Drug Seeker Stories - page 4

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... Read More

  1. by   Dixielee
    I have had that same situation where you are supposed to make sure they have a ride present after meds. I have seen them get into a taxi, drive to the end of the parking lot and get into their own car. I document that I informed the patient prior to the meds that they would need a ride or they qould be guilty of driving under the influence of narcotics, document them them getting into the taxi. Short of tying them up and throwing them into the taxi with instructions to the cab to not untie them till they get home, what do you do? What ARE our liabllities if we do all we can? At what point do people have to take responsibility for their own actions? Is this different from bar owners getting sued for allowing a patron to drink too much? Where do we draw the line?
  2. by   RN92
    I agree with TraumaIntheSlot. Alcoholism is not a disease - its a "character flaw". We all have genetic tendencies - but we dont act on them. I have many alcoholics in my family. One of which is on Disability!! So, me and other tax payers are getting the bill. Disease is a condition that you have no control over (except to be compliant with treatment). Alcoholism is a choice that we make.
    Another tell-tale sign of drug seekers is when the patient not only asks what you're giving, but wants to know what dose.
    At the ER, we(nurses,doctors) say that "we're not going to care anymore about you than you care about youself" (to the patients).
    I believe that seasoned nurses can tell the difference between real pain and faking/fudging pain.
  3. by   Nursingangel
    Quote from TraumaInTheSlot
    How "angelic" of you to be chastising your peers on this message board.
    I do not mean to chastise but I am coming from the veiw point of a chrionic pain pt., Who, in the past before I found a treatment that worked, had to go to the ER alot, and was acused of being a drug seeker, by some nurses and docs. I don't know if they did not care to find out the truth or where just so jaded that they did not care to find out that I had gone to 11 docs in 11yrs because all they did was throw pain meds at me, and I did not want to be on narcs the rest of my life. That I is One of the reasons that I am becoming a nurse is to help others that are Truly in pain and need help.
    Why do you say,ERSlave, that a sign of a drug seeker is to ask the dose? I ALWAYS did so that I could put it in my pain diary so that my doc knew EXACTLY what I was having to take to survive.
  4. by   z's playa
    Quote from Nursingangel
    I do not mean to chastise but I am coming from the veiw point of a chrionic pain pt., Who, in the past before I found a treatment that worked, had to go to the ER alot, and was acused of being a drug seeker, by some nurses and docs. I don't know if they did not care to find out the truth or where just so jaded that they did not care to find out that I had gone to 11 docs in 11yrs because all they did was throw pain meds at me, and I did not want to be on narcs the rest of my life. That I is One of the reasons that I am becoming a nurse is to help others that are Truly in pain and need help.
    Why do you say,ERSlave, that a sign of a drug seeker is to ask the dose? I ALWAYS did so that I could put it in my pain diary so that my doc knew EXACTLY what I was having to take to survive.

    I too ask the dose when I go in to the ER for migraine. So what? Wouldn't you want to know?To avoid asking a nurse what I'm getting like asking whats in a loot bag..I discuss treatment with the doctor first. If I go in early enough I can forgo narcs altogether and wouldn't want a hefty dose of demerol so early in the "game". Nothing like a surprise shot. (not) I also ask the dose of my Torodol since too much mixed with Maxeran gives me an adverse reaction. But I guess thats not drugseeking behaviour since it isn't a narc.

    My doctor gets the ER sheets sent to him so as to keep him informed prior to my visits.
    Last edit by z's playa on Sep 29, '04
  5. by   Victoriakem
    People with chronic pain often find relief using amitriptilline, for nerve pain, which is not taken care of by narcs. A fellow nurse went to a Pain clinic offered by a British nurse who said that using narcotics is not doing it for sufferers. She tried amitriptilline & it took a couple of months but she was able to return to work. Talk to your Doc about this.
  6. by   z's playa
    Quote from Victoriakem
    People with chronic pain often find relief using amitriptilline, for nerve pain, which is not taken care of by narcs. A fellow nurse went to a Pain clinic offered by a British nurse who said that using narcotics is not doing it for sufferers. She tried amitriptilline & it took a couple of months but she was able to return to work. Talk to your Doc about this.

