Drug Seeker Antics and Dramas

ZAHMAN · Jun 22, 2004

I'm not an ER nurse, but in the ICU we have our fair share of addicts, ETOH patients. On one occasion we had a pt. who was on our unit for almost two weeks for DT's. Well, he would become beligerent, physically and verbally abusing the staff during his admission. On one occasion his abuse towards me become escalated (Seeking ativan). This particular day I called him on his bluff. I told him Mr..... I've charted that you were alert and oriented and acting appropriatly. If you decide to hit me or any of the other staff from now on I will notify the police and file charges against you. Well I got called a few choice words, but he became very cooperative with the staff and was discharged the next day. Makes me wonder if he had any warrants.

ZAHMAN

z's playa · Jun 22, 2004

Let me see if I can keep "the rules" straight:
1. Don't be too "familiar" with names of medications (esp. it it's a pain med).
2. Make sure you know the name of the med that works for you; don't be coy and "pretend" not to know.
3. Make sure you puke your head off.
4. Don't puke...if you can puke, that means you were able to eat, so you couldn't have felt that bad.
5. Make sure you wear sunglasses in the ED; you can't have a real migraine if the light doesn't bother you.
6. Please skip the melodramatic stuff like wearing sunglasses in the ED.
7. Please don't bother the ED with something like a migraine...there are people out there with "true" emergencies, and you just hold us up from taking care of them.
8. Stop being so judgemental by assuming that all ED nurses think that migraine patients are a nuisance.
9. It would help to expedite things if you bring in a letter from your primary care doc that outlines a plan for when you have a severe migraine.
10. Please do not do something as lame as bringing in a plan for when you have severe headaches...it's probably bogus, and even if it isn't we still think you're a seeker.

:rotfl: :rotfl: :rotfl: I'm printing this!!!!

RN92

I know where I fit in..it's trying to get some other people to realize it that's the problem..... and fab4 just said why. Sad but true. Even if we don't match the criteria at your ER...no matter what we do... we match it at ours. :stone

Why back off? You have your side and unfortunately we have ours.

teeituptom, BSN, RN · Jun 22, 2004

I've been less than impressed with that one over time (and still the potential cardiac side effects.) You had to admire the "Drop" power of droperidol .

I loved droperidol also

but its been yanked

**canoehead, BSN, RN** · Jun 22, 2004

Perhaps the patients and the nurses should go play seperately on different threads? Both sides have a need to vent- but not to each other.

You know what they say- if you don't like what's being said on one thread, start your own, but hijacking someone else's thread is considered rude.

stevierae · Jun 22, 2004

What ever happened to Cafergot for migraines? I got migraines until my early 20s. Don't know if I outgrew them or pregancy somehow "cured" them, but my migraines vanished when I was pregnant with my first child at 24, and they have never come back. Cafergot worked great except when I was nauseous, then I got Compazine as well.

Quickbeam, BSN, RN · Jun 22, 2004

I have a non-nurse colleague who suffers from awful migraines. For a while,it was the ED, all the time, every week, with the requisite feelings that no one liked her, was suspicious, etc. I told her to ask her MD to set up a plan to help her avoid the ED....scripts, standing orders, home supplies. It has taken some work but she hasn't been back to the ED more than once in 6 months.

I'm sure EDs don't want to see headache sufferers any more than people with a raging migraine want to be there. What I don't understand is why MDs and insurers aren't more pro-active at avoiding it. I think it is very do-able.

Kayzee · Jun 23, 2004

Let me see if I can keep "the rules" straight:
1. Don't be too "familiar" with names of medications (esp. it it's a pain med).
2. Make sure you know the name of the med that works for you; don't be coy and "pretend" not to know.
3. Make sure you puke your head off.
4. Don't puke...if you can puke, that means you were able to eat, so you couldn't have felt that bad.
5. Make sure you wear sunglasses in the ED; you can't have a real migraine if the light doesn't bother you.
6. Please skip the melodramatic stuff like wearing sunglasses in the ED.
7. Please don't bother the ED with something like a migraine...there are people out there with "true" emergencies, and you just hold us up from taking care of them.
8. Stop being so judgemental by assuming that all ED nurses think that migraine patients are a nuisance.
9. It would help to expedite things if you bring in a letter from your primary care doc that outlines a plan for when you have a severe migraine.
10. Please do not do something as lame as bringing in a plan for when you have severe headaches...it's probably bogus, and even if it isn't we still think you're a seeker.

