sitting with drug seekers.

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So my job is primarily sitting with people for various reasons, one of them being people who are aggressive, or suicidal. 9 times out of 10, these people are wanting drugs at a pretty constant rate...the problem is when they are told that it isnt time, or when the doctor cuts them off completely. they act like its my fault or something..any ideas on coping with these guys?? 8 hours in a room with someone constantly freaking out because they didnt get their q4 dilaudid right on the dot get very very tedious. :blink: and now im just griping, but really hate it when their families show up, and either get them all riled up, or start fighting, etc.

Specializes in Oncology.

I am a nurse (RN) and somehow manage to get all my work done during my 12 hour shifts, including the MOST important part of my job, which happens to be treating my patients pain and making sure they are as comfortable as possible and are receiving the respect they DESERVE to keep their dignity intact throughout their hospitalization.

I am a very new nurse perhaps I will change my tune about "dope seekers" soon, but I doubt it. I want all of my patients to feel special and important which I do by treating them with respect and trying to keep them physically. mentally, and emotionally comfortable. I take every complaint of pain seriously. I check on my patients pain constantly throughout my shift, and if they are in pain I give their PRN pain medications as soon as possible. Maybe this is incorrect and I should wait for them to complain of pain rather than assessing their pain constantly.

I am very new and if my view of patients and their pain is skewed I am open to suggestions.

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Specializes in Oncology.
Profile says is a nursing student, although has ASN,RN as credentials. Jacob, if you are a student TOS prohibits use of titles not earned. And if you are a student then you have no idea what nurses actually have to deal with on a shift.

I am a practicing licensed RN now. I guess I did not fix the profile properly. I will work on that now, thank you for pointing out issue. I am also a female and had trouble turning my little picture into a female.

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Specializes in Oncology.
Unfortunately most of the time you cannot please them unless the nurse is sitting by a clock with a syringe of dilaudid in her hand. Which is impossible because there's a good chance the nurse has multiple pain management patients who all expect the nurse to be in on the dot. When I have patients who require ATC pain medicine (PRN by order, but scheduled per the patient),I try my very hardest to get it on time, for the patient but also for the ease of my day. I'll even go in 15 min early before they have the chance to call, if I know I'll be tied up for a while with another patient. I do know various nurses that approach these patients differently though, making them wait just because they are sick of them, which is very sad to me and really just makes for a more stressful day.

This is how I feel all nurses should aim to handle this kind of situation, but I am a new nurse, so what do I know?

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Best advice I can offer is to just keep doing what you are doing to try to calm them as well as just sympathizing (or acting like you do). When my patients are upset about anything I just keep saying "im sorry you're going through this and I'm doing every thing I can to make it better" just be very compassionate toward them. Granted there are some people who are going to act out how they will no matter what you do.. And you just have to keep your cool and then come vent here lol

I'm a very compassionate person but I also sometimes cannot do what they are asking of me.. Sometimes things are not ordered and docs don't get back to me.. Sometimes it's something totally unrelated to nursing.. And sadly us caregivers (nurses, CNAs, etc) we get the anger displaced on us often. It's just part of the job.

Make sure you are taking care of yourself when you are not at work. This is a very stressful field and doing things to de-stress when you're off the clock helps.

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Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.

I am very new and if my view of patients and their pain is skewed I am open to suggestions.

I am a practicing licensed RN now. I guess I did not fix the profile properly. I will work on that now, thank you for pointing out issue. I am also a female and had trouble turning my little picture into a female.

OK so you have abut 6 months of experience ? If you joined May 2015 and were a student at that time? You list '0.125'years of experience.? What type of unit do you work on? Is it with adult patients? Med-surg? How many patients per shift are you typically assigned? Are you on nights or days? I am asking as there are a lot of variables that you may not have considered. You also called nurses "lazy" in your first post and that is concerning. Without knowing all the details (acuity levels, nurse-patient ratio, ancillary staff/cnas/techs etc) I would be hesitant to label another nurse as "lazy". I venture you have not yet had the type of patients that request PRN meds 30 minutes before they are due, and do it every 4 hours. They know how long it takes for you to get the message, get the med signed out and get to their room down to the seconds!

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First off all I get your frustration and need to vent. To say that sitting with difficult patients is easy would be a lie. Your employer should be giving you training in how to positively redirect a person in distress. When I worked in drug rehab I saw plenty of faked seizures but we still treated them as seizures non-the-less. The point is this is not about you and you have absolutely no idea if a person is in pain or not! Stop saying they are not in pain. Until you walk even an hour in the shoes of someone who has constant unremitting pain even at a level of 1 or 2 you cannot fully appreciate what it is like. Are there patients out there who abuse the system to get high absolutely but Dilaudid is a very short acting medication with a sharp fall-off in relief as it leaves the system. PS you don't get high from opiates, you get down. If you want to see a real drug addict in action go spend some time on the detox ward of any in-patient drug rehab facility. I actually hope you are never in pain and have to deal with the kind of narrow-minded judge mentalism so many here are spouting. It's a disgrace. Dealing with difficult patients is a part of the job. If you don't like it quit.