    Are you directing your answer at me? (I'm too tired to go over all the posts to figure it out :chuckle ) I don't have chronic pain thank gosh just migraines once in a while, but I was on amytriptaline at one point and gained 45 pounds. I've never been quite the same. It didn't really help my headaches either, so the side effects far outweighed the benefits in my case. For people with a tendency to gain weight easily, I would never recommend it. I'm a skinny person with a high metabolism and poof..it was gone.
  7. by   Nursingangel
    I too tried amytriptaline when I was looking for a mirical IT WAS NOT IT! HA I started getting BOTOX for my chrioc debilitating migrains about 21/2 yrs ago and went from being basicly bedfast to working FT and in nursing school FT. Now I may get one med migrain in four months, and all I need is maxalt most of time.:spin: Thanks for trying to help though.
  8. by   mistyann
    When I worked ER we thought it would be fun to put a coin operated machine in the lobby. You know the "claw" kind where you can try for a prize. In it we would have unmarked bottles. Sometimes ya get percocet ect, sometimes ya get biscodyl or other mundane med. The revenue for the hospital would just roll in, hey and talk about laughs!!
  9. by   laurakoko
    I have read almost all of these replies and have my own story.

    My sister called me on a Saturday, complaining of abdominal pain. She is not one to complain. She said she couldn't stand the pain, abdominal pain, and I pointed her to the ED. The ED gave her nothing for her tremendous pain, dx her with a UTI, and sent her home. She did a a Rx for pyridium and abx. The next day, she called me again, this time, in SEVERE pain. I took her back to the ED. She was N/V, diarrhea, and could NOT STAND UP STRAIGHT. The nurses from the ED dept recognized her, from the day before and thought she was drug-seeking. Well, a CT, that was NOT performed the day before, that I, her sister, an RN INSISTED upon, revealed free air in her abdomen. She had diverticulitis, and her bowel perforated,( she ended up with an emergency colostomy. ) At the time, the ED still would NOT address her pain, or at least it took me screaming at the desk, to get her something for the pain. That was the saddest thing I had ever seen. I know this particular ED did NOT do their job properly, but PLEASE do not think that everyone that enters the ED without perfuse bleeding, acute chest pain, or trauma does not have pain. This makes me furious! I can understand why JACHO has implemented an entire assessment of pain!
    This past Thursday, she got her colostomy reversal, and the nurses on the floor were just as judgemental of her pain. She was hurting. She had an incision from her navel to her pubis area, and another to the L side (where the colostomy was). She was on a MSo4 PCA, and was not obtaining relief. The charge nurse finally came in and said, "look you have got to stay pushing that button." SHE WAS. Give thanks that I was a collague of her MD, and told him, as he changed her meds, and put her on a pain schedule that was all PO!!!!!! I have to trully wonder about those other patients who do not have someone to stand up for them........... Isn't this what NURSING is all about???????? Being an ADVOCATE for YOUR patient. I least I can go to bed knowing that I AM.
  10. by   z's playa
    Quote from laurakoko
    I have read almost all of these replies and have my own story.

    My sister called me on a Saturday, complaining of abdominal pain. She is not one to complain. She said she couldn't stand the pain, abdominal pain, and I pointed her to the ED. The ED gave her nothing for her tremendous pain, dx her with a UTI, and sent her home. She did a a Rx for pyridium and abx. The next day, she called me again, this time, in SEVERE pain. I took her back to the ED. She was N/V, diarrhea, and could NOT STAND UP STRAIGHT. The nurses from the ED dept recognized her, from the day before and thought she was drug-seeking. Well, a CT, that was NOT performed the day before, that I, her sister, an RN INSISTED upon, revealed free air in her abdomen. She had diverticulitis, and her bowel perforated,( she ended up with an emergency colostomy. ) At the time, the ED still would NOT address her pain, or at least it took me screaming at the desk, to get her something for the pain. That was the saddest thing I had ever seen. I know this particular ED did NOT do their job properly, but PLEASE do not think that everyone that enters the ED without perfuse bleeding, acute chest pain, or trauma does not have pain. This makes me furious! I can understand why JACHO has implemented an entire assessment of pain!
    This past Thursday, she got her colostomy reversal, and the nurses on the floor were just as judgemental of her pain. She was hurting. She had an incision from her navel to her pubis area, and another to the L side (where the colostomy was). She was on a MSo4 PCA, and was not obtaining relief. The charge nurse finally came in and said, "look you have got to stay pushing that button." SHE WAS. Give thanks that I was a collague of her MD, and told him, as he changed her meds, and put her on a pain schedule that was all PO!!!!!! I have to trully wonder about those other patients who do not have someone to stand up for them........... Isn't this what NURSING is all about???????? Being an ADVOCATE for YOUR patient. I least I can go to bed knowing that I AM.

