Last Wednesday I encountered the reason for the sometimes crappy treatment I get in the ED concerning my migraines. I actually met a real life in the flesh migraine faker! :
I was waiting in the Ed waiting room, waiting for my boyfriend to get off work, and noticed a couple sitting across from me. They were chatting happily, laughing and pigging out on candy bars and chips and cokes. I noticed the hospital bracelet on the girl and after about 10 minutes, I couldn't help myself.... I asked her what brought her to the ED at 3:00 in the morning. She looked at me and says..."Migraine"
I'm in shock at this point but then I get angry!
I say" YOU have a migraine and you can EAT and DRINK? Isn't the light bothering your eyes? You do NOT have a migraine and you know it!"
I turn away disgusted. Well....guess what...she goes into "migraine mode". Gone are the chips, the chocolate and the cokes, and out come the dark sunglasses, the cold ice pack and she puts her head down on her boyfriend's shoulder and starts to grimace in "pain"
I start laughing out loud. :chuckle I could not believe it! I still can't!
I have to drag myself into the ED, feeling half dead, wishing I was, and I get the red flag because the staff encounters people like this girl!
When I finish nursing school I want to work in the ED and I'm guessing I can't do what I did Wed, but I think I'm going to have a hard time keeping my mouth shut.
Honestly, I never quite understood how the cynicism towards migraineurs came about until now. Another part of me can't see how the real thing can be confused with these obvious cases of faking it. A dilemna that shouldn't exist I suppose.
How do you handle people like this? Can you get your license taken away?
"There are plenty of non-narcotic pain relievers out there for addicts, and I disagree that Docs never treat pain of those who suffer an addiction. It's kind of unfair to suggest that a physician refuses to treat you because you are an addict... Perhaps it's more like.....We refuse to give you narcotics...and you feel because narcotics aren't offered, they are refusing to care/RX your pain.
My point is....if the addict tells the doc he's an addict, does the Doc have an obligation to give him narcs? Or does the doc have a moral/ethical obligation to suggest other pain reducers along with discharge teaching an follow up care for this persons Chronic Pain in the ER.
I think it is pretty obvious if a poster is a nurse or not, almost immediately when reading the post. (Yes, this does mean you, utsuprainfra.) I hate it when people's opinions are bigger than their knowledge base......and drug seekers in the ED!!!!!
"Doctors will -never- treat my pain because I'm honest about being an addict. One exception was the car accident, where they gave me morphine every hour and dilaudid every third."
Wow. That's cold. Because you are honest about your addiction they're just assuming that you never, never have pain unless you're in a car accident. A human being in a human body will have pain some time even when not in a car accident. They need to reevaluate their assumption and praise your honesty.
"There are plenty of non-narcotic pain relievers out there for addicts, and I disagree that Docs never treat pain of those who suffer an addiction. It's kind of unfair to suggest that a physician refuses to treat you because you are an addict... Perhaps it's more like.....We refuse to give you narcotics...and you feel because narcotics aren't offered, they are refusing to care/RX your pain.:twocents:"
You're a nurse? Interesting that you defend that docs never treat pain for addiction "sufferers". I said that docs never treat -my- pain when I'm honest about being an addict. What non-narcotic analgesics -really- work for severe pain? I'm not talking about local anesthesia. The truth is, and has been since Hippocrates' day (and he actually mentions the value of poppy derivatives in treating pain and as a styptic), that narcotics calm a patient, they mute the pain experience. "We" (doctors, not nurses, and nurse practitioners have their place as well) refuse to give me narcotics because -you're- afraid of something. You're a nurse. Alcohol is addictive, but it's legal. Until the early 1900s, opiates were legal in the US. Opiates do not cause organic damage at even the doses that I would use. I have used 700mg+ of MS daily. Yet, my problem only cropped up when my supply was interrupted.
I'm off on a tangent. I'm currently on 50mg methadone daily to treat pain. It does not work as well as hydromorphone, morphine, or oxycodone, but the government and my doctors feel more comfortable with methadone because I am an addict. That's only been a convention since the 60s or 70s I believe.
Are you a nurse? I do not want you in my ER as a pt or nurse.
If you are on methadone, I do not want you as a nurse around me. Either working on me or with me.
