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.

196 Answers

Specializes in Emergency room, med/surg, UR/CSR.

It is historically these drug seekers that don't get what they want that will get and respond to a survey. Our ER swears by Press Gainey and now the new Studer Group. :uhoh3: It seems like if you take the total number of patients we see in a month's time, subtract the admits that don't get a survey, then subtract from the remaining number the people that have been in the ER more than once in the past month (i.e. numerous times), and if ALL the remaining people got a survey, you still wouldn't have an accurate accounting of how well the ER staff takes care of patients. Yet, these inaccurate numbers are what management looks at. :angryfire Sorry, just a little pet peeve of mine.

As for drug seekers, yes, there are those that seek drugs and there are those that are legitimate about their pain. My experience has been that those that whine, yell or moan about their pain and ask for pain meds before the doc even sees them, are usually the ones that are in the least amount of pain. It's those folks that don't complain that you have to watch out for cause those are the ones that are being tough guys and trying not to be babies about their pain. These are the ones that are usually in enough pain to put a horse down, but won't ask for pain med or more pain med because they don't want to bother anyone.

I'm glad we have this forum to vent our frustrations without fear of being criticized. Sometimes we just have to let off steam and this is a safe place to do that as well as get support. :) For those occasional responders who do post disparaging replies, just remember, it may be you someday that needs support and a place to vent for your frustration! :) And the gang here at Allnurses will be there for ya!!!!

Thanks Allnurses!

Pam

Specializes in Me Surge.

I had one drug seeker who would change her name and social slightly, so she had a few variations. She filled out the admission forms with her first name spelled one way and signed her name spelled differently! On the same piece of paper! Of course will still had to treat her, whatever her name was.

Specializes in ER.

I was standing outside the door while one woman did the pee in the cup routine. When she opened the door, she still was holding the opened safety pin she had pricked her finger with, and she had not shaken the urine cup so the little blood drops were still working their way to the bottom of the cup. I had another man who used one of the metal dental picks to make multiple stabs in his gums to cause redness and bleeding to show how bad his tooth pain must be. and of course, most are allergic to NSAIDS, compazine, Imitrex..etc. but I rarely have anyone allergic to Dilaudid!

Specializes in ER, PACU.

I had a guy come in a few weeks ago screaming and throwing himself on the floor in triage..OK, this guy was in a week before with confirmed kidney stones..So I go to get the toradol to give him before I start the IV and fluids..He stops me and the first thing he says to me is "Dont give me Toradol, that stuff doesnt work, the only thing that works for me is 10 mg of Morphine with 50 mg of Demerol". When he says this to me, he stopped rolling around and spoke in a normal tone of voice. When I told him that was not happening, he then stands up and starts to yell at me that I can check his records and that he really has kidney stones, and that he gets that every time. I told him that the wait is about 4 hours until he sees a doctor, and he shouldnt waste his time waiting for narcotics because he wasnt going to get any. He then proceeds to sit in the chair, calmer than anything, not even squirming, nothing. He waits another half hour, and then starts to yell again that he wants his pain medication. When told that he will have to wait, he then threatens to walk out (dont let the door hit ya :devil: ) and proceeds to walk outside, have a cigarette, and comes back about a half hour later. He wound up waiting 5 hours before he was seen, and left without his drugs.

When I was a new grad 30 years ago a woman would perform realistic grand mal seizures. I was shocked when the doctor told me to give her a placebo (water shot). The doctor told me to tell the woman that it was a demerol shot. Seconds after I gave the "water shot" she immediately stopped having the grand mal seizure. She should have gotten an "Emmy award" for her truly realistic grand mal seizures performances.

:rolleyes: Got one better. I work in ICU and we have frequent flyers all the time. Sunday night I had a OD come in at 8:30pm, she was demanding a central line for narcotics. I told her she could have a Lortab; she rolled her eyes and said they didnt work. She said I have had at least 10 central lines before. Then she said, how am I gonna get fluids? I said drink them, maybe???

