Believing your patient

Nurses General Nursing

Published

Specializes in ER, Med/Surg.

How are you able to believe anything a patient tells you when you have proof that they have lied about some of the things they tell you?? How can you care for someone when you never know if anything they say is true or not?

This is short and not well thought out question.

Thanks,

Pat

Specializes in ICU/CCU/CVICU/ED/HS.

I work in ED and ICU and we have a saying... Rule #1, The patient always lies... The answer to your question, however, is that we as nurses(most of us) have a caring spirit about us. I will continue to care...:twocents:

Specializes in LTC, Med-SURG,STICU.

People lie period end of story. I believe very little of what comes out of anyones mouth. I do not take it personally. It is what it is and people are what they are.

How do I continue to treat people who lie? I do not think about whether or not they are lying while I am taking care of them. I try to see around the words that they are speaking and treat the true problem. I know I am not wording this right, but I guess I go by what their body language is saying. In my opinion, a person's body language can tell me a lot more about what is going on with a person than what they are telling me with words.

Specializes in ER, Med/Surg.

What about someone who is wanting pain medicine, who has a drug screen positive for opiate and cocaine that is still telling you that they need something for the pain......"Oh, it's killing me....the pain.......whhaaaaaaaaaa"

I KNOW most everyone lies, but you have to believe them, or at leasst that is what they tried to brainwash me into thinking in nursing school. I have a patient currently who has answered twice, when asked, "Do you use any street drugs?" "No." Even though I have her UDS that shows THC. I KNOW she is lying. It is hard to take anythingg she says as being true.

(sorry about the typos, this computer has probblems)

Pat

Specializes in COS-C, Risk Management.

Do you honestly think that someone who has a substance abuse problem doesn't have pain? On the contrary, the substance abuse tends to create a high tolerance level for narcotics and they need more to achieve pain relief. Sure, there are some (many?) who will lie and be drug seeking, but unless you are working in a substance abuse clinic, the pain is what the patient says it is and should be treated accordingly. Some may not consider marijuana to be a street drug, as well, reserving that category for things like crack, heroin, meth, etc. Please don't become yet another jaded nurse. You don't have to believe them, you just have to treat them to the best of your ability.

Specializes in ER, Med/Surg.

I believe they have pain. I also believe they should get with a doctor and get it taken care of, not self-medicate with illegal substances, then come to the hospital sayinng they hhaven't taken anything, which could lead to an overdose.

Marijuanna is a street drug the same as every other thing you listed. I'm so sick of people saying, "It's JUST pot". It is illegal until it is made legal and no where here is it legal. Taking your moms oxy's is "street drug use" too.

I was a jaded EMT long before I became a nurse.

Pat

Thing is, you have to treat them for pain while they are under your care. That's all.

Other than the usual teaching... "get some help, here's how" on discharge, you can't legally give them "hard knocks" care. All you can do to protect yourself is to discuss lab results with MD for consideration. Assess before you give, during giving, and after giving - -always repeating that too much too fast can do more harm than good. Chart away.

Specializes in ER, Med/Surg.

I remembered something about a drug causing false positives for THC.

Turns out tthat Protonix can cause false positives on urine drugs screens. This pt. is taking Protonix.

So, I will admit, it could be wrong and I falsely judged. I'm human, it happens!

FYI: The patient recieved the same level and quality of care I always give, and I've never had any complaints.

Pat

Specializes in Med/Surg.

Why do people assume that having opiates come up on a drug screen means that the patient is either, a drug seeker, or lying about their pain (I know that cocaine came up as well, and that's not the part I'm talking about). I am on a long-term extended release narcotic, so I will always have an opiate + drug screen. That doesn't mean I don't ever have pain, or that I'm doing something I'm not supposed to be.

That way of thinking makes me sad, and it also makes people fear seeking treatment for pain that's out of the ordinary, since they know they won't be believed.

You're there to do a job, to provide nursing services to people, not to become BFF :). People lie and manipulate to get their needs met (we all do, to some degree). Sounds like you (the OP) are maybe taking this a little too personally. Just stay professional, do your job, and "keep on trucking." :smokin:

Specializes in ER, Med/Surg.

If you are up front and when you are triaged say, "I'm on Oxycontin". Then when it comes back in your system (at leastt in my mind), I don't care. You have an RX for it. It isn't prudent to the situation.

You can't get an RX for marijuana in Indiana, and RARELY does anyone say "Yes, I smoke MJ". If they do, then I KNOW it is gonna be there. Be TRUTHFUL. If someone comes to the ER with back pain and says that they got a Percocet from their grandma, we might say, "You shouldn't do that." But we know it is gonna be there if a UDS is done, no surprise, no LIE. Medical folk and patients have a relationship that should be built on trust. Patients trust us to know what we are doing, (although suing has taken this oout of the equation) and we trust our patients to tell us the truth. This relationship doesn't exist anymore.

We need to know what you have taken to make sure we don't KILL YOU. (Chronic opiate use + Stadol = Narcotic withdrawl ~ death) Not always.

Also, the "opiate, cocaine" story was a story, it was an "if".

Why do people assume that having opiates come up on a drug screen means that the patient is either, a drug seeker, or lying about their pain (I know that cocaine came up as well, and that's not the part I'm talking about). I am on a long-term extended release narcotic, so I will always have an opiate + drug screen. That doesn't mean I don't ever have pain, or that I'm doing something I'm not supposed to be.

That way of thinking makes me sad, and it also makes people fear seeking treatment for pain that's out of the ordinary, since they know they won't be believed.

Specializes in ER, Med/Surg.

I don't care about this type stuff on a general basis. And it never affects the care I give.

I do my job very well, I treat it as more than a job. I don't WANT to touch these people, much less "hang out" with them.

You're there to do a job, to provide nursing services to people, not to become BFF :). People lie and manipulate to get their needs met (we all do, to some degree). Sounds like you (the OP) are maybe taking this a little too personally. Just stay professional, do your job, and "keep on trucking." :smokin:
+ Add a Comment