Earlier this week I had a patient that apparently comes into the ED frequently always with abd pain, they can never find anything wrong with him. He must have thought I was an easy target because I have never seen him before. (I only started on the unit in August) Chief complaint? Constipation x 2 days. Takes multiple narcotics, hx of abuse, ect. He is complaining that he has 10/10 pain, as he is sitting up calmly, and is asking for pain meds. I went to the doc and was like, this guy claims 10/10 pain, but look at him. So he goes and does the abd exam with no tenderness on palpation. I had 9 patients that night (some of them really sick) and his wife was harrassing me every minute for something, I was like (in front of the patient too) I have a lot of patients, many sicker than him, that I need to attend to right now, I cant get a pill/give him dilaudid/get him another blanket. The nice lady in bed 2 is about to be intubated and she needs my attention right now. Give me a minute please. He starts saying to me that he is very sick and dying and that I need to focus my attention to him mainly. Than he tells me that I need to order Klonopin for him NOW because he takes it at home and he missed his dose and if he doesnt take now it its "very dangerous". (The doc was getting the d/c papers as we were speaking). He than becomes mad when he finds out he was being d/c'd, he "demanded" to be admitted. Sorry, but a clear CT and x-ray is not going to buy you a day or two free drug stay!
Thank you all for listening to my vent!! I love this site, I can vent about this and you all have been there done that and understand!
I used to work with a gal who had chronic headaches that were extremely debilitating. She was constantly in being seen in the same ER of the hospital that we work in. She started being labeled as a drug seeker since MSO4 was the only thing that relieved her pain, and she knew and told them that it was the only thing that worked. After 3 months of pain, she went to another hospital for a second opinion. They found a large anerysm in her brain which was causing the headaches. After surgery, she had some cognitive impairment that prevented her from working.
Perhaps if someone had taken the time to take a history or listen to her, she perhaps could have had a longer career in the nursing field.
Imagine if we had the ability to be empathic for just one day, particulary on the "drug seekers"?
I used to work with a gal who had chronic headaches that were extremely debilitating. She was constantly in being seen in the same ER of the hospital that we work in. She started being labeled as a drug seeker since MSO4 was the only thing that relieved her pain, and she knew and told them that it was the only thing that worked. After 3 months of pain, she went to another hospital for a second opinion. They found a large anerysm in her brain which was causing the headaches. After surgery, she had some cognitive impairment that prevented her from working.
Perhaps if someone had taken the time to take a history or listen to her, she perhaps could have had a longer career in the nursing field.
Imagine if we had the ability to be empathic for just one day, particulary on the "drug seekers"?
I cannot believe in all her visits to the ER no doc ever scanned her head...
Quite a shame.
Although I wonder...why she never sought out a neurologist instead of only using the ER...doesn't she bear part of the burden of her own medical care?
Specializes in LTC, CPR instructor, First aid instructor..
I'm not refering to the ones that go in 6 or 7 times a week allergic to every drug except drug of choice. Isn't it possible that because of these people, legit pts that present with some of these "symptoms" of drugseeking behavior, like allergies to whatever(not everything) are treated poorly due to 10 previous seekers in the same night? My doctor even admits thats the case.
Excellent point, and one I have to deal with all the time.
there is no doubt that even after many years of experience with seekers, or frequent flyers, that you become jaded,hopefully one does not lose their compassion...I am sure there is not one of us who, on a extremely busy shift when half the staff has called in and all hell has broken loose with every serious cardiac, respiratory problem presenting and not enough hands to even hold the ambu bag, or monitor the drips and heart rates, has lost the edge of compassion, missed a symptom, only to find out the next shift and be brought humbly to our knees before God that we let that edge drop. It is very difficult in todays medical environment to maintain that edge within the parameters we are expected to practice within. The "data to support the need" in regards to staffing in the ED has certainly impeded the focus to maintain that very important edge....sad.
I'm not jaded yet, but probably getting there. I'm known as the gullible one on my shift because I believe until I'm proven otherwise. I really hate to be taken advantage of as I'm sure most people do. The drug problem in this area is rampant and only getting worse as alot of MD's are trying to cut down on the narcotics they write out of their offices to keep out of trouble themselves. They're flowing into the ER's. The economy in this end of the state is bad..no jobs for people and they've found a lucrative business in selling prescription and street drugs to get by. Alot of them live better than me judging by clothes they wear and vehicles they drive. Some make it their "jobs" to go from one ER to the other gathering up scripts. My son comes home and tells me of the Lortab, Xanax and Percocets being sold in school and snorted right under the teacher's nose..and where are these coming from? So that leaves us Where? Where's the middle ground..do you treat these seemingly perfectly healthy people's pain according to their perception of the pain scale and contribute to the amount of drugs on the streets getting to our kids? We try to refer alot of our frequent flyers to pain clinics, neurologists, etc. to manage their illness once their physical exams have been completed and cleared. Some just won't go for one reason or another and expect the ER to supply their needs. OK...I'll get off the soap box for now..By the way..anyone know of a good travel company to sign up with to travel within the state of KY?
Specializes in LTC, CPR instructor, First aid instructor..
The drug abusers have made it verrry bad for those of us who are the legitimate ones who really do need the meds. How very SAD. No wonder the doctors and nurses don't believe us when we really are telling them the truth anymore.
But it does make us feel bad all the same. I wish the bad guys would let the good guys alone.
The drug abusers have made it verrry bad for those of us who are the legitimate ones who really do need the meds. How very SAD. No wonder the doctors and nurses don't believe us when we really are telling them the truth anymore.
But it does make us feel bad all the same. I wish the bad guys would let the good guys alone.
You are SO right. I just read in the paper that the DEA is starting to invesitgate how doctors prescribe narcotics, and legitimate patients who NEED these drugs are being shorted because their doctors are so paranoid about prescribing them. I know that one place where I did a clinical won't take a chronic pain patient because of the risk of liability. What are people going to do? :angryfire
I wish the bad guys would let the good guys alone. 
z's playa
2,056 Posts
Yes ,Yes and Yes!!!!!!!!!!!!!