Treating pain in ER

caroladybelle, BSN, RN · May 28, 2011

And could I suggest that perphaps since according to your listed experience you have never worked in the ED...so you probably don't have a very good sense of what my job is like. I also view your comment as a personal attack and will report it as such.
Now please continue to enable each other on this site.

Pot, meet Kettle

I believe what may have been meant, is that it is not the "patients like you" but the MDs/system/ stress, etc.

The OP has been polite, and your comment about them could be more closely perceived a "personal attack" than what was directed at you.

To the OP: chronic pain and it's exacerbations rarely gets treated well in the ER. Your pain control specialist should have a plan in place for proper care of exacerbations outside of normal business hours. It is what a RESPONSIBLE practitioner of pain control does, knowing full well the problems his/her PTs will have in the ER. If they do not, then perhaps a chg is in order.

Butterfly0328 · May 30, 2011

Nynurseatheart- Thank you for your post. To answer your question besides the oxycodone I take advil as needed. My dr had tried me on naproxen but it gave me stomach probs. He also gave me lyrica but my insurance wants me to pay 50% and I can't afford it. My mother passed away 4 weeks ago and the stress has increased my pain 10 fold. I get what you mean about finding another dr but it's so hard to find a good pain dr where I live. I have never had my pain flare out of control like this before. So hopefully it won't happen again. Thanks again for the advice. God Bless

Butterfly0328 · May 30, 2011

Also, could you elaborate more on the biofeedback you use for pain control? I want nothing more than to be off narcs completely. I HATE being dependent on them. Also, how do you utilize hypnosis? I am very interested in anything like this as I know the brain is a very powerful organ. Thanks again so much!

badphish · May 31, 2011

probably has already been said i dont want to sift through the pages of this thread.

but, i would definitely look not START a nursing career if i had chronic pain issues!! 1. your condiion will only worsen, way too much lifting pushing pulling etc. 2. you will be expected to be at work when scheduled, 3. school is a bear and does not allow for many absences, light duty etc. 4. if narcs go missing guess who they will look at first. 5. being in constant contact with narcotics may be too tempting.

Again the ER is not for chronic pain issues, call your doc's service, and/or next visit ask for some meds for when you have break through pain, ( or you could just move down here to florida and visit one of our many many pain med mills,, :) )

ER staff are very callous sorry nature of the job, we see way too many drug seekers, and we dont like to get burned. so when we see red flags like : chronic pain, taking massive oxycodone, history of chronic kidney stones, chronic back pain, nueropathy, nuero myalgia, etc we see drug - seeker, and we do not give out dilaudid lightly. many ask for it by name.

the many many many hours on your feet, 12 hour work days are probably not a good fit for you.

peace out,

brett

sorry if i offended anyone, things lose their meaning in this medium

keikei · Jun 14, 2011

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...

This is my reason for reading the posts on here, though I don't post much since I don't have any real nursing experience. I want to get a feel for what I'll be doing before I invest a lot of time/money into schooling for it. I want to make sure I have the right personality and that I would do a good job. But right now, my only experience with hospitals is from the view of a patient. I am in pre-nursing now (just finished up the STNA course, waiting to take the exam so I guess I did get a few hours of "clinic" time in). I am also a very compliant patient and it's interesting to me to see how you all think of us "chronic pain" patients. I'm actually the patient in room 35 who was called on her cell-phone while grocery shopping urged to IMMEDIATELY head to the ER because my nephrologist had just gotten my blood test back & my potassium was 1.7. I had no idea this was a big deal until I had arrived (I had been complaining of feeling very weak & exhausted to the point where I couldn't get up from the floor sometimes, but as it usually is, doctors tell you to just drink more fluids, get more rest, etc). So that's me in there, quietly writhing in pain because IV potassium is one of the most painful experiences I've ever had. And I had to have it for 17 hours while also being given Potassium pills and even bags of potato chips. Meanwhile, all around me I hear patients come in with gunshot wounds, stabbings, an old lady having chest pains, a 20 something girl crying very loudly because her stomach hurt (turns out she had gas, they sent her home after they gave her simethecone). But the most fun was the drug OD in the stall next to mine. She was ranting all crazy, calling the nurses, docs & anyone else in there horrible names and then when they'd leave the room, she'd get on her cell phone & chat away like she was at ClubMed. She was asking for some sort of pain med, they told her no so she fake fainted by lying carefully on the floor when they walked in (by now the gunshot had gone to surgery, stabbing person wasn't as bad as it seemed, he was stitched up and sent back to jail, fart girl had gone home so it was old lady chest pains, OD girl and me, potassium IV person. I never asked for pain meds or even a drink of water because I knew they were busy and didn't want to bother them. I was dying of thirst but I couldn't get up to get my own drink due to being tied to the IV pole and the heart monitor. At one point, the pain from the IV potassium got so bad it must have showed up on the monitor because someone came in to make sure I wasn't dead or something.

