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?
Specializes in LTC,Hospice/palliative care,acute care.
Originally posted by harry Krishna
I whole heartedly agree w/ you A.T.
It seems the MORAL MINORITY that also post here like to twist others words or assume that just b/c you talk about a drug seeker, that it doesn't mean you don't medicate them or treat other patients who need pain meds the same as the seeker or without compassion. Gotta luv them though,,,,,,as if they are going to change my view on things. sounds like a cult... and they're recruiting!!!!!!!
Good post-very true....Some of us will jump on the PC bandwagon and flame others for venting about a particular type of patient-often when it is something that hits close to home...Other times it is OK to vent away...ya just never know....Substance addiction-for me is a very challenging type of nursing and I have taken care of many that I call PITA patients of that nature...Drunks and druggies-incontinent and confused and pulling out lines,falling down and seizing....Awful shifts.....But my step dad whom I loved very much died of cirrhosis of the liver.He stopped drinking many years before he became part of my family but it got him in the end.I had to see the frustration and impatience on some nurse's faces when they dealt with the challenges of his care-just like I am sure had been seen on mine in the past.....That's why boards like this are so great-we can b*tch all we want to here and that will give us the strength to face our challenges head on....
It seems the MORAL MINORITY that also post here like to twist others words or assume that just b/c you talk about a drug seeker, that it doesn't mean you don't medicate them or treat other patients who need pain meds the same as the seeker or without compassion. Gotta luv them though,,,,,,as if they are going to change my view on things. sounds like a cult... and they're recruiting!!!!!!!
or...as if you are going to change anyone else's opinions...cult? harry Krishna? :chuckle Sorry, just got a kick outta that!
For instance, my periods are extremely painful, but because I think about how other pain might feel in comparison, I tend to rate the pain lower. I think well, it can't be over a 5 because it's just a painful period. Obviously someone with a worse condition would have a higher rating. Although to me, in reality, the pain feels more like an 8. Any thoughts on this?
I know what you mean about ranking according to the "pain expectation rating" of a given condition. In addition, I think people tend to rate pain according to the pain that they have personally experienced before. Like, I would have given myself say a "6" for something back in the days before I experienced unmedicated childbirth, whereas that would now maybe rank "4" or whatever because I may think I have an idea of how much worse it can be.
Deb wrote
I have worked with gall bladder pain so bad I could barely stand. But by outward appearances, I seem fine. I even ---gasp---eat. But trust me, the pain is 8/10 minimum. Thank Goodness I carry bentyl everwhere I go. Nothing showed up on u/s so no surgery for me. I will have to be caught in the act of passing a stone, I guess before anything definitive is done. OH well.
OMG - I hear you! I had misdiagnosed gall bladder problems for 13 YEARS starting when I was a teenager. The most common thing (even from my mom) was that I had a "nervous stomach" and "needed to relax". I actually did get quite good at sort of meditating and pushing the pain away, but that only works to a degree! Often I would still have to get things done, so no one would know unless they were someone I confided in. Other times I just couldn't function (especially later in the day or evening of an attack). I would wish for sleep at night (it would usually be subsided by the morning if I could ever finally fall asleep from exhaustion or pass out or whatever) - that was the worst part because I'd be up doubled over during nights and then have to function the next day. Finally got it diagnosed right after giving up for a number of years and just thinking I had mystery pain or a nervous stomach I guess, got the gb out and not one ache since. I am so thankful every time I think of it, that it got fixed! Looking back now, it was just such a big painful routine in my life for so long. By the way, during a bad episode, if you had awakened me a little while after (finally) falling asleep I would have still been in bad pain! Although I admit, achieving sleep *was* very difficult during the pain -that's why I used to wish for it, so I couldn't feel it. I also couldn't have just fallen asleep during heavy childbirth pain. Anyway Deb, maybe you should try again for some help with it. I think I had an ultrasound early on as a teen that showed nothing abnormal but then when I went (before the surgery) it did show the stones. It was definitely the same pain all along (unmistakably unique and memorable after all those years). I remember the GI doc also said something about "sludge" (laugh)... but really he did and I don't know how that could affect someone & maybe not show up on u/s?? Anyway, hope you find a way to get it resolved :)
aaannnnnd... on the migraine thing, I got one out of the blue after never having any problems my whole life - I was in so much pain I wanted to make sure I didn't have an aneurysm! So I went to ER where I got Imitrex (I was happy to get rid of the pain, but my main concern was to make sure it just wasn't anything serious and then just let me go back home & to bed). Actually the Imitrex was probably the one thing in the world that could have made me feel WORSE - it made me feel very nauseated and faint. I was like, hell just get me out of here. I went home and could NOT function for a week - it was awful. I mean, I could not move or it would get much worse and it was bad even being still and dark and quiet - I had a newish baby and my husband had to bring the baby and lie him beside me to nurse and then take him back away. Thankfully I've only ever had a couple more and I had prodromal (sp?) signs (I see zig zagged lines) and took codeine (that another doc gave me later - just a very few that I've had for so long they are prolly expired) and I think it headed (no pun intended) it off a little bit... was just a day or two.
I am a lot less judgemental than I was when I was younger and had less experience in life. I'm pretty bichy now, but man I was bad then...
...Actually the Imitrex was probably the one thing in the world that could have made me feel WORSE - it made me feel very nauseated and faint.
Ditto here. Doc gave me some and I tried it the first time and vomited about ten minutes after I took it. Thought maybe I had waited too long before I took it that first time, so on next occurence I tried again...same thing.
