So the last 8 days of my life have probably been the worst 8 days of my life. It started 8 days ago while I was fishing with the abrupt onset of a horrible headache on the right side of my head. Irronically I got called into work for a stat C-section so I took a few motrin and fought through it. The next day the headache was still there so more motrin and I worked a 12 hour shift. By that night, the headache was getting worse. By sat. evening it had gotten even worse. It was still unilateral and it's focal point was at the base of my skull and radiated up the right side just shy of my temple. Sunday was basically unbearable so Sunday night I went to my local ED to make sure I didn't have a bleed. I drove myself so I informed them I wouldn't be able to take anything for pain. I had a negative CT and the ER doc wanted to do an LP. I had no fever, no stiff neck, no nausea and had delt with an LP headache about 4 years ago so I politely refused. He offered me Lortab and I declined and requested Tramadol so I could still function. He also wrote for neurontin and tegretol thinking it may be trigeminial neuralgia. I saw my PCP on monday and she told me to hold off of the heavy neuro drugs so I only filled the Tramadol. She checked me and gave me a consult for a neurologist and wrote for steroids. I scheduled an appointment with them for Wednesday. Tuesday night was my worst night. Tramadol and 800 of motrin with 650 of acetaminophen wasn't touching it. I was also nauseas. I decided to go to the ED at the hospital my neuro has privledges incase they admited me for pain and obs. When I got to the ED, I gave them my history. They put me in a room and the doc asked me a few questions.
Here is where the offensive part starts. The Doc comes in and asks me questions. I give him my history. He offers LP and I decline again. He says he will start an IV and give me something for pain and I also asked for Zofran. Nurse comes in and gives Toradol 30mg and Zofran. Fine with me. Then, I don't see anyone for about an hour. I'm still in terrible pain. Nurse comes back in and I ask for water. She says she needs to check. 30 min. go by and she stick her head in to say she still is waiting for doc to tell her if I can have water. One hour later, another nurse comes in (this is not shift change by the way) with a glass of water and discharge papers. I'm baffled. I ask what this is all about and he responds that I didn't want an LP. No plan, no labs, no regards for my pain as far as I'm concerned. I ask him that if they are so concerned about a brain bleed and want to do an LP, than why did they give me toradol. He tells me that's not the only reason they do an LP and that they also check for meningitits. I promptly reply that I have no symptoms of meningitis. He looks at me baffled and leaves to get doc. While I'm sitting in the room, I hear someone in the hallway say "the medical professionals always know the right things to say to get them." Now I'm in severe pain and ****** off. The doc comes in and asks me what I want him to do. I tell him to help me figure out what is wrong with me and help me figure out how I'll survive through the night. He says he can give me a couple of pills and writes a script for 6 percocets. Fine. Get me the hell out of here.
I have never been so offended in my life. I plan to write a letter to the president of the hospital which happens to be in the same system that I work. I am not a drug user. I actually hate the things and still have 4 of the 6 percocet left, not to mention about 25 tramadol left. I have been taking Fioricet and motrin for the last 3 days with tegretol. Turns out I have Occipital Neuralgia which is a headache worthy of suicide. Today I received an Occipital Nerve Block. It is helping quite a bit. I'm not 100% but at least I'm not debilitated. So much for being a drug seeker. It's unfortunate that in today's society there are some many people addicted to these things but it's not fair to assume that everyone that comes in complaining of pain is drug seeking. I would love to see those nurses or that doc experience the pain I have experienced for 8 days and then tell me I was drug seeking.
Actually, Nick, the only thing that's obvious is that YOU are offended. Generally speaking, I couldn't care less about your experience at some unnamed ER, or what you think about ER nurses.
I ended up in the ER with terrible pain in my head.
I would let them do ANYTHING they wanted to, to help me get out of pain. Hell, check my prostate if you think that would of told you something, I wouldn't care. Just please help me!! Be a patient and not a nurse. Let the doctor practice medicine.
The question I have is, couldn't the ER MD get a neuro consult?? I don't know, I don't work in the ER.
Sounds like you got caught up in a mix of high expectations and some poor communication from the ER staff.
ERs are unfortunately in the business of throughput. You seem to have been well versed on your condition and what you were looking for. While you were obviously not seeking, you were there expecting some sort of assistance while ruling out many differentials that the ED doc was contemplating. This may have just been a case of the ED doc not knowing where to go next since all of his bases have either been covered by your provided history and previous encounters, or that he didn't like to be cut short with his choice of examinations and decided to let you settle with the zofran and toradol and rest a bit before sending you on your way.
