chasing my orifice taking her Dilaudid IV and Phenergan IV all day around the clock. :smackingf Well, I didnt call the doc when she claimed to have had a seizure...what exactly would I tell him? She was fine, had just painted her toenails and asked me if I liked the color, she had eaten a ton and drank a ton of pop, chocolate milk, etc. But yet she needed her Phenergan. grrrr. Well, anyway, when the doc comes to the floor he is upset with me that I hadnt called over her "seizure" and I assured him that I had seen NO seizure activity. So he ordered an EEG stat. Of course it showed nothing. She even told me it would show nothing.."it never shows anything." Then to top it all off, I go into her room and she has picked the dressing off her port and as Im re-dressing it and adding IV extension tubing, she starts fluttering her eyes, she wont answer me for about 10 seconds, and then looks at me and says "what are you waiting for". I took her vitals, all WNL, made dang sure that I called the doc. He comes to see her. She tells the doc that I told her she had a seizure, I said NO SUCH THING. He assessed her, tells me she is crazy and leaves. I felt like :selfbonk: by the end of the shift. I ran out of that place as fast as I could. Its people like that who make me HATE my job.

Specializes in Med/Surg, Home Health.

oh also, we had a nurse who worked in ICU and was stealing the patients' ativan and going into the bathroom and injecting it into her veins. She also came into work on her night off in her house slippers and gown and was firing off orders at the other nurses and writing orders in the patients' charts. She then came to my floor and visited her soon-to-be-exhusband who was a patient. She got mad at him because he didnt want her there and she ran out of the room and SLAMMED the door and almost broke it off the hinges. This happened about 6 months ago. They finally fired her last week over something. Nurses who are addicted need help. Instead the facilities are covering up for them and docs continue to prescribe the meds until finally they have no choice. I dont understand it

Specializes in Med/Surg, Home Health.

And our facility makes us keep the patients we have. We cant "trade" or switch around from day to day. Its just the rule, so whoever is the lucky one to have such a patient ends up exhausted by the end of the week.

Specializes in ICU/Critical Care.
When patients are known to be faking seizures do you call a psych consult?! I've never had this happen as of yet so just wondering.

I would try and make sure that all the nurses have to take a turn with her as patients like this are exhausting.

Sweetie, that patient I wrote about in my post was being seen by a psych doc. The bad part was that fact that her mother thought her seizures were real. Not only did she fake seizures, she faked respiratory distress. That night I took care of her, she started her stridor routine, I told her to knock it off. Respiratory was listening to her lung sounds and said she could tell it wasn't true stridor and after I snapped at my patient, her lungs were all clear. I'm telling you this girl was a walking psych case, she got herself intubated several times for faking her respiratory distress. They did a videotaped 24hour EEG, which was normal by the way, but the girl sat straight up, and said to the nurse, just wanted to see you jump.

Specializes in Med/Surg, Home Health.

I have discussed with their doc about a psych consult, but its ultimately up to the doc to write for the consult (at my facility anyway).

And our facility makes us keep the patients we have. We cant "trade" or switch around from day to day. Its just the rule, so whoever is the lucky one to have such a patient ends up exhausted by the end of the week.

That's absurd. Patients like this should be split up. I'm sure you are exhausted and stressed after days of her.

Sweetie, that patient I wrote about in my post was being seen by a psych doc. The bad part was that fact that her mother thought her seizures were real. Not only did she fake seizures, she faked respiratory distress. That night I took care of her, she started her stridor routine, I told her to knock it off. Respiratory was listening to her lung sounds and said she could tell it wasn't true stridor and after I snapped at my patient, her lungs were all clear. I'm telling you this girl was a walking psych case, she got herself intubated several times for faking her respiratory distress. They did a videotaped 24hour EEG, which was normal by the way, but the girl sat straight up, and said to the nurse, just wanted to see you jump.

I guess the mother is in denial that her daughter is mentally ill which only makes it worse. I guess the cycle just keeps continuing. What a waste of money and time for all involved.