I am going to climb off my soapbox now and get something useful done with my day off.

Hppy

I think the connotation of "high" in the context of this discussion has a very wide continuum. Without being present at the OP's assignment, we are able to only speculate and build our opinion based on what information we are given.

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Specializes in Oncology.

I've got less than 6 months of experience working as an RN. I am not speculating that the nurses are lazy, with the information given by the poster, it is easy to assess the situation and come to the (correct) conclusion that the nurses she/he works with are lazy little "gods". The only information it takes to figure this out is the posters. She/he says the patients constantly want their pain medications, the meds are q4, and are requested at least one half of an hour in advance. If a nurse knows the patient wants the medication, because patient requested it, the nurse is a scum bag for not giving the patient their medication.

I only graduated in December have less than a month of actually working as a "real nurse".

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Specializes in Geriatrics, Dialysis.
I've got less than 6 months of experience working as an RN. I am not speculating that the nurses are lazy, with the information given by the poster, it is easy to assess the situation and come to the (correct) conclusion that the nurses she/he works with are lazy little "gods". The only information it takes to figure this out is the posters. She/he says the patients constantly want their pain medications, the meds are q4, and are requested at least one half of an hour in advance. If a nurse knows the patient wants the medication, because patient requested it, the nurse is a scum bag for not giving the patient their medication.

I only graduated in December have less than a month of actually working as a "real nurse".

Don't you think it might be a bit much to call nurses lazy little "gods" and "scumbags" if they aren't able to deliver pain meds the moment a patient requests them? Do you suggest that if this "scumbag" nurse is in the middle of an emergency he or she say "excuse me, I have to leave to give patient x their pain pill now." Even if "scumbag" nurse is not in the middle of a code, I guarantee there is a lot on their plate. Your so called scumbag nurse is prioritizing patient needs which can be as simple as take a number wait in line if all of the patients want something at the same time but rarely is it that simple.

At this moment in time you are acting like the scumbag nurse by assuming that other nurses ignore patient requests for pain meds. Get some experience under your belt before you resort to name-calling like this.

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I agree that nurses get held up and no one should be called lazy or scumbag if pain meds are late for legit reason.

I also agree it's healthy to express frustration (here or in private) when you are stressed for whatever reason.. Whether it be demanding patients or anything for that matter, this job is stressful!!!

What I have issue with is labeling people addicts and seekers and ignoring legit pain. Even addicts have legit pain sometimes. I don't agree with DC'ing pain meds all together cause how is anyone to judge subjective pain other than the patient? Decreasing, I understand but leaving a patient to suffer?

These people may very well be acting out cause they need relief and can't deal with pain properly. It sucks and yes there are better ways to express your need for pain management but it just is what it is. Some people can't tolerate a pain level of 2 and it's not my place to judge.

Again as a nurse AND patient with chronic pain.. Lupus and RA.. Although I am always very patient and kind to nurses who are late with pain meds, that can also be misinterpreted as, "oh, she's so calm.. She's not really in pain"

It happened once and I politely said, "I am a nurse and I know you are busy and what you go through, so I'm tolerating the pain until the meds come.. What more can I do..."

Ps. In the time she took to question my need for medication she could have prepared it.

This is not a black and white area here. Some are "drug seeking" and some are in pain. We're not here to judge we are here to care for the patient the best we can.

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If it is a PRN order it is NOT our job to give it every 4 hours. We can give it up to every 4 hours AS NEEDED. Even scheduled meds usually have a 15-30 minute window before or after the due time as it is impossible to give 5 patients 0900 meds at 0900.

I really hope this post was actually sarcasm...I really really hope.

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Ah, but when patient is a pain seeking patient, q4 PRN to them equals/means scheduled. To them it's always "needed." Sigh.

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Ah, but when patient is a pain seeking patient, q4 PRN to them equals/means scheduled. To them it's always "needed." Sigh.

But maybe it really is needed Q4 and maybe it's not our place to judge. If that keeps happening I would call the doc and have it scheduled. I take aspirin every 4-6 hours at work and fiorinal every 6 hours off the clock. It sucks and may seem ridiculous but pain is a vital sign for a reason.

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But maybe it really is needed Q4 and maybe it's not our place to judge. If that keeps happening I would call the doc and have it scheduled. I take aspirin every 4-6 hours at work and fiorinal every 6 hours off the clock. It sucks and may seem ridiculous but pain is a vital sign for a reason.

Yes, I agree 100%. Unfortunately, it's hard to tell if it's needed or wanted.

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