I had to take care of druggies today, and was disgusted!

jesa · Dec 30, 2006

if that was offensive to you it wasn't meant to be. personally, I am thankful not to be plagued with diseases I don't have.

RN 4 U · Dec 30, 2006

I didnt find this posting offensive at all either. I completely understand where the OP is coming from. I realize that addiction is a disease. We see so many people with many forms of illness but I do find it much more difficult to care for someone who could have control over the disease if they'd accept responsiblity for their actions. There is a difference between a drug addiction and a 40 year old woman dying of breast cancer. They both cause illness however how many times have you taken care of someone that is struck with a life changing illness and would do anything possible to overcome that illness and cherish life but they cant. It is very frustrating to see people that can make a difference in their outcomes but chose not to and those are the same people that manipulate and expect us to "fix it" for them. I have much more empathy for those people that want to help themselves compared to people who expect everyone else to take care of them when they refuse to do for themselves.
I know people are going to say that my view is not a good view but I think we as nurses are so focused on helping everyone that we neglect to see that some people could help themselves. What other profession will take over and "fix" whatever is broken? In all other walks of life we are expected to help ourselves as much as possible.
If I choose not to do something that I should do no one else comes in and just does it for me because they have empathy for me. I am responsibile for me and I accept that....if I choose not to pay my bills or put gas in my car then it was me neglecting my responsibilities and no one comes along and says let me do it.

I totally agree with everything your post said. Just the fact of taking care of someone like this was very frustrating. The care i gave this man was no less than the care i gave to my other pts. I realized he is a sick man and that his addicitive behavior is what brought him here. But to munipulate someone into giving you drugs and demand that you bring his pain medication on time, everytime, as scheduled is a bit much. If you are getting pain medication strong ones at that how do you have no relief. I am a nurse, not anyone maid and I just wanted to voice my frustrations about this as i was really frustrated. I am educated, i graduated from nursing, i know all about addiction but in the real world which i am in now, it was a totally new experience for me. People have to take responsibility for their destructive behaviors even addictive ones. Just because you have addiction does get you off the hook. If the police catches some one who is addicted to drugs with drugs they don't say, "you have disease and you can't help it i'll let you off the hook this time" I'm sorry that just does not happen. I would have more respect for someone who acknowledges the fact that they have a problem and are actively seeking help that the one who does not think they have a problem and continue to munipulate others into getting what they want.

RN 4 U · Dec 30, 2006

have to chime in here again. personally, I am a recovering alcoholic/addict. I have almost 6 years sober. I think what people don't understand is the nature of this disease. no other disease tells the sufferer that they do not have a disease. this disease does. no other disease affects the mind, body, and soul like addiction does. treating addiction doesn't work with a simple treatment method like taking medication. the truth is, just like any other disease, you cannot judge someone about their treatment or lack thereof until you have HAD the illness. to say that they have help and why don't they just get it is the common mistake people who have no understanding of this disease make. it makes my heart break to watch people with addiction not be able to stay sober. I would suggest everyone get a copy of the big book (AA's main book) and read it to understand more. go to a couple open AA meetings and listen to these people. they are human and working against a disease that is working on a daily basis to KILL them.
I understand the OP's frustration and commend the OP's ability to be honest and look at her feelings about working with people who have addiction, the thing that bothered me about this post was the title "I had to take care of DRUGGIES today", those words immediately show a lack of knowledge and a blatent stereotype and disregard for the patient's disease.

Let me first say that i knew from your first post that you must have been a drug addict. My pt was a drug addict, druggie whatever you want to call it, it is a fact of what he was. "It is what it is" plain and simple. i have no lack of knowledge as i am educated, as i stated in my post. I am a new nurse, no lack of knowledge here. And if there is a stereotype of a drug addict, I'm sorry my pt conveyed all of them, the munipulation, the lying, etc. I wanted some advise to deal with this type of pt as i have never had to deal with before. The lying the munipulation, etc is what i had a hard time dealing with and wanted some advise in how i should deal with these things. I have no lack of knowledge about addiction and if my title offended you sorry that it did but this is my feeling.

