Treating pain in ER

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Do you nurses typically see patients undermedicated in the ER for pain? I had the worst experience this past weekend. I have suffered chronic pain for about 10 years and at one time was on 600mg of oxycontin a day for about 5 years. I have weaned myself off of the oxycontin and now am on 120mg of roxycondone. I recently learned I have spinal stenosis in my lumbar, along with chronic kidney stones and neuropathy. So early sunday morning, after waiting over 8 hours for the pain to let up, I finally went to the ER. The ER doctor would only give me toradol and phenergan for nausea/vomiting ( I was also vomiting blood ). Finally he agreed to give me 1 ml of dilaudid (what a nice man. gag) which literally only took the edge off of my pain for about 15 minutes. Worst experence ever. I left in about the same pain I arrived in, only not vomiting. I made it a point to tell the Dr that I unfortunatelly have a high tolerance to pain meds, but he didn't care. Said chronic pain isn't treated in the ER. I thought if someone comes into the ER in chronic pain it must be treated, regardless of the cause. I wasn't asking or and RX or narcs, as I already had that at home, just wasn't working with this severe pain. Now I know the addicts probably mess things up for us who really need the relief, but shouldn't the doctor be able to tell the difference? Just curious about what you ER nurses see with regards to the subject. Thanks

Specializes in CVICU,ED,ICU,Nursing Supervisor.

I agree that Butterfly and the other poster had a bad experience, honestly i do. but the issue here for me has become that this site is designed for nurses to use to exchange information,experiences and a safe place to vent. I left this site for a long time and have only recently returned because i got to the point where i just could not take coming on here and reading one more patient or nurse wanna be slandering and bashing nurses. well it appears that that is still the genereal theme on this site. its bad enough that i have people like this at work, patients family member all wanting to tell me how to best do my job but to then have to deal with the same sense of entitlement and know it all attitude here, a site for NURSES, is just too much.

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Specializes in future OB/L&D nurse(I hope) or hospice.

I am probably the most compliant patient you will ever have. I NEVER press the call button-ever. I never demand. I have dealt with pain for years, and I can assure you that I have never gone to the ED for my chronic pain issue-until this day... I didn't even know if it was my kidneys or the stenosis I was recently diagnosed with. My doctor told me to go the ER if my pain level accelerated to a 10/10. What was I supposed to do? We do what our doctors advise us to do. You are correct in that I am not a nurse yet, so how could I possibly know what I am doing is considered wrong? Now, that night I had no issues with the nurse I had. She was very nice-and I never expect anyone to rub my brow or hair. Good grief. I was only accused of that. And just for the record, the ED was not busy at all. It's a new hospital. Of course I would expect the emergencies to be taken care of first-I am not that selfish. My gripe now is the responses I have gotten from a few on here judging me and for all intents and purposes classifying me as a drug seeker and addict. So, to end this nonsense the only thing I would expect of any nurse, including myself once I get that license, is to treat all with respect and not to judge. I did once go to the ER a few years ago due to kidney stones and they were swamped. So the ER doc was very nice, came in and told me they had several life threatening emergencies he had to attend to but wanted to make sure I was comfortable as soon as possible until he could get to me as my vitals were fine. So he had the nurse medicate me with morphine, even though he offered dilaudid. I was more comfortable with morphine since that is what I have been treated with in the past for kidney stones. Now, if I were a drug seeker I would have taken the dilaudid. Now, in my opinion thats the way to treat.

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True. But, last time I checked, this forum was called "allnurses", not "allpatients". I listen to my patients when I am at work. When I come here, it is to discuss topics relevant to my work as a nurse with other nurses, not to be chided by people who are NOT nurses, telling us how we OUGHT to practice.:nurse:

Quite interesting that those telling us how we ought to practice are often those who did not get the 5 star, full service, I-got-what-I-wanted-at-the-moment-I-aksed-for-it, not emergent, hold-my-hand, chronic-pain-that's-not-being-properly-treated-by-their-primary- MD, but-I'm-going-to-btich-that-the-ER-didn't-give-me-the-exact-meds-I-wanted-quick-enough types.

OP excluded of course.

