Drug Seeker Stories

Specialties Emergency Nursing Q/A

Well I had one of those lovely drug seekers the other night. Patient said she had a kidney and was peeing prue blood. Well, I had her get a CC urine. When I went back to get her urine, I noticed her finger was bleeding and some blood spots on the sheet. And her urine was a weird pink color. So I told the doc and he had me cath her....her urine was completely clear. Of course, she tried to make up a story about how sometimes she pees blood but sometimes pees clear too. Whatever...sent her out the door...

Also had someone come in 3 times in one week who used a new name everytime. Turns out he was going to ER after ER in my city using differents names for drugs...sent him out the door and to jail.

How about "I'm allergic to 2mg of dilaudid. But I can take 4mg okay."

We have an interesting and effective way of dealing with these drug seeking, experienced consumers of healthcare services ( love that phrase!)

After we determine they DON'T have pathology...and treat them with the NSAID dijour, we look at their face sheet and if they (invariably) live more than ten miles away from our ED, we put their address into mapquest, print up a map, and put little red dots on the map to indicate the approximate location of all of the hospitals they passed on the way to our ED....

This, all done with the highest degree of compassion( with a straight face) and, with the hope that their future care is not delayed due to their being unaware of the resources available to them closer to their home.

I can see what you are saying acutecarenp; however, I would like to add an exception to this. I rarely go the ED myself. However, when the rare instance comes up (and hasn't in nearly 4 years), I go to the hospital which I feel is the best. My PCP and other doctors are in the same system. They have records immediately available to them from every doctor's visit I have within the last several years. If I have to go on that rare instance, it's nice to know that all my records are available to the ED docs. Easy for me, and them. On the way to that hospital, we pass two other hospitals where we could stop, but then I'm left explaining everything to them. Anyway, I certainly don't want to be a wet blanket, but there are reasons to pass up other hospitals. I do hope you understand what I'm saying. BTW, I didn't notice the date on your response. This is a thread from 6 years ago and I'm not sure you are here.:)

enchantmentdis - I am so sorry that this happened to you. ((hug)) Obviously you did not deserve to be treated this way by management, nevermind that patient who had self-inflicted injuries and was demanding all his drugs at once. I got mad just reading your post. Although I am happy that you were able to get a new job, it really stinks to be in a position that you have bills to pay and no way to pay them and you are getting cut off. Oh, hon,I wish I could do something for you... I just got so angry that a hard working nurse got fired due to his insatiable appetite for drugs. Hang in there, hon. ((hug))

Kellie626 - Patient - "I'm allergic to 2mg of Dilaudid, but I can take 4mg Dilaudid." This made me laugh so hard! What are some people thinking?! Maybe a few points for creativity, but, still... one of the stupidest things I've heard in a long time. Just when you think you've heard it all... Thanks for posting that, I, for one, got a good laugh out of it.

Miss Julie - Now those are the sort of unbelievable stories that have entertainment value. It's really amazing what drug seeking people will try to do in order to get more and more and more drugs. They just don't realize that CII drugs are so highly controlled and watched via systems by the state. They may think they are clever and fooling the system, but what a rude awakening they get when caught! Bless your heart for putting up with their tactics. It's too bad that people in true pain have to get behind these yahoos...

Can I leave you all with my one story of someone not getting their drugs in the ED? It ends with true appreciation for our ED nurse who helped us. The early morning of our planned vacation, DH sat straight up in bed and told me he had CP and felt that he needed his BP taken NOW. Since he was undergoing EXTREME stress with his job, this was one of my fears, that the way he was going he was going to end up with an MI or CVA. Since I didn't have a cuff with me, I took him to a 24 hr pharmacy and discovered that his BP was elevated. Even though I suspected that this was stress, no way was I going to mess around with this. We scooped up our sleeping daughter and went to the hospital. Pretty soon they had him on monitor. And then, the most wonderful, most appreciated thing happened. His nurse came into the room, explained in detail what was going on, what could happen next, and did an excellent job calming our fears. Keep in mind that she had worked 7p-7a. She could have taken that time to finish up her charting and getting ready to give report (oh, I forgot to mention that this was about 6:20am), and just getting herself ready to go home; however, she took quite a few minutes to take time to explain to our family what the labs showed so far, what we could expect, etc., and as stated above, spent a bit of time with us, in an honest way, to calm our fears. This was just sooooo appreciated.