    Thank gosh you were there. I've been in the ED on numerous occasions and usually i have my BF with me but on a few occasions he was unable to go. It really sucks when you're in pain w/ a migraine, lights hurt, you don't want to walk and you get put as FAAAAAAAAAAAR away from the nurses station as possible. It makes it hard to get anyones attention for repeats on meds or even a glass of water. I am a strong believer in pt advocacy as well.
  11. by   mantaray
    (This was posted in reply to someone on page 3 who questioned the experience/license of someone who wondered if an addict had received any care aside from denying him drugs..)

    Firstly, I dont think she's being naive. She's being humane.
    Secondly, she's not attacking anyone, she's just asking if there was followup, eg an appropriate nursing-oriented psychosocial intervention.
    After reading these posts it seems to me that the only intervention going on by RNs with both real and supposed drug-seekers is judgement.
    This kind of attitude - condeming, dismissive- is the thing that turns me off from ED nursing, which otherwise I think I would really enjoy.
    I understand that you see true drug-seekers all the time, and it is true that they are a burden on your time and the money and time of the system. I know that over time you (and I) create interesting ways of coping with what you deal with on a daily basis, like joking about it or becoming emotionally detached from your the crazy things around us.
    But it truly boggles my mind that so many nurses in the ED (and on the units) use their capacity to express empathy only when they judge someone to be deserving of it. If someone comes into the ED with septicemia from an abscess created by the use of dirty heroin-injecting technique, putting them in jail for being a junkie or a user is a thought that theoretically should never enter your mind, since law enforcement is not within our scope of practice. Caring for human beings is.
    Oh, and also, if you encounter drug addicts (alcohol and otherwise) on a daily basis, please educate yourself and think seriously about how arbitrary and hypocritical our drug laws are. I know drugs ruin lives, you dont need to give me a lecture about that, but we all know that in our culture it's quietly accepted and "ok" to give children speed and housewives benzodiazepenes though it makes someone a 'bad person' if they use the same drugs or others to self-medicate their pain 'illegally'.
    Some of the examples people have given could be legally considered assault (in terms of threatening to withhold meds) were the case to be that said individual was say, a young man with Crohn's truly experiencing severe pain and say, he knew what drug works best on his spasmodic pain. Sometimes pain really is what the patient says it is, let us not forget about that.
    We occupy a special position as nurses; we arent concerned with power the same way MDs have been historically. As a result, we tend to cling to any form of tangible power we might have. Let's try not to lord over those we consider to be weak just because we have special information and access to that which they are trying to seek.

    S

    "Be the change you want to see in the world." -Gandhi
    Last edit by mantaray on Oct 4, '04
  12. by   mantaray
    "At the ER, we(nurses,doctors) say that "we're not going to care anymore about you than you care about youself" (to the patients)."

    Does that "hard line" tactic really work?
    How realistic is that?
    I know you have to get hard at some point, maybe with a pt you see all the time but would you treat a new "user"/"seeker" like that?
  13. by   RNin92
    And please keep in mind that this forum is a place for VENTING frustrations which we encounter in our ERs across the globe.

    No one is advocating judgemental attitudes or care any less than compassionate.

    Please allow us this arena so we CAN be fresh and open minded and patient advocates.

    Please don't judge me, as you accuse me of doing to my patients.

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