EmerNurse, BSN, RN · Dec 30, 2006

In the ER I see frustrating patients all the time. One guy comes in once a month at least with a severe exacerbation of CHF, another having had a few seizures, another in DKA (and wanting strong pain meds for fibromyalgia). Not one of them is compliant with their medications, or with follow-up with their PMD/clinic. But in they come. They all get the same care everyone else gets. Pays my paycheck (well sort off, since they're all state funded). Job security anyway. I've learned to quit beating my head against the wall and just give the care I know I can give. The rest is beyond me.

damarystx · Dec 30, 2006

Hello everybody. I am a new nurse and I had my first patient who was a drug user yesterday. I took care of him but found it difficult to deal with having a patient like him as he was basically using the system to get his drugs. His problems all came from using drugs and that is why he was there, but this man was in no pain or having no anxiety attacks but requested pain medication around the clock stating no relief, mind you he was laughing, being disrespectfuly at times and wanted me to wait on him hand and foot. I refused to cut up his salad, because there was nothing wrong with hands. I took good care of him but i did not want to be really bothered with him as there were really sick people in the hospital that needed my attention. I just do not know why drug users are allowed to get away with this. The hospital is basically providing all their drugs. Was I wrong to feel this way?

Hi,

I think from your op people didn't understand that you were looking for help on how to deal with this type of situation in the fututre, it just sounded like you were venting, that is how it came across to me anyway, and it came across as very judgemental which is why I think you are getting the responses that you are. I am one semester away from graduation, work in the field and have spent hours researching addiction, actions of the different substances, long term physio. effects of different addictions on my own and by picking the brains of our physician's and np and we all realize that there is a lot that we don't know about addiction. All of my nursing texts and the critical care nursing texts just kind of scratch the surface.As for tips on how to work with these clients in the future: 1. Set firm boundries, I can't say it enough, they are manipulative by nature and even with firm boundries they may still be able to manipulate you it's just part of the addictive bahavior. 2. Know that these people are getting judged and hounded by people on a regular basis, your not the first, just one in a long line. I think this adds to some of the behaviors, they get defensive, they give in and just "fulfill that prophecy". 3. Reflect on your own feelings, dig deep. And see if maybe some of your own behaviors came across to this person, did he get the feeling that you were "disgusted" because that is a pretty strong feeling to have toward someone and hide it, and that may add to someone acting out.

I truly hope that you are getting the help that you are looking for in this post and don't feel "beat up" by some of it, it's just a heated topic.

Good luck to you.

damarystx · Dec 30, 2006

Damarstyx---I understand what you are saying and I can appreciate where you are coming from. I admit that I have no experience with the psychological issues that go along with drug/alcohol addiction. I see the patients when they are in the acute phase in the ICU. Please dont misunderstand that I dont have empathy for those that are truly in need and are seeking help....I realize everyone has issues in their life and some people havent developed or been taught good coping mechanisms. When I say "fix" I am referring to those patients with medical problems whether it be a chronic disease related to drugs/alcohol or any other medical condition. I see alot of people that want no responsibility for their well being but they expect the medical profession to make things better and that is why I put the word "fix" in quotations. I have had family members and patients come right out and tell me that they know we can fix the B/P or Blood sugar or whatever seems to be ailing that person and then get upset when the problem is corrected and they go home only to return a week or two later because the problem returned because the patient didnt take their medicine or whatever the case may be and they blame the medical profession ie doctor or hospital for not being treated right the first time around but they fail to understand their responsibility in the disease process management.
I completely understand drug/alcohol addiction is a disease process....My ex-husband had a alcohol/drug problem and I have attended many AA meetings and therapy sessions attempting to help him thru but he wasnt able to accept his responsibility in the situation and whenever he didnt like what the therapist had to say he quit going because he felt the therapist didnt like him and was taking my side. I guess this is a touchy subject for me because I hold resentment towards him for always placing the blame on others and never accepting his responsibilities to me, his kids or himself.

I get ya', I come from a long line of alcoholics. By the grace of God I didn't end up an alcoholic myself. I have lived first hand with the devastation that it causes, my grandfather was a horribly abusive alcoholic who died in his 50's from cirrohsis and I have family members who are currently alcoholics and no where near ready to acknowledge that they even have a problem.

