RNs, I got a question about pain meds

Published

I tell you, working as an RN, you start to see a pattern in every corners. When you get a report, the minute the ED nurse says "the patient is obese", your immediate reaction is "okay, CHF, BNP higher than Empire State, probably diabetic with messed up kidneys, etc, etc" or you will get a report saying that the patient has "allergies" to toradol, acetaminophen, and morphine, and you start chuckle and think "this one is looking for dilaudid!"

I am not condoning to be judgmental, but you know what I am referring to about the "pattern." I have question to experienced nurses and non-experienced nurses likewise; do you think that socioeconomic status has impact on how much pts are "pain med seeking?" For example, I work in the "hood" (don't live in it, thank God) where most of pts are... of low socioeconomic status and 8/10 will do and say any rotten lies to get more pain medicine; I mean we all have seen it; a pt who is watching TV or talking on a phone, laughing with friends, then turning to you and say they got pain 10/10; having seen so much of that, I don't believe what the nursing school teaches about the "golden scale" of pain, which is whatever the heck they say it is.

I saw men in their 60s and 70s on IMC floor recovering from open heart surgery and they tell me "oh I will try to do without it." and this was from a hospital that I worked before where the clientele were relatively more educated and wealthier.

So this led me to this curiosity; does socioeconomic status affect one's pain med seeking behavior? From my experience so far, the hypothesis seems to prove itself true. I want to hear your experiences.

Up Vote Up Vote ×
Specializes in MDS/ UR.

I see questionable drug seeking across the whole age range. I am actually seeing more of it in the 45-65 age group.

Up Vote Up Vote ×

I work in a universal healthcare system. Education does not play a role in drug seeking. Economic status is not really relevant.

The 70/80+ population is either very stoic and has to have pain meds pushed on them or so med dependent they never stop asking.

What I do find more and more is Google has made the drug seekers more aware of how meds should be prescribed and how often they can take them.

Up Vote Up Vote ×

I do not see a difference. Some of my more educated patients are drug addicts as well. Overal heroin and cocaine are high dollar addictions compared to meth

Up Vote Up Vote ×
Specializes in Pain, critical care, administration, med.

Drug seekers do not discriminate. It's isn't fair to judge anyone because of socioeconomic status.

Up Vote Up Vote ×
Specializes in Nurse Leader specializing in Labor & Delivery.

I also do not see a difference. I work in a community health clinic in arguably the most dangerous neighborhood in Denver where literally 98% of our patients are on Medicaid or uninsured, and I don't see any more drug seekers here than I did in a private hospital near Sedona AZ.

Up Vote Up Vote ×

okay, seems from many of you that socioeconomic status does not affect habit of drug seeking... I am surprised to hear that the drug seeking habits are of equivalent prevalence in both kinds of hospitals that serve high and low socioeconomic status. Man, is everybody hooked on these meds? I don't quite get it.

Up Vote Up Vote ×
Specializes in Emergency & Trauma/Adult ICU.
okay, seems from many of you that socioeconomic status does not affect habit of drug seeking... I am surprised to hear that the drug seeking habits are of equivalent prevalence in both kinds of hospitals that serve high and low socioeconomic status. Man, is everybody hooked on these meds? I don't quite get it.

No, but they are hooked on the notion that they should be pain-free. We reap what we sow ... and this is what more than a decade of healthcare regulatory emphasis on "pain management" has added to our culture.

Up Vote Up Vote ×
Specializes in Psych, Corrections, Med-Surg, Ambulatory.

I did see a lot more drug-seeking behaviour in the jail than in med-surg, so I guess that would be the non-law-abiding vs the law-abiding population. On med-surg I did give more pain meds to younger people; older people tended to be much more stoic. I theorized that older people had been through a few bumps in life and didn't get wigged out as easily. Young people tended to be much more anxious about what was happening to them, and having anxious parents at the bedside didn't do much to reassure them.

Up Vote Up Vote ×
I did see a lot more drug-seeking behaviour in the jail than in med-surg, so I guess that would be the non-law-abiding vs the law-abiding population. On med-surg I did give more pain meds to younger people; older people tended to be much more stoic. I theorized that older people had been through a few bumps in life and didn't get wigged out as easily. Young people tended to be much more anxious about what was happening to them, and having anxious parents at the bedside didn't do much to reassure them.

^^^This^^^

I'm amazed at the number of young people (21+) that have their parents stay at the bedside with them 24-7 and seem to dictate their lives.

Up Vote Up Vote ×

I have pain med seekers of all ages, gender and cultures....

However, the largest group so far are middle aged white females age 40-70

They are poor and they are rich, so socioeconomics sees to have little to do with it

Up Vote Up Vote ×
Specializes in Surgical, quality,management.

As an abdo surgical nurse men in their 20s are big wimps lap appendix requiring a PCA. In the next bed a 70 something war vet who had had a 6 hr laporotomy OOB 6 hrs post op. The 20 something women fall into either "this is the worse pain and nobody can understand so I will howl" or the stoic who will ask for a pain killer then do as they are told

Up Vote Up Vote ×
+ Join the Discussion