While I can totally understand your frustration with your condition, I think that you may be going a bit far in writing letters and complaining. ERs are not places that cater to your every whim and desire. They exist for emergencies. While suffering is definitely an emergency, when you go in with the intent on asking for specific meds and then get mad when all you get is what you asked for and nothing more, I think you need to step back and look at it from the point of the ED staff.
How would you feel if a 36 week woman came in (I'm assuming you're an OB nurse) and told you that her water broke but that she is refusing a digital exam from you because she had a nurse with big hands hurt her with a previous exam? You can't go in and tell the staff what will and won't happen and expect them to be fully understanding of your situation.
I'm glad you're feeling better and that your have a diagnosis to work with though. Good luck with your continued care.
I have to agree with you. While it may not have been handled up to the posters expectations I see nothing negligent or even uncaring in the experience as explained.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
It's obvious the ER nurses are offended here. Maybe because they are being called out for their normal behavior. Fine. I didn't decline narcotics, I tried to use the least strength med that would work and when that no longer worked, I went back. Continue to treat your pt's this way and take nothing from this post. If I decide to write a letter to the hospital, its my freaking prerogative. I'm tired of all of the old jaded nurses (not all jaded nurses are old) labeling every pt in pain as a drug attic(the spelling is addict) It happens on my floor as well. The open minded nurses reading this may use it as something to think about. The rest of you will continue to walk around in your own little jaded world and complain about everyone who walks through the door. (are you not complaining?) Peace out.
I am not offended and I have been an Emergency Nurse for a lifetime. I also gave you a lengthy explanation of the EDMD's thought process which you stone walled at every turn. They did attempt to treat your pain........"He says he will start an IV and give me something for pain and I also asked for Zofran. Nurse comes in and gives Toradol 30mg and Zofran......that I didn't want an LP. No plan, no labs, no regards for my pain as far as I'm concerned"They did medicate you and labs weren't indicated
"I ask him that if they are so concerned about a brain bleed and want to do an LP, than why did they give me toradol. He tells me that's not the only reason they do an LP and that they also check for meningitits. I promptly reply that I have no symptoms of meningitis. He looks at me baffled and leaves to get doc." Have you ever had that patient that cut you off at every turn because they KNOW better??? Really annoying. I will also say that sometimes when we a medical professionals and we make it clear we are....we become our worse enemies. Medical professional assume we know the why's and how's of what they are or are not doing....and frankly we don't. When I was about birth I made it VERY CLEAR the I knew NOTHING about birthin NO babies!!!!!
You did decline narcotics...."Sunday was basically unbearable so Sunday night I went to my local ED to make sure I didn't have a bleed. I drove myself so I informed them I wouldn't be able to take anything for pain. I had a negative CT and the ER doc wanted to do an LP. I had no fever, no stiff neck, no nausea and had delt with an LP headache about 4 years ago so I politely refused. He offered me Lortab and I declined and requested Tramadol so I could still function."
I answered your request for the reasons for the thought process of your visit to the ED and you didn't respond. So I will assume that you agree. I am sorry you were upset at your visit and yes at times ALL nurses can afford to be placed into that vulnerable position of being a patient and frightened...I hope this experience can help you help your patients even more.
Oy Vey...I AM an ER nurse, and in no way offended.
OP went to first ER, refused recommended tx. OK, gets out, has F/U with PCP, neuro. Still had HA, but did not think to ask, in advance, for a back up pain med until he/she could finally be given a definitive diagnosis.
Then gets into a cycle of pain, and no recourse but to visit another ED, (first mistake- should have gone back to original).
OK, I am 100% with you so far....
Then, you don't get water in a timely manner, and you over hear a convo you "think" was about you.
Sorry....too many others have already explained to you how ER works, yet you don't seem interested in accepting any part of this that may have led to why you got the tx. you did.
Most patients who come to ED with non life threatening headaches do not leave with a definitive dx or tx plan. They leave with instructions to see the specialist.
ER is not a clinic, not a PCP, not a specialty office.
We are there to treat emergencies.
Get over it. You should have called the on call person for your PCP or neurologist and had a scrip sent to a 24 hour pharmacy if you were unwilling, once you re presented with the same complaint, to undergo the desired work up and testing that this second ED MD advised. (the LP)
As asked earlier- what exactly did you want the ER to do for you? You got a stronger pain med (which you should have taken the first time offered, and avoided the whole second trip to begin with)
And your suicide comment??? Did you verbalize that while at either visit??
