pain in the ed

a little communication, a little education, and less complication and the world would be a better place.

thank you avigail.:)

i always wonder about those who speak of themselves in third person......

i agree that people can function in pain - however until i walk a day in your shoes or you in mine this debate is going nowhere

you all continue to assume that i am speaking of a patient who has a back inj and ........ IF you bothered to ready any of my posts in their entirety you would see that i actually know these people as well as the doc's know these people and we have evidence that they are selling rx on the street - they are not in pain they are ACTUALLY there for the narc's either for themselves or to sell...... believe it or not it actually does happen.... and believe it or not they actually threaten our lives when we don't give them that 8th dilaudid shot.......

i have all the empathy in the world for those in pain - you all have no clue what my life consists of - perhaps i myself have been a cancer patient..... i just post here at times to vent - to allow a small window into my world - i guess that is too much to ask of some.....

-the real slim shady....

oh - by the way - a little culture never hurts.....

Originally posted by athomas91

i always wonder about those who speak of themselves in third person......

i agree that people can function in pain - however until i walk a day in your shoes or you in mine this debate is going nowhere

IF you bothered to ready any of my posts in their entirety you would see that i actually know these people as well as the doc's know these people and we have evidence that they are selling rx on the street - they are not in pain they are ACTUALLY there for the narc's either for themselves or to sell...... believe it or not it actually does happen.... and believe it or not they actually threaten our lives when we don't give them that 8th dilaudid shot.......

i have all the empathy in the world for those in pain - you all have no clue what my life consists of - perhaps i myself have been a cancer patient..... i just post here at times to vent - to allow a small window into my world - i guess that is too much to ask of some.....

-the real slim shady....

oh - by the way - a little culture never hurts.....

culture is as culture does. i agree, a little culture never hurts! unfortunatley, not all of the people who reply to these threads are as open minded as you. open mindedness....... i think a great quality in an er nurse. you have to be open minded enough not to take every issue or complaint personally and open minded enough to have a sense of humor about things. after all, if we had no place to vent, like our fellow staffers or this bb then the work stress would follow us home..... and well, you know what can happen.

culture is a goooooooood thing! thanks athomas91! i like your thinking.

THE SOUND OF WATER SAYS WHAT I THINK. - lao tzu/tao te ching

:kiss

This is to athomas91 and avigail

I completely respect what you've had to say here. I am very disappointed when advanced practice nurses and similarly experienced nurses trash the views of other nurses. We each have a unique experience that should be considered and respected. Though we all appear to be coming from a patient advocate type of perspective, we indeed do have a lot of variance in them. This is good!

YES! We DO need to be nonjudgemental in our assessments of patients, including pain. But, this needs to be tempered with our EXPERIENCE. I am personally aware of a "sickler" whose a regular in our ED that has a script for (are you ready???) 3200mg of oxycontin q 8 hours!!! I am serious! She then expects this from us in ED for exacerbations. We were all stunned when the doc looked up records on said pt during a recent visit and found this rx! I fail to see how a human being could tolerate that much. This aside, the patient DID get enough IV pain meds to releave her symptoms, though no where NEAR what she was asking for. We all assume, this is a second income for her - keeping the local junkies fixed... Of course, Medicaid (WE) pays for this.

A person's perceptions and personal habits (drug use) do indeed have a drastic affect on their pain perception and how much it takes to get relief. I have no problems with ensuring a pt gets relief. In fact, my biggest problem is getting a reasonable order from a doc for pain control. How many times have you had a huge person with obviously severe pain get a rediculous med order, such as MS 2 mg IVP?

There's a happy medium here, some where. Trashing other nurses opins do not help.

athomas91 and avigail, read this as I am in agreement with you. And, to my learned colleagues that laud themselves over our "ignorant" views: get a life! You should learn to respect your colleagues as much as you respect your drug abusers.

'nuff said!

------------------------------------------------------------

"Discretion in speech is more than eloquence."

Sir Francis Bacon

:chuckle

erkev, i wish there was a smily for a standing ovation. but there is not so...... clap clap clap.

life is what you make it.

Thanks, Magik Girl!