I didn't say that right before she came in, there was a huge disturbance next door. As the walls were a little thin and the voices violent and loud, I overheard everything. A man and a woman got violent because they felt that the nurses were doing nothing for whoever was the patient, and began yelling because he wasn't getting narcs IV ("The one that starts with a "D"!!! You people don't listen and don't care, and you aren't even giving me something for home" - that was the gist of the convo). They were freely shouting all the swear words in the book and physically fighting whoever was in there. Now, I work in L&D on staff at a local hospital, so I've heard my share of words, but my 3 y.o. was so scared. She got in the corner with tears in her eyes, and started sucking her thumb heavily. I wanted to take her out soooo badly, but in order to do so, I would have had to pass the commotion (which had gone out into the hall at this point) to get to the WR. Also, the nurse who had spent so much time with us, could have had to take time away from us to tend this this person, but she felt it more important to spend time with us....

I can not begin to tell you all how much we appreciated this. So much so that when we came back from our short vacation (hubby was just fine and the ED doc insisted that he go on vacation [he was thinking of canceling]), I called and asked to speak to the ED manager about how this nurse had gone way above and beyond, and how much we appreciated her. I only got her first name, and "BSN" from her scrub top, but I'm sure they can look at the records to see who we were talking about. I even wrote her a little thank you note, but I'm not 100% sure she got it. I hope that she did.

I know that this is quite long, but I just wanted to say "thank you" to all the ED nurses who spend time which they don't have because they are concerned about their patients well-being. I can not adequately convey how much this is appreciated. I just want to say "thank you." I know that this post is so long, but wanted to convey to those who may be discouraged, there are more patients who appreciate you who may not voice their appreciation. I admire you all!

Again, "THANK YOU" sometimes just doesn't cover it. :yeah::flwrhrts::tku: :hug: :kiss

mmutk - I really don't think that it's stupid, or should be embarrassing for someone of any age to go to the ED for chest pain. You did the right thing, obviously as there was pericarditis discovered.

Stories like these always remind me of the two-time gold medal pairs skater, Sergei Grinkov, who died in 1995 of an MI while practicing. He was married to his partner, Ekaterina Gordeeva, and she was with him when he went down. It turned out that a genetic disorder caused him to have a massive MI. This guy was an athlete, in very good shape, tested frequently in Russia to be sure he was in top physical condition. Autopsy showed extreme blockages as well as evidence that Sergei had a small MI the night before. If he had not ignored the pain, he may be with us today. He was 28 years old, his wife became a widow at 24, leaving her to raise their three year old daughter, Daria. :crying2:

Didn't mean to hijack this thread, but obviously, if one is having CP, most of the time an ED visit is appropriate.

I just reread my post and it looked like an 8 yo typed it. Sorry.. No wonder I got no feedback, and No I am not a nurse. I have no clue about what really happens in your ER's, on a daily basis and I will never claim too. I have never had any issues with any nurses, and have always appriciated their ability to take care of any pain I was having promptly. It's MD's I have the beef with. I am gonna try to make sense this time. About 2 weeks ago I was at the local ER, I have chronic Migraines, that day had been day 2 with a horrible migraine, slight fever and neck stiffness. When I got to the ER, I was seen quite quickly, the second the doc heard "Migraine" he got that glazed look in his eyes, he told me to bend my neck down, so I did with some stiffness, which was worse if I bend my neck backwards, and I told him this. He didn't do any type of exam, and left it at that. The nurse came in with IV and drugs in hand. I was given Regulan, Benedryl and Toradol. I went with it, usually it never works when the headaches get this bad, but I was desperate for any relief. 45 minutes go by and the doc comes back in and asked if it worked. I said no, nothing at all. He got snippy and asked what works and I didn't beat around the bush, I said Narcotics!! I said Dilaudid. I specifically said, I am not asking for it, I will take anything you think will work, he ignored me as I repeated it and walked out of the room. 5 minutes later they gave me a large amount of Dilaudid and sent me home after another few minutes. I am NOT a seeker, well scratch that, yes I am!! I was seeking relief to very real pain, and was treated like a druggie. I was so mad I called the hospital and told them what had happened. They were nice about it, and said the doctor had disiplanary (spell) action taken against him. So he was wrong not me. I was so messed up from the Dilaudid that night I still don't remember much of what happened that night AFTER the med was given to me. The dosage was way too big. Unless that med is meant to really f you up.

