I give in to drug seeking patients

stanleyrn · Mar 16, 2011

I feel about as bad for drug seeking patients as I do the extremely obese patients that come in that refuse to take care of themselves. I can't stand either and every time I take care of either of these patient populations, it becomes harder.

General E. Speaking, RN, RN · Mar 17, 2011

I feel about as bad for drug seeking patients as I do the extremely obese patients that come in that refuse to take care of themselves. I can't stand either and every time I take care of either of these patient populations, it becomes harder.

I hope you are just having a bad day and really don't mean this. If not, I truly feel sorry for your patients and I hope you are never my nurse.

October97 · Mar 17, 2011

We as nurses need to be careful with thinking every one who appears to need a lot of pain medication or has a high tolerance is a drug seeker. My husband has back problems and was a "frequent flier" in the ED for a long time until someone finally figured out what was wrong with him and has proceeded to try to fix it. It was very annoying when nurses and doctors treated him as a drug seeker when his had tears coming out of his eyes and BP as high as 202/119. I got a whole new perspective on how we treat pts when I was on the other side as a pts wife. A pts pain is what they say it is (I know, some people milk it for all it's worth), especially when the vital signs also back it up.

jeffsher · Mar 17, 2011

Having worked outpatient for the past 17 years, I can tell you that there is a HUGE market for narcs. We would frequently get anonymous and caller-identified calls about a patient getting his/her 180 or 240 Percocets, and selling them in a bar, at a housing complex , etc. At a street value of $5 each, that's a HELL of a lot of money. And, it's fraud, because the insurance or Medicaid is paying for it.

As far as inpatient, I don't hesitate to give a PRN narc if it's needed.

And, as one poster said, if someone has chronic pain, it's time for Pain Clinic. I'm all for drug contracts as well.

lwd338 · Mar 17, 2011

I work on a med surg unit in a city hospital.,i am not there to rehab you, you are onley there for maybe a week? So if you want pain meds and there are orders then you get them. I,m not fighting with anyone, if the doc,s think you need it than you can have it ok, have fun. Nures of 35+ years

Awesomepossum · Mar 17, 2011

We are not here to judge; if you want to judge someone else's business save that for church. We're here to save lives, not souls as it were. The way I see it it doesn't effect ME if someone is a drug seeker. Don't sue me and whatever.

rkitty198, BSN, RN · Mar 17, 2011

If you want pain meds and there are orders you will get them. I like that!

ejdj1501 · Mar 17, 2011

Have you tried alternative pain management regimes? For example massage, repositioning, application of hot or cold packs TENS or for chronic pain alternative therapies like acupuncture,meditation, herbal remides that dampen inflammation responses? Can I suggest that "drug seekers" may have underlying psychological issues that lead to a decreased sensitivity in pain- Especially for relatively young pts with chronic conditions that are life altering and difficult to deal with. Depression and other mental illnesses left unrecognized or untreated can lead to "drug seeking" for physical and mental pain management. Not all durg seekers are looking to sell their meds. Many are stockpiling to commit suicide-not publisized but very true-I know from personal experience. Yes doctors may prescribe recommended dosages for verbalized pain experience but rarely do they have the time for a hollistic aproach to the patient and an indepth look at the psychological and social wellbeing of the patient. This is left to be decided by a "multidisciplinary" team that hopefully have great communication skills and are on the same page. As nurses I guess we are the source- we need to collate ALL of the information and communicate with the patient to work out what is really going on. We may not diagnose or prescribe but the information we gather and convey is imperative to ongoing patient outcomes. Ultimately we are here as nurses to help heal and relieve suffering-yes we have been taught if someone is in pain- give PRNs or reg meds and thats fine, why not treat the cause not just the symptom?