So I'm sorry that patients like us, the chronically ill who sometimes have medical emergencies, are making you want to leave nursing. It's bad enough being relatively young and living with such a crappy disease that I have from no fault of my own. I'm a non-smoker, non-drinker, never taken street drugs, only take what is prescribed and exactly how it is prescribed, I'm the rare one who prefers NOT to take narcotics if something else will work. I'm pleasant, I try to be understanding, I don't complain, I DO fill out the Press-Gainey but with one exception, it's always been all positive as I made it a point to find the good rather than focus on anything that was bad. I know patients like me bring you down but what else can we do? I don't know where else I could have gotten this care but at an ER? Where else should I go for pain control when I'm passing one of the 15 kidney stones they've counted in my kidneys? When my potassium goes to low, where should I be treated, is that not an emergency too? From the way the drs and nurses acted it was. When I asked to go home, the brought in four different doctors to convince me to be admitted because they said I could walk out of the hospital & have a heart attack. What about the fact that I'm slowly bleeding 24/7 internally from one cyst or another on my kidneys or liver and that causes severe anemia (that isn't noticed until it shows up on a blood test. The only treatment for that is IV iron and the last time I had that, I went in to anaphylactic shock. (or maybe something else, I'm getting blood taken tomorrow & I have a feeling that anemia is back, I don't know how they'll treat it this time *nervous*

So I come here and I read about what you all experience at your jobs and try to decided if and how I could fit in somewhere. I've had some excellent nursing care. To the point where I STILL remember their names and every once in awhile, I send over a treat of some sort just to let them know how much it meant to me that they cared that much. I have had nurses who have taken the time to put a cold cloth on my forehead (when I was in a lot of pain & they could see how much it must have been hurting) even when the place was being slammed and tell me "please let me know if there is anything at all I can do for you, ok? Just press the button and I will be here" That made me feel like it was all going to turn out OK. And that's they type of nurse I'd like to be for someone. Not that creepy one who tells me how nice my private parts look while she's putting a cath in me. :eek: So see, just as we need to understand what you are going through as nurses, sometimes the patient point of view is valuable too. And I hope while I'm on this journey from pre-nursing, to nursing student to finally becoming a nurse, I am able to find those good nurses that I know are out there who are willing to share the good, the bad & the ugly with me to help me be a better nurse one day too.