Specializes in med/surg, psych, public health.

smilies-6913.png [in Reply to busyrnandmom]

:eek: :bugeyes: :eek:

[in reply to busyrnandmom]

P.S. off topic, but I have to tell you I love your sleeping dog

avatar; the dog is so cute!

Specializes in ER, TRAUMA, MED-SURG.
oh also, we had a nurse who worked in ICU and was stealing the patients' ativan and going into the bathroom and injecting it into her veins. She also came into work on her night off in her house slippers and gown and was firing off orders at the other nurses and writing orders in the patients' charts. She then came to my floor and visited her soon-to-be-exhusband who was a patient. She got mad at him because he didnt want her there and she ran out of the room and SLAMMED the door and almost broke it off the hinges. This happened about 6 months ago. They finally fired her last week over something. Nurses who are addicted need help. Instead the facilities are covering up for them and docs continue to prescribe the meds until finally they have no choice. I dont understand it

Hey chenoaspirit - you hit the nail on the head! So many facilities would rather just sweep it under the rug, or terminate the employee but keep the reason a secret. I have seen both happen in our town and believe me, it does more harm than good. I can speak from experience, I have been an RN in recovery for 7 yrs. and I was lucky enough that my facility reported me to our state BON. Yes, I was angry, but it kept me from killing someone. That facility is placing themselves at risk by ignoring it.

Anne, RNC:banghead:

Specializes in ER, TRAUMA, MED-SURG.
And our facility makes us keep the patients we have. We cant "trade" or switch around from day to day. Its just the rule, so whoever is the lucky one to have such a patient ends up exhausted by the end of the week.

Oh, and the rule your facility has about keeping the same patients day after day, THAT IS ABSURD!!! Just in my opinion, there is nothing wrong with rotating patients, wherther it is patient request, or staff request.

So much for staff morale!

Anne, RNC:twocents:

Specializes in Assisted Living, Med-Surg/CVA specialty.
When patients are known to be faking seizures do you call a psych consult?! I've never had this happen as of yet so just wondering.

I would try and make sure that all the nurses have to take a turn with her as patients like this are exhausting.

Yes, I had a pt who was "faking seizures" at one point. When I had her as a pt she came in with CVA but was non compliant with meds. Was on Dilanton and Phenobarbital, both lab levels were very low but MD never ordered any bolus doses of either. Had a szr with me, which I dont think was fake, but apparently continued to have like 15 seconds of "seizure activity" and then would wake right up and be fine, no post-ictal state at all. Eventually got a psych consult.

Specializes in Psychiatric.

When I worked inpatient psych we would have this one guy who would come to the nurses' station every night around 8 and fake a seizure...he would get up after a few minutes and ask 'What did I do wrong?' LOL:bugeyes:

Specializes in ICU, CV-Thoracic Sx, Internal Medicine.

Addiction is a disease process, even though the medical society has been slow to acknowledge this. There are few treatment options for drug addiction for the regular joe off the street. Insurance and Medicare coverage is inadequate in offering coverage for treatment. Usually only the very wealthy have the means to take advantage of intense addiction rehabilitation programs/treatment centers.

My advice would be to remember instances such as this. They are tragic and costly. Starting with the impact on the professional life of your "nurse-patient," her family, her community, and now your facility.

A quick glance at what is lost:

1. Personal income

2. A productive tax paying citizen

3. A nurse (as it is we don't have enough)

4. Now becomes a burden on family

4. Financial burden to the healthcare system and hospital

Believe it or not but there are actual political forces that have a vested interest in NOT recognizing drug addiction as a disease process. Let me just say that the majority of incarcerated persons are in prison for drug related crimes. Let's just hypothetically say that drug addiction WAS RECOGNIZED as a disease process then all of those prisoners would require treatment for their drug addiction. That's alot of $$, maybe enough $$ where a blind eye is turned.

I know this sounds like a conspiracy theory kinda thing. But I'm taking a graduate research course on drug addiction and it has really opened my eyes to this problem through a global perspective.

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