Great response!!!!

[email protected] · Jun 23, 2004

i get migranes as well. i have found that when i feel them coming i have 5 minutes to take action or i am sick for days. well when i was in highschool (puberty) i found myself getting them very often. my mom would have to take me to the er when they became to bad to handle, unfortunatly demeral is that only thing they would give me. but since i came in asking for shots of demeral (remeber been in pain for 12hrs by then) i would have to sit for 3-4hrs and wait so they could be sure that i was not just looking for a great high. now i am imune to demeral and doctor look at me like i am insane when i ask for percaseds

teeituptom, BSN, RN · Jun 23, 2004

Had one last night

I will be a lil vague for hippas sake

pt c/o renal colic

got IV, labs,ct

No renal colic

ED Md refused pain meds

then pt walked out and across the street

called EMS to take the person to a different ER

we are the base station, We called report, The ER nurse said is coming to us.

recognized pt by history..

LTC_LPN · Jun 23, 2004

I have had migraines since my daughter was born in 1988 (c-section w/epidural). I've only been to the ED twice in the last 3 years, tho, but each time I couldn't help but feel as if the nurses were "rolling their eyes". And it doesn't help when they stand just outside your doorway talking to each other about your "complaints". Last time I went, my BP was 130/78 with a scale of 8/10 for pain after 2 hours onset. (I have tension headaches on a regular basis and take either Fioricet or Lortab when a really bad one hits.) But the migraines, with the classic N/V, lights, etc. do me in. last trip, I had Toradol and Phenergan, repeated x 1, then Demerol 50 and 25 more of Phenergan. Not to mention I have no health insurance - working for a local nursing home, and I don't go to the ED unless I'm DESPERATE for relief. But still, even going to the doctor's office c/o headaches is bad. As a nurse, I hesitate to even ask for pain relief because everyone suspects everyone else to be a seeker. (thank you, small town America...) My last visit to my doc, I actually asked for an RX for Lortab, as the Fioricets weren't helping much. He wrote the prescription, but afterward I felt worried....as if "state" was gonna come knock on my door and drug test me. That's my biggest fear - testing positive on a drug test. I don't drink, don't smoke. No past HX of drug use. Even though my meds are legal, I still don't like taking them...but how else can I deal with the pain when it hits? Also, I have macular degeneration in my R eye and other vision probs which don't help with my situation. I just hate that I feel so bad... and have to feel worse just to get better.

kids · Jun 24, 2004

Perhaps the patients and the nurses should go play seperately on different threads? Both sides have a need to vent- but not to each other.
You know what they say- if you don't like what's being said on one thread, start your own, but hijacking someone else's thread is considered rude.

Bumping this with a reminder that the purpose of this thread is to provide an oppertunity for ER nurses to vent and having to defend their feelings while doing so is NOT appropriate.

Education is good in the right environment, this is not it. I would suggest that someone start a migrainers support thread where those who feel they have been labeled or had other negitive experiences when dealing with the ER.

As is been done with this thread the moderators will make every attempt to keep it on topic and avoid hijacking as is being done here.

RNin92 · Jun 24, 2004

Bumping this with a reminder that the purpose of this thread is to provide an oppertunity for ER nurses to vent and having to defend their feelings while doing so is NOT appropriate.
Education is good in the right environment, this is not it. I would suggest that someone start a migrainers support thread where those who feel they have been labeled or had other negitive experiences when dealing with the ER.
As is been done with this thread the moderators will make every attempt to keep it on topic and avoid hijacking as is being done here.

Muchas Gracias..Many Thank Yous