Esme12, ASN, BSN, RN · Jun 14, 2011

This is my reason for reading the posts on here, though I don't post much since I don't have any real nursing experience. I want to get a feel for what I'll be doing before I invest a lot of time/money into schooling for it. I want to make sure I have the right personality and that I would do a good job. But right now, my only experience with hospitals is from the view of a patient. I am in pre-nursing now (just finished up the STNA course, waiting to take the exam so I guess I did get a few hours of "clinic" time in). I am also a very compliant patient and it's interesting to me to see how you all think of us "chronic pain" patients. I'm actually the patient in room 35 who was called on her cell-phone while grocery shopping urged to IMMEDIATELY head to the ER because my nephrologist had just gotten my blood test back & my potassium was 1.7. I had no idea this was a big deal until I had arrived (I had been complaining of feeling very weak & exhausted to the point where I couldn't get up from the floor sometimes, but as it usually is, doctors tell you to just drink more fluids, get more rest, etc). So that's me in there, quietly writhing in pain because IV potassium is one of the most painful experiences I've ever had. And I had to have it for 17 hours while also being given Potassium pills and even bags of potato chips. Meanwhile, all around me I hear patients come in with gunshot wounds, stabbings, an old lady having chest pains, a 20 something girl crying very loudly because her stomach hurt (turns out she had gas, they sent her home after they gave her simethecone). But the most fun was the drug OD in the stall next to mine. She was ranting all crazy, calling the nurses, docs & anyone else in there horrible names and then when they'd leave the room, she'd get on her cell phone & chat away like she was at ClubMed. She was asking for some sort of pain med, they told her no so she fake fainted by lying carefully on the floor when they walked in (by now the gunshot had gone to surgery, stabbing person wasn't as bad as it seemed, he was stitched up and sent back to jail, fart girl had gone home so it was old lady chest pains, OD girl and me, potassium IV person. I never asked for pain meds or even a drink of water because I knew they were busy and didn't want to bother them. I was dying of thirst but I couldn't get up to get my own drink due to being tied to the IV pole and the heart monitor. At one point, the pain from the IV potassium got so bad it must have showed up on the monitor because someone came in to make sure I wasn't dead or something.
So I'm sorry that patients like us, the chronically ill who sometimes have medical emergencies, are making you want to leave nursing. It's bad enough being relatively young and living with such a crappy disease that I have from no fault of my own. I'm a non-smoker, non-drinker, never taken street drugs, only take what is prescribed and exactly how it is prescribed, I'm the rare one who prefers NOT to take narcotics if something else will work. I'm pleasant, I try to be understanding, I don't complain, I DO fill out the Press-Gainey but with one exception, it's always been all positive as I made it a point to find the good rather than focus on anything that was bad. I know patients like me bring you down but what else can we do? I don't know where else I could have gotten this care but at an ER? Where else should I go for pain control when I'm passing one of the 15 kidney stones they've counted in my kidneys? When my potassium goes to low, where should I be treated, is that not an emergency too? From the way the drs and nurses acted it was. When I asked to go home, the brought in four different doctors to convince me to be admitted because they said I could walk out of the hospital & have a heart attack. What about the fact that I'm slowly bleeding 24/7 internally from one cyst or another on my kidneys or liver and that causes severe anemia (that isn't noticed until it shows up on a blood test. The only treatment for that is IV iron and the last time I had that, I went in to anaphylactic shock. (or maybe something else, I'm getting blood taken tomorrow & I have a feeling that anemia is back, I don't know how they'll treat it this time *nervous*
So I come here and I read about what you all experience at your jobs and try to decided if and how I could fit in somewhere. I've had some excellent nursing care. To the point where I STILL remember their names and every once in awhile, I send over a treat of some sort just to let them know how much it meant to me that they cared that much. I have had nurses who have taken the time to put a cold cloth on my forehead (when I was in a lot of pain & they could see how much it must have been hurting) even when the place was being slammed and tell me "please let me know if there is anything at all I can do for you, ok? Just press the button and I will be here" That made me feel like it was all going to turn out OK. And that's they type of nurse I'd like to be for someone. Not that creepy one who tells me how nice my private parts look while she's putting a cath in me. So see, just as we need to understand what you are going through as nurses, sometimes the patient point of view is valuable too. And I hope while I'm on this journey from pre-nursing, to nursing student to finally becoming a nurse, I am able to find those good nurses that I know are out there who are willing to share the good, the bad & the ugly with me to help me be a better nurse one day too.