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Specializes in future OB/L&D nurse(I hope) or hospice.
True. But, last time I checked, this forum was called "allnurses", not "allpatients". I listen to my patients when I am at work. When I come here, it is to discuss topics relevant to my work as a nurse with other nurses, not to be chided by people who are NOT nurses, telling us how we OUGHT to practice.:nurse:

My original post had nothing to do with the nurse, but just a question regarding how pain is treated where you all work and an opinion. I didn't get upset until some nurses on here started passing judgment and classifying me as a drug seeker. This sight is also for pre-nursing students, which is what I am. I have just as much right to be here as you do. We got way off topic here. I know you all work very hard and couldn't be more appreciative for what you all do. The nurses I have had over the years have been incredible-for the most part. God Bless you all for what you do. I am done here with this thread.

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. And just for the record, the ED was not busy at all. It's a new hospital.

This is a pretty asinine statement.

Now, if I were a drug seeker I would have taken the dilaudid.

You did take Dilauded.

And, drug seekers don't always take the strongest medication we have. They want what they like. Sometimes it's Ativan, sometimes it's dilauded, sometimes it's demerol, sometimes it's morphine.

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Specializes in future OB/L&D nurse(I hope) or hospice.
This is a pretty asinine statement.

You did take Dilauded.

And, drug seekers don't always take the strongest medication we have. They want what they like. Sometimes it's Ativan, sometimes it's dilauded, sometimes it's demerol, sometimes it's morphine.

If you read my post more clearly you would have seen I was referring to a time I went to the ER several years ago due to kidney stones. Yes, I did get dilaudid this time. The reason being I have become more tolerant to pain meds.

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My original post had nothing to do with the nurse, but just a question regarding how pain is treated where you all work and an opinion. I didn't get upset until some nurses on here started passing judgment and classifying me as a drug seeker. This sight is also for pre-nursing students, which is what I am. I have just as much right to be here as you do. We got way off topic here. I know you all work very hard and couldn't be more appreciative for what you all do. The nurses I have had over the years have been incredible-for the most part. God Bless you all for what you do. I am done here with this thread.

Your original post was as a patient, not a pre-nursing student. A pre-nursing student might have asked what are some typical pain protocols for the ED and left the patient experience out.:twocents:

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If you read my post more clearly you would have seen I was referring to a time I went to the ER several years ago due to kidney stones. Yes, I did get dilaudid this time. The reason being I have become more tolerant to pain meds.

I read your post. You said that if you were a drug seeker you would have taken the Diluaded.

Based upon your logic, drug seekers take Diluaded. You took Dilauded. Ergo...

(The point, because I don't think you'll be able to figure it out, is that your logic is bad.)

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I know you all work very hard and couldn't be more appreciative for what you all do. The nurses I have had over the years have been incredible-for the most part. God Bless you all for what you do.

Thank you for that. I'm sure your experiences as a patient will help you to be the kind of nurse that you aspire to be.

I think some of us, myself included, can be quick to be defensive, because we get treated like dirt every single day, usually by the least sick who have unrealistic expectations. It's really nice to hear a "thank you" every once in a while.

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Specializes in future OB/L&D nurse(I hope) or hospice.

I couldn't agree more. In my opinin you are all saints for the work you do. Like I said , this thread got way off topic. If you go back and look at my original post the first thing I asked is how pain is typically treated in the ED where o

you all work. Then I followed by my experience. I never ever said I expected any nurse to rub a brow, stoke my hair etc. That is just plain stupid to expect or even want! I have read several of your posts and really do like you and admire your level of expertise. I can tell you are an exceptional nurse. I truly mean that. I get tempers flare and understand the best I can the crap you all deal with everyday. I have no issues at all with you. God bless and keep up the great work.:)

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
True. But, last time I checked, this forum was called "allnurses", not "allpatients". I listen to my patients when I am at work. When I come here, it is to discuss topics relevant to my work as a nurse with other nurses, not to be chided by people who are NOT nurses, telling us how we OUGHT to practice.:nurse:

I know but she is going to go to school or is in school......I just wanted to give her a peek as to why we feel the way we do.....If you're going to enter a field you need to have some insight as to why we feel the way we do...and maybe change the way we are percieved to change the way we are treated...

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Specializes in future OB/L&D nurse(I hope) or hospice.
Quite interesting that those telling us how we ought to practice are often those who did not get the 5 star, full service, I-got-what-I-wanted-at-the-moment-I-aksed-for-it, not emergent, hold-my-hand, chronic-pain-that's-not-being-properly-treated-by-their-primary- MD, but-I'm-going-to-btich-that-the-ER-didn't-give-me-the-exact-meds-I-wanted-quick-enough types.

OP excluded of course.

Don't think for a second I didn't "get" your sarcastic remark by saying "OP excluded of course".

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