:nurse:

owlyhecate · Mar 17, 2011

Maybe b/c of working as a jail nurse I see the worst side of where addiction has taken the drug seeker - jail, DWI, violance, and all kinds of underhanded ways. I even have some family members like this and let me say if some intervention was inplace to keep tabs on the amount fo s*** they get . OMG . but then pvivacy rights would be involved. one of the companies I work for now has a wonderful system inplace - if u have lots of "issues" when u come in ur down to see psych and the Doc. -Now back to people and my family- it's nice to see after a few monthes in jail how well they look and admit to feeling off all the heavy stuff. PLS don't get me wrong some people really need the heavy stuff and by all means if they need it let them have it. I guess my rambling point is where did the breakdown occur REALLY? somedays I just work in shock of how /why the seeking behavior got to that point. It really destroys everyone. Then the oddest thing when they are telling whats physically wrong AND mentally - just by the drug combos u can pick the Doctors, and guess what else ! They are the docs that are ultra luxourious ! and the amount of addiction scrips the give " u can't stop taking it for any reason -u'll seize and die" once hooked and a docs word like that the house is paid for! Never mind they do come off the same "u'll die pills" s seisure and did the doc even know about the daily ETOH, pill swappin with others and jail stents for all the Hell u raised while trying ur neighbors painpills -NO. but heres ur next refill !!!! (we can't fix it or can we) :eek: Sorry, but it all came outta nowhere wooosh

allnurses Guide · Mar 17, 2011

Have you tried alternative pain management regimes? For example massage, repositioning, application of hot or cold packs TENS or for chronic pain alternative therapies like acupuncture,meditation, herbal remides that dampen inflammation responses?

The Emergency Department is not the place to handle withdrawal, many times the patient will refuse to even look at all of the referrals, flyers, booklets, phone number lists, etc. I haven't run across too many opiate-addicted persons who are interested in those alternative pain management regimens, but who wouldn't wish they were? It's depressing even for cynical nurses to see a fellow human being's life reduced to nothing more than a quest for their next fix. :-(

CynicallyVexed · Mar 17, 2011

I have very little tolerance for drug seekers. In my town several pain clinics have been busted which means more patients in the hospital that are drug seeking... What does our hospital do? Gives anybody that walks through the door 0.5mg - 1mg of dilaudid automatically to anybody that complains of pain... no joke. They said in a meeting one time that they are starting to do this to improve their hospital scores!! I understand the pain control issues and all, but when these patients get admitted and they are getting dilaudid every 2 hours and they are calling out 30 to 40 minutes after their dose for another dose or phenegran and a ham sandwich yeah I start to wonder and I do put a halt on allot of it and do other interventions before pain meds. And if they complain of nausea with me the only food items they are getting from is going to water or sprite. I call the MD and get heat and ice treatments ordered the effective area, ect. Or try and get alternative Nausea meds like Zofran and Reglan

yes I know it's not my place to judge, but I do believe any doctor prescribing these medications should be aware that the patient is drug seeking and it should be put in the H&P especially if my instincts are right and they are drug seeking. I give Pills before IV meds and remind my patients when they go home they will not be on IV pain meds and need to be adjusted to PO pain meds. If I have had a patient on a PCA for awhile I watch for S&S of withdrawals and trust me I see them about every 3-4 hours breaking out into sweats, chillin, nervous, anxiety attacks, c/o of extreme pain, and these are seen as hospital psychosis allot and not treated and they need to be treated with some type of withdrawal protocol! Try and prevent your sick patients from becoming addicts. and I never give PRN pain meds to anybody with a low BP/HR or is calling out and when I go in the room, they are fast asleep and don't wake up to the knock on the door. It absolutely annoys me to see a nurse who had a patient call out for pain meds and falls back asleep and when the nurse walks in the room she can knock the door, run the medcart by "accident" into the bed and call out the patients name and all you hear is a snore and they continue to wake the patient up and give them more meds.. I don't understand that.....

jeffsher · Mar 18, 2011

What does our hospital do? Gives anybody that walks through the door 0.5mg - 1mg of dilaudid automatically to anybody that complains of pain... no joke. They said in a meeting one time that they are starting to do this to improve their hospital scores!!

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