abusers and losers. Can you top this one? - page 3

Last monday, I had a lady come into triage with a godawful, pity-me limp. She proceeded to tell me that she had terrible pain from her low back radiating into her left leg. She offered up that... Read More

  1. by   Robinellah
    I think your ER doc is a jerk. To give saline and suggest that they are getting pain medication is a wonderful way to lose your pt trust. If it is not illegal it should be.
    He should be called in to answer any questions that the patient may have about what the medication is and what it is used for and if he lies to the patient he should be reported to the Medical Board....he gives docs a bad name. I wouldn't give the medication under false pretenses.
  2. by   teeituptom
    Hi Ya'll

    After many years of debating the pain control issue. and the frequent flyer issue. and the abuser issue. Maybe I should say decades now. Multiple, ahh well. I have the easiest and least stressfull way to deal with this issue. Leave it to the doctor to decide, how he wants to handle it.
    If someone is fraudently using the ER to obtain narcotics, what can you do. Can you notify the police. No Its a HIPPA violation.
    If someone is faking pain to obtain scripts. If you deny them pain control even if it is all subjective they can notify and you can be spot inspected for this by the state health department, or whoever they complain to.

    Is it worth the stress you inflict on yourself to fight this issue, Not really. Been there done that too.

    Been chewed on by administration over this issue.

    Why fight it, The victories are too few and the satisfaction too little.
  3. by   Robinellah
    I work for a pain management doc and see a lot of drug seekers/abusers.
    It always seems like the one that you doubt the most is the
    one who inevitable has cancer that has metastasized or
    herniated disc flattening their spinal cord or some such very painful physical problem.
    Alot of the time they are addicted by the time they see us just from the meds they are prescribed for chronic painby their GP.
    The tolerance that is built never stops amazing me. I don't know why half of them are not dead from the sheer quantity of "dope" that they are taking. Yet they continue to walk thru the door...Scary part is they normally drive themselves...
    We actually drug test some of our patients to make sure that they have pain meds in their system.
    We have pts on Oxy and MS Contin that test clean.
    Some of them have had these meds prescribed for years for what the diagnostic tests show to be a very painful lesion or whatever.
    But basically they don't hurt enough to take their pain meds.
    When we find one like that we take that many drugs off the streets. Talk about a war on drugs.
    It's a lose lose situation.
    And as someone else mentioned...we are not going to cure their drug addiction.
    Pain is subjective.
    Sorry I am rambling...2 am and beat down. heading to bed.
    Have a good day all...
  4. by   Scis
    If only these types (of which there are many) would use their brain power for the greater good imagine what a world we would have! It never ceases to amaze me how ignorant they think we all are! Patty :roll
  5. by   RNPD
    . My seekers are usually allergic to toradol, motrin, and tylenol. I had a women once, in again for migraine, 3rd time in one day, anyway, doc told her she would get demerol shot, ordered toradol, Patient left without any allergic symptoms and no pain 10 minutes after the IM toradol.

    Sounds like an extremely dangerous, unprofessional game to play. What if the woman was truly allergic, and had an anaphylactic rx? Then both the prescriber and yourself would be in a lot of legal troubles-that is malpractice!

    I don't think our job should include "busting the liars". As others have stated, we can't rehab them in an ER visit.

    I think it is up to the ER docs to decide what to do on an individual basis. I think it is up to the nurse to carry out those orders if they feel they are safe and appropriate for that moment. If not, tell the doc, the sup, whatever. But don't judge. Even addicts have pain.

    That said, I know it is extrememly frustrating to have to deal with people who are obviously lying & drug seeking. But that is part of their illness, as well. Who are we to say what s/s are acceptable to us for rx and what s/s are suspicious so we will refuse to rx?
  6. by   JOY LEE
  7. by   Uptoherern
    re:teeituptom, etc. I figure...why should I let the docs give these people rx's, when I know that they are wasting MY time! I don't over extend myself being super "nurse-cop", but I do consider it time well spent, when in a few seconds I can deduce that a patient has been seen in a sister facility recently. AND, having visited that facility has recieved narcotics that should have sustained them for longer than...oh, say one or two days!... I will not put up with the people who abuse the system!!! If the only thing that I accomplish is that they know better than to come to MY er, then so be it.................... they can waste some other nurses time. At another facility. .........................I rather enjoy it.
  8. by   AZEMS

    i work in phoenix and feel your anguish. I like you give everyone a equal chance to tell their story and get treated as if family. But out here its horrible. People abuse and use ER's like I've never seen. Its time nurses take the upper arm and make patients establish TRUST. If they expect the same then we should from them. Good job I think many times we feel like cops. With the need to investigate the WHY they are here and the objective facts for their needs
  9. by   teeituptom
    Hi yalll

    The trouble now ERdiane is that any facility that gives you such info is in violation of HIPPA. When other ERs call us about known drug abusers we cant offer any information about even if they had been seen here. Sad but true. HIPPA protects the abusers of the system very much so.
  10. by   Medic946RN
    HI All!
    First post on this board, stumbled upon it by accident, but what a nice accident! I have been a paramedic for 24 yrs and now am a baby ER nurse. I was absolutely stunned by the amount of drug seekers that come into my small community ED. There's a couple of them who come into the ER three and four times in a 24hr period, now that's dedication. One of ths doc's I work with has taken to giving the identified regular seekers Haldol. And it works! The patients state they feel better and leave happy. Pretty amazing huh!
    I also run into the pt's who are allergic to every pain med but their drug of choice which is usually dilaudid or oxcycontin. I even tested one seeker one night when she asked me what was in the syringe, I told her hydromorphone. She got real upset stating the MD promised her dilaudid for her pain. Once I explained it was the same thing she calmed down. Did I mention that she had been in twice earlier that day, strangely her visits seemed to coincide with the physcian's shift changes. What were the odds?
  11. by   Uptoherern
    teeituptom: We have a computer link between our hospital and our two sister facilities. One has a similar name, the other is completely different. I'm able to access pt.'s visits, and am able to determine reason for visit. I think since all three hospitals are owned in the same area by one owner, it is not a hippa violation. I don't actually talk to anyone....I can easily get info out of the computer.