She said I want to leave AMA. Had the papers ready in 5 minutes.

So many patients, so little time :)

Pt "X", who calls 3-4 times a day, complaining of severe pain, but refuses to see his own PCP ( because pcp has put a drug seeking alert on his electronic chart).

Pt. "X" thinks that if he gets a different nurse each time he calls, someone will get him his drugs. One night I got him 3 times out of the 4 times , he had called within a 2 hr period. Boy, did I suprise him, when I told him that I had just spoken to him 20 minutes ago, and that my instructions had not changed.

Pt. "Y", who called after recieving Morphine injection in the medical office, took both short acting and long acting oral Morphine, when "Y" got home. Two hours later, recieved phone call stating her pain med was not working. I got hold of the on call Dr., who told me that "Y" was crazy, and that if "Y" wanted more med, then "Y" would have to meet the Dr. in the ER. "Y" refused to meet the Dr. in the ER and stated she would take a Tylenol instead. So much for severe pain:uhoh3:

After 21 years in the ER, last 17 in a Level 1, I now work totally in our Fast Track section, which I refer to as "CandyLand". A typical day:

Patient #1: I was opening my bottle of Tylox, and spilled them on the floor, my wife was vacumming and sucked up every last one of them. Prescription for 80 was given by ortho the day before. Hmmmm....can't you just empty the vaccum bag?

Patient #2: I have a prescription for 120 Oxycontin, don't have the money to get them filled. Can you call the Social Worker to see if they can get it filled and pay for it. Hmmmm....why not pawn the Mr. T starter set you have around your neck and on your fingers?

Phone call from local pharmacy: Mr. X is getting his prescriptions filled that y'all just wrote him. He doesn't want his Pen V K. Only his Vicodin. What should we do? If he doesn't want his PenVK, he can't have his Vicodin.

Patient #3: I'm out of Percocet and i'm going through withdrawal, I've called ortho and they can't see me til next week. Phone rings: This is the sec in the Ortho Clinic, we see Joe Schmoe is in the ER, we talked to him this morning and he has scripts up here waiting for him to pick up. Joe needs to learn that our tracking system can be viewed by most everywhere in the hospital.

Phone call from another pharmacy: Mr. X wants his Vicodin and not his PenVK. When will he figure it out, we aren't going to let them fill the Vicodin without the other.

By the way: both meds were written on the same script, so the pharmacy can't fill just one without our OK.

I could go on, I get real frustrated with these patients, but also get a chuckle out of them at the same time. I've asked management if I could make a banner "Welcome to Candy Land" to hang over the door, but for some reason they won't approve it.

One of my friends worked in LTC, and one night a guy with a gun came in.

He said, "Gimmee all ya dillyadids."

My friend couldn't figure out what the heck he wanted but finally figured out he was looking for Dilaudid.

One of our regulars was asking for pain medicine. The Doc ordered him some. When I went back to give it to him - he was sleeping/snoring. I said' "Mr. so and so, you must be feeling better since you're able to get some sleep?"

His reply was, "Oh, I was hurting so bad-the pain must have knocked me out"

Interesting, if you're in severe pain, it might "knock you out" - who needs pain meds? Just sleep it off (pain).

Specializes in CCU/ER.

We have several frequant flyer patients who ask at registration, before even seeing the triage nurse, "Which doctor is here tonight? Cause if it's that Dr So-and-so he won't care about me and give me what I need. I want to see Dr What's-his-name. He gives me the medicine I need." The most frustrating to me are the ones with true disease processes who milk the system. "The pain just never goes away...." But you just saw the patient driving around town hanging out with friends and laughing while on your way to work. When we're having a bad night, it is only complete when one of a few certain patients arrives. Then we know it's truly a bad night!!!

I don't think it is being an uncaring nurse as much as being a realistic one. If people really want help, they can go to Rehab. There is only so much time you can give to these people in a full ER and it is especially difficult when you know they are frequent flyers and have heard it all before. I think you are being a little too judgmental there yourself. :rolleyes:

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