BTW I went to my PCP and was told the reason for those symptoms was because of a bacterial infection I had in a wound that I hadn't paid much attention too. DUH!! Blood test!! Bacterial infections can be detected in blood samples, and isn't a work-up usually done for migraines with stiffness in the neck? Thanks Alot Doc!:mad:

Specializes in Peds/outpatient FP,derm,allergy/private duty.

First we aren't allowed to give medical advice here, so the below is just some general information and not a recommendation that you do or not do any of it.

I'm sorry you had such a difficult experience mommanonurse. Many Emergency Room docs see the same types of complaints and the same requests and unfortunately, that causes some to jump to conclusions. It sounds lke the doctor did a quick assessment for meningitis and probably some things to rule out a stroke if you told him about your past medical history about "a little blood clot in your brain". It can be very difficult to rule out every single possible reason for a headache in an ER visit. They don't have the resources to readily view your complete medical history, such as CT scans, etc.

If you told them "I have a migraine" he may have automatically decided you were "one of those", and you're right, it isn't fair. Sincere and straight-forward patients do get labelled as seekers, because to be honest, the true "seekers" demoralize the staff after a while.

It isn't always true that an infection somewhere in your body will cause you to have bacteria in your blood. It could indicate an elevated "white cell" count, but that means your body is responding to an inflammation or infection (usually) but not where or what type of infection it's trying to protect itself from. A small infection can lead to a big one or full-blown sepsis or bacteria in the blood, which is very serious and life-threatening. (That's how Christopher Reeve died), so don't delay in getting that treated.

It's always best to see your PCP on a continuous and regular basis, excepting rapid worsening or sudden onset of symptoms that don't fit your regular pattern. Hope you are feeling better!

I love that we can see visits from other facilities within the same company.

Provider: What brings you in to the ED?

Patient: Back pain

Provider: Have you ever had back pain before?

Patient: No

Provider: Are you currently on any medications?

Patient: No

RN: Are you still on the 4mg of dilaudid 5x daily, the tramadol, the lorazepam, the morphine, percocet, vicodin...?

Patient: No, I don't know what that is for.

RN: Looks like you've been treated for back pain in the past...most recently a few days ago.

Sounds about right to me.

Specializes in Emergency.

One of our frequent flyers came in over the weekend. Has no actual medical hx, just constant vague c/o pain. Many allergies, except to morphine. Anyway, told us had gb removed 2 weeks ago in out of area hospital. Now has abd pain. When asked why surgery was 200 miles from home, pt was evasive. Pain always 10/10. Can regularly be busted by ninjaing into room where pt is typing on laptop. As soon as pt sees me, falls back moaning.

Manipulative with an enabler spouse. Time actually stands still when you have this pt. It's like your shift will never end. And still not our most annoying....

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Can regularly be busted by ninjaing into room where pt is typing on laptop. As soon as pt sees me, falls back moaning. ... Time actually stands still when you have this pt. It's like your shift will never end.

BWA HA HA HA HA!! I almost snorked my coffee when I read this, it's one of those universal truths/patients ...

I am curious as to how you treat a frequent flier when they have real pain? I have been to the ER 2x in 6 months. Both for stones, the first time the doc treated me like sh**, he had the nerve to ask me if I wanted to seek treatment?! I said yes, I want to seek treatment for this pain. (I knew what he really meant.) He gave me some toradol, that stuff is a joke for stones. He did this just because I don't scream and yell and cry when in pain. I am quiet, and I move around a lot to find a comfortable spot. The 2nd time I went is because again I had a stone. I was quiet, and moving around while holding my stomach. This time they got a CT and I was diagnosed with a stone and calcium deposits. AND given real pain killers. Morphine

Specializes in ER.

mommaNonurse

I've seen toradol work like a miracle for stones, so that people that were thrashing and crying don't need other meds. Of course sometimes it doesn't work that well at all, but he wasn't blowing you off by giving you toradol.

Toradol = miracle drug. [tu] Made the first 24 hours after a c-section pain-free! Only had trouble with pain after it was d/c'ed.

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