Disregarding the first ER doc's advice for the tegretol or neurontin, whichever it was that was Rx'd...why??
You went to an Er and basically chose to direct your own care anyway. It's not a buffet where you pick and choose what you want. The doc develops a care plan, and is not simply throwing in pieces willy nilly. There is a reason for what he or she advised.
I am sorry you had this tremendous amount of pain.
But, I am even sorrier you chose to ignore the standard of care MD recommended tx.
Had similar experience with a gynecologist....and, I have seen this gynecologist three times. Went in because I was somewhat remiss on my annual and had one cycle that was early by three days. My gynecologist switched hospitals and therefore did not have access to my information. He completes the Well woman exam and tells me that I have an endocervical polyp and, because the stalk is wide and he does not have electrocautery equipment in this office, he feels uncomfortable removing it there. I have no issues with this at all. This is fine with me. He then tells me that he would like to do a d and c and a hysteroscopy. He also recommends birth control pills. Noting my apparent anxiety...he tells me that "I can come in next week and sign the papers then." I said: "ok" I was "ok" outside of the office. The gyno handed me educational pamphlets, none of which indicate the complications of the procedures, to read. I was also ok on the ride home with all of these procedures...however, when at home, out came the books...and I went from ok, to not ok, to hot you-know-what by the time the next appointment came. On arrival at the next visit, my BP of 157/70 clearly indicated that there was to be no signing of consent forms. Stood in the office and refuted this doc. This doc then turned around to me using the tone of a two year old who was refused dessert, "I need to get my sample." Let's just say I held my tongue...as we were standing in the hallway. Will never to return to this doctor. My PAP/HPV are neg, CBC is normal, and mammo is neg.....sorry TA123, wish doctors would behave as though student nurses and nurses had a brain. Folks, this is the situation I used for the basis of my post Ethics 101...should nurses just stand by, not act, when a doctor advises a patient of a need for a procedure that is not necessary, and carries complications? A dilation and cutterage, according to my new gyn, is an old fashioned procedure...and, no, I didn't grill my former gyn in front of the new one.
To NickB: Did you initiate any discussion with the nurses or doctors questioning why you felt that they felt that you were seeking drugs, or is this something you actively observed but did not question at the time?
To all: Is it wrong for nurses/nursing students to be proactive and become knowledgable in there own care? Why or why not?
I didn't get what the provider did wrong in the OP's scenario, and I missed it in this one too. They gave their opinion, you decline, so where's the conflict? If you make a suggestion and they say no and explain their reasoning, same thing- it's a discussion right? Seriously- I'm missing the problem behavior, unless either party is confrontational and aggressive, but I don't see it.
Specializes in Addiction, Psych, Geri, Hospice, MedSurg.
think how much more humiliating as a nurse it would be to be labeled as a drug attic.
Hmm... I can't imagine being labeled as any kind of attic. That is where the old stuff and cobwebs are. Now, are you talking about being a drug ADDICT? (Ok, sorry - but I had to.)
It seems like you are making much more out of this than there is. Simply put, you can't be 100% that they were talking about YOU just because it happened outside your room.
I've been talking about family, friends, co-workers, visitors, and other pt's outside doors... not talking about the person INSIDE that room - even if the situation is similar. I suppose you'll say, now, that you are the only one that was in the ER at the time?
I'm not an ER nurse. I work with addiction... and frankly, I am upset simply because you hit a pet peeve of mine - judging "drug seeking behavior". (Not that you were - but you think they were accusing someone - possibly you - of doing it.)
A person coming into the ER or hospital is there for a reason, drug seeking or not. Yes, if they are - huge waste of time and resources - but they are generally there because they are sick and can't get their fix... so, they are legitimately sick.
It is not our job to play rehab nurse and judge addictive behavior if that is not our specialty. Just like everyone is saying don't play ER nurse, or LD nurse - if that is not your field... why is it ok to play rehab nurse? *THAT* is my pet peeve.
Back to your letter... Write it if you feel that strongly about it, but it will probably be as harshly critiqued as it was here. What you went through wasn't bad at all. At least you were medicated and treated. I can think of plenty of people in my life who haven't even been able to receive that at some ERs.