Everyone deals with their pain differently. I've been getting cluster headaches since late 2004 after getting radiation for a benign pituitary tumor. After learning how to deal with them and getting my meds right, I can go to work, take care of my family and live a semi-normal life. That is until I experience the breakthrough pain. It usually means a trip to the ER, fluids, zofran and dilaudid. Occasionally there is ativan involved. I take topamax daily which has decreased the occurance of the breakthrough. I have a headach everyday now, but when I get my clusters, it can last up to a month, including the facial numbness and everything else that accompanies the clusters.
My friend on the other hand gets a tension headache and is holed up in a dark room for days. I'm not saying she doesn't have pain, just that everyone deals with it differently.
Everyone deals with their pain differently. I've been getting cluster headaches since late 2004 after getting radiation for a benign pituitary tumor. After learning how to deal with them and getting my meds right, I can go to work, take care of my family and live a semi-normal life. That is until I experience the breakthrough pain. It usually means a trip to the ER, fluids, zofran and dilaudid. Occasionally there is ativan involved. I take topamax daily which has decreased the occurance of the breakthrough. I have a headach everyday now, but when I get my clusters, it can last up to a month, including the facial numbness and everything else that accompanies the clusters.
My friend on the other hand gets a tension headache and is holed up in a dark room for days. I'm not saying she doesn't have pain, just that everyone deals with it differently.
True..so true......thing is we are talking drug seekers and fakers...ER nurses know them.....and we deal with them appropriately...You are obviously not a faker......You have a co-morbitity that enhances your assessment....and I'm sure that your physician will prescribe meds to help you without having to go to the ED on a Saturday night, my doc couldn't get me in, I'm allergic to all meds that would help....although ......non-narcotic! There is a difference...every ED nurse knows the difference.....
Specializes in CNA, Surgical, Pediatrics, SDS, ER.
We've got a list of pt's who are seekers. We have caught them before going from one faciliy and then a few hours later turning up at ours or checking several pharmacies in town and finding out how often they've had narcs filled. We pretty much have the same pt's come in w/ migraines often.
I personally do not have migraines but my husband and my 8 yr old daughter do and I see how miserable it is for them. My husband can't believe that people come to the ER for that. He said he barely wants to move or do anything esp go and wait in an ER for hours to get meds.
I understand everybody's pain is different and I try to give my pts the benefit of the doubt, but when you see them multiple times over the weekend it does get discouraging. I guess for the most part you can tell which ones really do have a migraine and which ones do not. I try to stay as nonjudgemental as possible hard as it may be at times.
Trouble with a list like that, if the wrong person ever sees it. That's a hippa violation
Our state has a registry and physicians can assess it and see what patient's visit many EDs and different pharmacies. We have a system that ***s the computer for drug seekers. Whether you're a new nurse or never met that patient, it's already been pegged. This is part of the computerized system in the hospital. And as the previous poster mentioned. We've called or have been called regarding a patient who frequently visits one or the other depending on whether they get their fix or not. I'm not certain what you mean by the wrong person ever seeing it. The physicians are the ones who have access, and our hospital's computer system tags them. We also have a case manager that personally takes most of the cases up. Not sure if tha helps as all as we still get the drug sekers over and over and over.
I am a nurse and understand there are drug seekers. I also suffer migraines and have ended up in the ER twice. Once after it suddenly appeared with severe chest pain and once because it had lasted over 3 days. The first incidence I was treated like a drug seeker. The lights were off, the doc came in and flipped the lights on and started talking in a loud voice. I was so mad! The next time I was treated after waiting SEVEN hours! At least then I got narcotic and phenergan.
I am a nurse and understand there are drug seekers. I also suffer migraines and have ended up in the ER twice. Once after it suddenly appeared with severe chest pain and once because it had lasted over 3 days. The first incidence I was treated like a drug seeker. The lights were off, the doc came in and flipped the lights on and started talking in a loud voice. I was so mad! The next time I was treated after waiting SEVEN hours! At least then I got narcotic and phenergan.
When you had the migraine for 3 days, was there a time when you called your own doctor about this?
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My husband can't believe that people come to the ER for that. He said he barely wants to move or do anything esp go and wait in an ER for hours to get meds.
TraumaNurseRN
497 Posts
Hagabel,
I am indeed an ER nurse......You have 2-3 posts mushed together there....