I was taking Fiorinal before then, and take it now when I feel a migraine coming on. It usually helps a BUNCH. Sometimes nothing helps...except morphine.
The worst pain I have ever felt was from pancreatitis, caused from a gall stone lodged in a duct. OMG...I thought I was having a heart attack...it was worse than labor pains and I had thought those were pretty bad! Thankfully, the nurses and doctors in the ER helped me manage that pain very well. I had my gall bladder removed and am thankful I have not had any problems like that since.
Everyone has their own tolerance level for pain, and who am I to say it doesn't hurt if someone says it does. I have to agree with some of the others who have posted that it is possible to sleep and eat at times and still be in excrutiating pain. I have at times put on a brave face for others, like my children, so they will not be frightened. My $ .02.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by athomas91
smilingblueeyes - no one here has left pain untreated - so i think your "fear" of running into one of us is kind of ridiculous - however
i will again repeat - most of the posts refer to pt's that we know very well....as in we see every day - and not the normal pt who seeks tx only when needed.
sorry you feel I am being "ridiculous"....I was treated like a drug-seeker w/the last bout of gall bladder symptoms and none of the nurses/doctors on staff had ever seen me before. Yet quick to judge, oh yep. I WAS given bentyl since the GI COCKTAIL DID NOTHING TO MITIGATE the pain I felt when I almost crawled into the ER at 1:00 a.m. last time. I found bentyl is my friend......a negative U/S is the ruling factor. I will get nothing further to treat my pain and frankly will hesitate to go to ER again unless I am dying. I was not happy w/the last visit ONE bit. Sometimes, there are MORE than one perspective to the "apparent drug-seeking" situation!
I am sorry that is so being PC and RIDICULOUS to all-knowing folks like you are.
Deb: Same thing happened to me w/ my GB; boy, were they nice to me all of a sudden when the U/S results came back (funny how that picture of a honkin' big stone got me treated with compassion, whereas prior to the U/S no one wanted to be bothered).
sorry you feel I am being "ridiculous"....I was treated like a drug-seeker w/the last bout of gall bladder symptoms and none of the nurses/doctors on staff had ever seen me before. Yet quick to judge, oh yep. I WAS given bentyl since the GI COCKTAIL DID NOTHING TO MITIGATE the pain I felt when I almost crawled into the ER at 1:00 a.m. last time. I found bentyl is my friend......a negative U/S is the ruling factor. I will get nothing further to treat my pain and frankly will hesitate to go to ER again unless I am dying. I was not happy w/the last visit ONE bit. Sometimes, there are MORE than one perspective to the "apparent drug-seeking" situation!
I am sorry that is so being PC and RIDICULOUS to all-knowing folks like you are.
Along with the times I have had good pain mgt. in the ER, there are numerous times I haven't and times I, too, have felt like I have been treated like a seeker. Like the nurses and doctors in the er have become hardened by so many who ARE seeking drugs that they tend to undertreat those in real pain. Don't see how they can truly differentiate, even if someone is a frequent flyer.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by LisaRN2B
Along with the times I have had good pain mgt. in the ER, there are numerous times I haven't and times I, too, have felt like I have been treated like a seeker. Like the nurses and doctors in the er have become hardened by so many who ARE seeking drugs that they tend to undertreat those in real pain. Don't see how they can truly differentiate, even if someone is a frequent flyer.
I dunno, if in doubt, try treating anyhow....esp w/someone who IS NOT A F/F......
I did not appreciate the doubt I was met with (like I was bothering them from more important things) when I went. I am sure I was not the most critical case in the ED, but don't treat me like I am lying.......If I say I am in pain, I AM!
I dunno, if in doubt, try treating anyhow....esp w/someone who IS NOT A F/F......
I did not appreciate the doubt I was met with (like I was bothering them from more important things) when I went. I am sure I was not the most critical case in the ED, but don't treat me like I am lying.......If I say I am in pain, I AM!
First of all, We are not to judge a patient's pain. A patient can most certainly be able to fall asleep and have horrib le pain. I had a cancer patient woman with cervical CA with mets who had a bladder distended up to her ribs but couldn't be cathed. She was within days of dying, visible tumors allover her body. Although the 75 mg/hr morphine drip with 2 mg ativan and 4 mg dilaudid per hour did occasionally allow her to sleep for a few moments, I know she was still in pain.
Secondly, drug seekers are more than likely addicts. Addiction is a disease of the mind and body. As an addict myself who has been gratefully clean for three years, I do have quite a bit of intolerance for such judgmental nurses. I;m sure there are times an addict comes to the ER for a fix in desparation for a way out of the torment of being trapped in the cycle of addiction. I wish more people could look at it this way rather than condemn and look upon addicts with disgust.
There is no easy answer. You can't very well ask them if they want help because that may be accusing a non-addict of lying about his or her pain. I also know that addicts are in their own kind of pain as well...Pain that is not as easy to relate to.
smilingblueeyes - i am sorry you had such a bad experience - i can tell you that noone i have ever worked w/ including myself would have thought you a drug seeker.....when i post - i truly refer to pt's that i have seen 2-3x/wk for the past 3 yrs in my current position - there is no doubt in my mind that 95% of the pt's i see are in true pain -
did they hida scan your gallbag?? - sometimes that is the only thing that shows the sludge..... most of the docs i work w/ will admit a pt w/ abd pain when we can't find the cause and they continue w/ pain....obviously something is there.
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ktwlpn, LPN
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