Like someone said, their job isn't really even to treat you - it is to ensure you are not suffering from an EMERGENCY, and if you are treat the EMERGENCY and send you on your way. You tied their hands by telling them you were, basically, in the worst pain of your life... and then told them what you would and would not take for the pain and what tests you would and would not allow.
What's worse than being labeled as drug seeking as a nurse? Being labeled as non-compliant, since we all know what it is like to work with those types of patients.
I'm not complaining about freaking water. I'm not offended by the fact that maybe they didn't know what else to do. I'm offended that I was labeled as a drug seeker because I complained of pain. I'm offended that they spoke loudly enough outside of my room that I heard them. I'm offended by the lack of communication. I'm offended by clear assumptions and a negative attitude because I declined a senseless test that carries its own set of risks. Of course I listened to my pcp. She's knows way more about me than an ER doc who has never seen me before. As a matter of fact, he was the ER doc at my first visit and he did an exceptional job. He included me in the plan of care and factored in my thoughts and opinions. It was the people at my visit later in the week that I have issue with.
In response to someone else's post. I have never had a baby nor will I ever have a baby so if someone tells me something they are feeling, I don't ever make biased assumptions about it. I listen to them and try to work through it with them. I'm sorry you have found a way to be okay with doing that. By the way. The ER doc did nothing for me. It was the pain doc two days later that did something for me. But at the time, I was experiencing a pain that I'm sure the majority of you have never experienced and I wish none of you will ever have to experience. That is why I went back to the ER.
We are all sorry for your pain and glad it has resolved. But I still don't understand why you would escalate this experience by letter writing etc. Of course it is your choice, but in breaking it down it seems you were in pain,upset, felt that you were misunderstood and unvalidated. Maybe you had different expectations since you worked at the facility. Maybe you expected to be treated differently than other patients? And when you were not you became upset and indignant.
And I don't think your comment about the old jaded ED nurses is helping your cause here on this forum. Most of the ED nurses provided good info and valid points.
I have had such a similiar experience. My partner had had surgery on a fissure and it had become infected- I'm talking giant hole seeping like a faucet....she was in tremendous pain and our private specialist OBVIOUSLY wasn't able to help at midnight when she was in searing pain (I didn't even attempt to call of course because it was midnight!). I gave every single possible pain relief that I could at home and in the end took her to the local emergency department. She was in so much pain she could hardly move so I threw on some tracky pants and a hodded jumper on her. Once there they took her through to a room- and advised me I wasn't able to go in because it's "family only" (we are a lesbian couple, we own a house together, and are by law recognised as a defacto couple). I sat there after being told NUMEROUS times 'no, family only' until finally at 4am she was in so much pain she walked in to the waiting room and opened the door for me to go through. Once there she was in tears of pain, I could not believe it! She hadn't been seen and hadn't been given pain relief- I stood at the counter while two nurses were out the back, patiently waiting and FINALLY they looked at me. I asked why she hadn't been given pain relief and they looked at each other like "yeah right"...hadn't even looked at my partner! They had NO idea what her pain was in relation to! I was advised "we don't give pain relief to people unless they have seen a dr and he is busy". I politely advised her that I am aware that they can contact the Dr for a phone order...funnily enough they did this.
When the Dr came a further 2 hours later my partner was in so much pain- he didn't look at her physically (honestly the hole was about the size of an Aussie 20 cent piece and STINKY infected), and said "what do you want me to do". I must say, it took a lot of strength NOT to say something nasty. We had waited 6 hours in there before a Dr saw us, my partner was in tears of pain the entire time, and I was forced to wait in the waiting room for 4 hours because "I wasn't family".
I politely requested he contact the specialist for advice, WHICH HE DIDN'T...he gave us a discharge letter with the WRONG diagnosis on it. I promptly contacted the specialist at 7am and he had her admitted to the private hospital and in surgery by 10am, on huge antiobotics and pain relied, and advised it was the worst infection and condition he had ever seen on someone her age.
I complained and nothing ever happened, not even an apology...
What bothers me about your experience is the ER doc wanted to do a procedure to rule out something, but you refused it. I get that you didn't have S/S of meningitis, but he was trying to cover bases and felt it was warranted. So your complaining of this severe headache and you won't let them continue the work up. Those are the patients where I'm thinking , seriously? Then why are you here. Get out of the ER. I can see why they would think you were drug seeking. Sorry.
mazy
932 Posts
Again, I am just so completely confused by and suspicious of the "drug seeker" part of this story.