Originally posted by MAGIK GIRL

:chuckle

erkev, i wish there was a smily for a standing ovation. but there is not so...... clap clap clap.

life is what you make it.

ERKEV - an er nurse w/ some insight..... thank you....

:D

Thanks, athomas:D

Nurses need to pull together....

[.

.

Dave, who will gladly order medication based on what the PATIENT says their pain is. [/b]

Perhaps it is this attitude by Private Medical Practioners that create the multitudes of drug addicts who frequent their local E.R's. Once the patient becomes annoying or unable to pay for service they are dumped and then have no PMD to take care of them, so they become "slaves to the system" and their only solice is to go to their local ERs for medical attention and "drug fix"

Also from an altruistic point, our primary job as an RN (in my opinion) is to be a patient advocate. Confronting (in a tactful way of course) a patient on inapropriate narcotic use and ER abuse is

not out of the scope of being an advocate.

HK

Also, may I prempt the Moral Majority who may negativly respond to this: first off, I am not accusing Dave (1st or 3rd person) of being a bad practioner, I'm sure he is very good at what he does), secondly, if I (or others) post something negative about medicating patients or meds seekers, it doesn't mean that we are terrible nurses who should look for other lines of work. Open your minds a bit and see we may be coming from a different angle.

On the flip side of that..I worked ER for a long time and Yes. I have seen the seekers over and over again but if we were TRUE advocates we would help them get help instead we either medicate them or refuse them and send them out them out the door to the hospital down the street...then we complain about them?? Addiction is a disease..In my opinion the problem is us and our misconceptions as well as the fact that we tend to think this is the person's own fault. I would agree at one point they had a choice but as addiction progresses there is no longer a choice at least not in the patient's mind. So if we were TRUE pt advocates we would do more than complain about them (maybe we complain about them becasue WE feel helpless to help them??) ..however I have no idea what a feasable solution would be..anybody have any ideas?? Erin

Originally posted by Erin RN

On the flip side of that..I worked ER for a long time and Yes. I have seen the seekers over and over again but if we were TRUE advocates we would help them get help instead we either medicate them or refuse them and send them out them out the door to the hospital down the street...then we complain about them?? Addiction is a disease..In my opinion the problem is us and our misconceptions as well as the fact that we tend to think this is the person's own fault. I would agree at one point they had a choice but as addiction progresses there is no longer a choice at least not in the patient's mind. So if we were TRUE pt advocates we would do more than complain about them (maybe we complain about them becasue WE feel helpless to help them??) ..however I have no idea what a feasable solution would be..anybody have any ideas?? Erin

It is difficult to try to change a lifetime of behavior during a visit to the ED on a full moon Saturday night...Or during a 3 dayy vacation on your med-surg unit whit a sky high census and acuity and no help.....We are HUMANS-venting is how we cope and isn't this an appropriate forum for that? We should be kvetching and supporting each other-not tearing each other down by being judgemental...Chronic pain is terrible for the patient and pain management is a wonderful field-we can all learn a lot right here from some of the members of this board....But dealing with druggy frequent flyers is also a challenging part of nursing-we can help each other out with that here also......

I am not denying anyone the right to vent here and I agree this forum is great in that it gives us an avenue in which to "blow off steam" what I am saying is that the drug seeking problem has two components..supply and demand..in order to stop the problem one or the other needs to be addressed..either the ER MDs quit giving narcs or the "druggy frequent flyers" get sober. Believe me I know the frustration, I have been there as an RN with a full assignment of ER pts that were truly sick / dying. The last thing I wanted or needed was someone who merely wanted to get high!! However 2 of my friends that used to be nurses and will never be nurses again are now the "druggy frequent flyers" so I now know that it is a disease. Both of these individuals are about at rock bottom..husband gone, career gone and kids taken away..both of these gals used to be great RNs..I see now that is is a disease just like any other so we obviously need to treat it just like we would treat any other disease. Would we give an overdose pt more drugs?? Would we lay a melanoma pt in the sun or give a diabetic with a sugar of 900 glucose?? Doubt it...so why do we give addicts more drugs??? I guess it is easier? I am not saying don't vent here..I am just wondering whether there is something we can do since we are supposed to be pt advocates... Erin