I by no means want anyone to feel like I am questioning their empathy or skills as a nurse on this thread, I know people have so many different personal experiences with addiction, I know that this is a venue for people to vent, debate etc. I think that everyone should be able to voice their opinions just like I voice mine, and I really do like hearing where everyone else is coming from and what different experiences bring people to where they are at in life. And I am sorry Kymmi for what you had to go through in your marriage and probably still, it's a tough, frustrating road to have to go down.

jesa · Dec 30, 2006

Let me first say that i knew from your first post that you must have been a drug addict.
I would love to know how "you knew" I am in recovery...
"My pt was a drug addict, druggie whatever you want to call it, it is a fact of what he was."
so if a patient comes in who is obese do you say "I worked on a fatty today"? it is what it is, right?
"i have no lack of knowledge as i am educated, as i stated in my post."
you obviously do have a lack of knowledge. you stated in a later post that you have a degree and know all about addiction. sorry, my dear, you do not know all about addiction. you, in my opinion, have much to learn.

sabrosa1 · Dec 31, 2006

I will graduate in May 07. I worked all summer has an extern and had about 5 patients which is a lot I thought I needed roller skates. The nurses told me that I spoiled the patients. I looked at all my clients has members of my family, the alcoholic that was dying of liver failure, the teen that needed a new heart, and the drug seekers. I took care of them equally, with care and lots of attention. That is my job; this is the reason why I will become an RN in May. All my patients' deserve my respect even the little old woman who cursed and tried to hit me because she was out of her mind. I figure "You never know what will happen to you, what situation you may find yourself in the future" I will keep on spoiling my patients, and maybe just maybe by giving that little extra care I may be able to make some of them better, because medicine alone can't do the job.

dijaqrn · Dec 31, 2006

All patients deserve our respect and care AND pain is whatever the patient says it is!!!! Please also remember that people who self medicated and are recovering have alot of issues with pain. Some of them have medical issues that cause pain that they've never felt and they end up in your facility actually needing pain meds and are not just drug seeking.

Anjann, RN · Jan 13, 2007

I think as a new nurse, like me, that your reaction is common. Learning how to deal with a specific patient population takes time. I even had a post-surg pt. 2 years ago whom we had to keep a stock of beer in the refrigerator for, because the doctor did not want the patient going through withdrawal in his current medical state.

The manipulation part drives me nuts, but I don't let it show, because they can sense it very easily, and I wonder how it would feel for me if I were on the other side of the counter and how I would want to be treated. We all have our weaknesses, but as nurses we can only do our best to assess, plan, intervene, evaluate, and educate. The rest is up to the patient.

nurse4theplanet, RN · Jan 13, 2007

Definitely sounds like a frustrating situation. Here's how I keep things in perspective: We have separate systems in the US that have different goals. In the healthcare system, we try to make people's physical and emotional problems better. In law enforcement, they catch and detain the bad guys. In the judicial system, they pass judgment on people and seek punishment for crimes. I just have to remind myself which system I work for whenever I feel the urge to do something besides try to make people better.

This is the best post in this whole thread.

Since I work in ICU, I don't really get that worked up about drug seekers. Usually, they are so unstable to be on my unit anyway that if they didn't get their usual supply then it would send them into withdrawl and make their situation even worse. If they ask for it, it's ordered, and its a safe amount...then they get it. And I don't beat myself up about it. I work in ICU, not Detox/Rehab.

I helped a nurse take care of a ventilated pt with pneumonia a couple months back (as a tech) who was a drug addict (everything from valium to morphine to heroin). He was on an ativan gtt, prn morphine, prn valium, prn dilaudid, and prn haldol and still had to be in four point restraints. He was only about 30 and very strong! His poor mother knew about his habits and raised hades with the doctor when she found out that he was getting narcotics. The doctor simply explained to her that he was an addict, had a very high tolerance to narcotics, would go into dangerous withdraws if they were held which could kill him faster than the pneumonia, and that the drug addiction could be dealt with after he was out of ICU. That pretty much shut her up.

exitthedragon · Jan 19, 2007

Addition is both a physical and emotional illness.I plan to work with addicts after I pass the state boards because I discovered in my clinical rotations that alot of my classmates had a limited insight and empathy for them. I found that I have no issues with understanding thier behaviors and I excelled at picking up the appropiate responses It is an important job but it is not for every nurse. Each one of us have special areas of intrest and skill.When we can find the correct position for ourselves the system works its best.