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?
Tweety; No, I realize I can get in huge trouble. Had to get it out of my system this one time. I swore to myself and to my fiancee to never do that again. I don't know how on earth you all manage to keep your true feelings towards certain pts to yourselves. I will manage also, but it will be tough! Thanks for the heads up!
It isn't easy. Believe you me it isn't easy.
I only wish I could say what I'm really thinking sometimes. LOL
Sedation does not equal pain relief, contrary to popular opinion. Do a little research and you will see that reputable pain mgmt. authorities will say the same thing.
Please don't perpetuate myths/inaccurate info.
Come back to reality my friend and get off thy high horse. If someone is sleeping, I would call that pain relief, regardless as to what your "reputable pain mgmt authorities" say.
If what you say is true, then the whole concept of conscious sedation would be ranked up with bloodletting, Lobotomy, and ECT without sedation. What I mean is when you perform conscious sedation (or whatever the PC term of the month for it may be), the person whom you are {reducing a fracture/dislocation etc...) will scream, writh, and shout while you are performng the procedure, yet whne they awaken, they cannot recall experiencing any pain, AND YET we inflicted some serious pain upon the patient while fixing the problem.
There are basically two type of patients seeking pain relief. One is too lazy or broke to drive down to the local corner to score a fix. The other is a person truly in severe pain and if you offer them a medicine "to make them sleep" chances are they will take you up on that offer, regadless if their pain is not totally relieved on some higher metaphysical level.
So just because you don't recall having the pain, means you didn't have it? j/k People don't recall having the pain after having conscious sedation because of amnesia producing medications such as versed, which is NOT a pain medicine. As far as sleeping while in pain goes... some people escape pain by sleeping. They shut down to escape it, so yes, you can sleep and still hurt.
Specializes in LTC, assisted living, med-surg, psych.
I envy anyone who can even barely FUNCTION during a migraine. I get these only once a year or so, but when I do, all I can do is lie in a cool, quiet room and pray for death........nothing touches the pain or nausea, the only way to escape at all is to take some Ativan and go to sleep. I don't go to the ER because I'm too ill to be moved, and anyway, I wouldn't want my co-workers to think the same thing some of the above posters think!
We all know there are drug-seekers in the world. However, we should also know that because we don't live inside other peoples' bodies, we cannot know how they feel........or judge how much pain they're in. Yes, I've given Demerol to patients who rated their pain 12/10, have taken enough drugs to kill me ten times over, and swear nothing touches it BUT Demerol.
But it's not up to me to change them, nor is it my job to determine how much pain they actually feel as opposed to how much they say they feel. I was taught in nursing school that pain is what the patient says it is, when the patient says it's occurring. I think that's a good principle, and until someone comes up with a better one, I'm sticking with it.
It's called sarcasm my friend. A warped sense of humor is required to work in an E.R.
Don't be so serious all the time.
Sorry.
Believe me I know all too well that warped sense of humor. Working in city trauma center (I'm not an ER nurse btw, just browsing through this thread) we get it all. As a sometimes house supervisor the time I spend in the ER and the "humor" I see is amazing.
Carry on. Keep the humor, just don't get too jaded. :)
i am not perpetuating any myths - i do not believe that i ever stated that sedation equals pain relief - i only said that when i wake a snoring patient and they tell me their pain is 10/10 that i believe that to be impossible - perhaps if i gave them 5mg of dilaudid - but let's face it - we rarely medicate patients that heavily........
HOWEVER - after giving a pt w/ a migraine a total of 8mg of dilaudid, 30mg of toradol, 2mg of haldol, 12.5mg of phenergen and i awaken them from snoring and with a smile they tell me their pain remains a 10/10 - GET A CLUE......
the only thing i am perpetuating by believing them is drug abuse.
Come back to reality my friend and get off thy high horse. If someone is sleeping, I would call that pain relief, regardless as to what your "reputable pain mgmt authorities" say.
If what you say is true, then the whole concept of conscious sedation would be ranked up with bloodletting, Lobotomy, and ECT without sedation. What I mean is when you perform conscious sedation (or whatever the PC term of the month for it may be), the person whom you are {reducing a fracture/dislocation etc...) will scream, writh, and shout while you are performng the procedure, yet whne they awaken, they cannot recall experiencing any pain, AND YET we inflicted some serious pain upon the patient while fixing the problem.
There are basically two type of patients seeking pain relief. One is too lazy or broke to drive down to the local corner to score a fix. The other is a person truly in severe pain and if you offer them a medicine "to make them sleep" chances are they will take you up on that offer, regadless if their pain is not totally relieved on some higher metaphysical level.
Well, if you know better than the info according to the Amercian Pain Society, the Agency for Healthcare Policy and Research on pain, the American Society for Pain Management Nurses, etc., you should fill them in.
Sleep is one of many escape mechanisms when a pt is in pain. This isn't my idea, it's in all the recent literature. Take a look at Margo McCaffery's pain mgmt manual...you'll see the same thing.
And I wasn't on my high horse, so I don't get the hostility, but, whatever...
:
Tweety, BSN, RN
36,347 Posts
It isn't easy. Believe you me it isn't easy.
I only wish I could say what I'm really thinking sometimes. LOL