I am not sure if you are unhappy with my post or me or just venting in general.........unfortunately there are bad nurses, bad doctors, bad surgeons, bad aides, bad teachers, bad police, bad politicians:uhoh3:, just about bad anything. I too have been both patient and nurse.......I have seen bad care given to people I love :devil: ........I hope your experiences do make you a better nurse. I don't excuse the bad attitudes or bad care. I try to get everyone to see things from the others shoes......to practice tolerance and understanding....to agree to disagree......and that we can disagree without being disagreeable. (I admit that the last one is a tough one especially sometimes here:cool:) I wish you luck on your endeavours and I hope your transplant goes well......peace:heartbeat

Music in My Heart · Jun 14, 2011

unfortunately there are bad nurses, bad doctors, bad surgeons, bad aides, bad teachers, bad police, bad politicians:uhoh3:, just about bad anything.

And let's tell it like it is: There are also bad patients and bad families.

keikei · Jun 15, 2011

I am not sure if you are unhappy with my post or me or just venting in general.........unfortunately there are bad nurses, bad doctors, bad surgeons, bad aides, bad teachers, bad police, bad politicians:uhoh3:, just about bad anything. I too have been both patient and nurse.......I have seen bad care given to people I love ........I hope your experiences do make you a better nurse. I don't excuse the bad attitudes or bad care. I try to get everyone to see things from the others shoes......to practice tolerance and understanding....to agree to disagree......and that we can disagree without being disagreeable. (I admit that the last one is a tough one especially sometimes here:cool:) I wish you luck on your endeavours and I hope your transplant goes well......peace:heartbeat

I am not sure if you are unhappy with my post or me or just venting in general.....

....

Oh, just venting in general... Even though I'm just starting this journey (and later in life at that), I feel that I've learned a lot just being a patient. I've gotten a unique view of what is going on in a hospital because I am usually there for a long period of time & once the nurses realize that I'm not "needy", they tend to let their guard down a bit and chat with me as a person, not a patient. When it gets quiet, I tend to be the patient the nurses come to check on and just sit & talk with, I listen to their concerns (without the violating another patients privacy), they tell me about their families or dogs or how long they've been there & how tired they are, etc. So even though I've never done your job and couldn't really ever know what it is like for you until I do, I am trying to understand and learn as I go along. I'm a very "thoughtful" person, meaning I like to consider all points of view when I'm making a decision and that's why I visit this site. I'll admit, sometimes I'm shocked at what I read, but I've also learned a lot as well. Thank you for you well wishes, transplant is scary, waiting is scary and all that goes along with being sick a lot is scary & frustrating but it's always nice to hear someone wish me well :redpinkhe

psu_213, BSN, RN · Jun 15, 2011

It is very difficult the few times I've been sent to the ER (my dr sends me as she only sees patients once a week and that's the only place for me to get care outside of those times for my kidney issues)

I am certainly not telling you what you have to do (I have no right to go that far)....however, I strongly recommend that you get a new PCP. If she sees the ED as the best place to treat your chronic pain, that I can't even tell you how misguided she is.

psu_213, BSN, RN · Jun 15, 2011

You know, seriouosly, you are there to treat-PERIOD!! Not pass judgment etc. You may get a lot of people YOU FEEL should lot be coming to the ED, but if it were a perfect world and only those that needed to go to the ED went, you may not have a job!! So, I guess you could say those of of "idiots" that go to the ED to have our brows rubbed, like we are attention seekers or something, are the reason you even get a paycheck. So, please stop judging and do your jobs please. GEEEEZZ

And it would be a really good idea (according to a non-ED nurse) to go and treat someone with chronic pain and say "I'll be there in a few minutes" to the STEMI pt.

psu_213, BSN, RN · Jun 15, 2011

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.

allEDdoctors?

psu_213, BSN, RN · Jun 15, 2011

She was asking for some sort of pain med, they told her no so she fake fainted by lying carefully on the floor when they walked in (by now the gunshot had gone to surgery, stabbing person wasn't as bad as it seemed, he was stitched up and sent back to jail, fart girl had gone home so it was old lady chest pains, OD girl and me, potassium IV person.

How do you know so much about the other pts. around you? Why is it any of our business? Most importantly, what does it have to with your or the OP's chronic pain? Not judging people or their pain, but I lose a lot of respect for a pt that tells me that their problem is more important that the pt in the next room.