I had to take care of druggies today, and was disgusted! - page 3
Hello everybody. I am a new nurse and I had my first patient who was a drug user yesterday. I took care of him but found it difficult to deal with having a patient like him as he was basically using... Read More
Dec 30, '06Occupation: Registered Nurse Specialty: none yet ; Joined: Dec '06; Posts: 68; Likes: 1Quote from jesaLet me first say that i knew from your first post that you must have been a drug addict. My pt was a drug addict, druggie whatever you want to call it, it is a fact of what he was. "It is what it is" plain and simple. i have no lack of knowledge as i am educated, as i stated in my post. I am a new nurse, no lack of knowledge here. And if there is a stereotype of a drug addict, I'm sorry my pt conveyed all of them, the munipulation, the lying, etc. I wanted some advise to deal with this type of pt as i have never had to deal with before. The lying the munipulation, etc is what i had a hard time dealing with and wanted some advise in how i should deal with these things. I have no lack of knowledge about addiction and if my title offended you sorry that it did but this is my feeling.have to chime in here again. personally, I am a recovering alcoholic/addict. I have almost 6 years sober. I think what people don't understand is the nature of this disease. no other disease tells the sufferer that they do not have a disease. this disease does. no other disease affects the mind, body, and soul like addiction does. treating addiction doesn't work with a simple treatment method like taking medication. the truth is, just like any other disease, you cannot judge someone about their treatment or lack thereof until you have HAD the illness. to say that they have help and why don't they just get it is the common mistake people who have no understanding of this disease make. it makes my heart break to watch people with addiction not be able to stay sober. I would suggest everyone get a copy of the big book (AA's main book) and read it to understand more. go to a couple open AA meetings and listen to these people. they are human and working against a disease that is working on a daily basis to KILL them.
I understand the OP's frustration and commend the OP's ability to be honest and look at her feelings about working with people who have addiction, the thing that bothered me about this post was the title "I had to take care of DRUGGIES today", those words immediately show a lack of knowledge and a blatent stereotype and disregard for the patient's disease.
Dec 30, '06Occupation: ER Nurse - Pedi and Adult Specialty: 6 year(s) of experience in Tele, ICU, ER ; From: US ; Joined: Aug '06; Posts: 502; Likes: 96In the ER I see frustrating patients all the time. One guy comes in once a month at least with a severe exacerbation of CHF, another having had a few seizures, another in DKA (and wanting strong pain meds for fibromyalgia). Not one of them is compliant with their medications, or with follow-up with their PMD/clinic. But in they come. They all get the same care everyone else gets. Pays my paycheck (well sort off, since they're all state funded). Job security anyway. I've learned to quit beating my head against the wall and just give the care I know I can give. The rest is beyond me.
Dec 30, '06Joined: Jan '06; Posts: 86; Likes: 8Quote from RN 4 UHi,Hello everybody. I am a new nurse and I had my first patient who was a drug user yesterday. I took care of him but found it difficult to deal with having a patient like him as he was basically using the system to get his drugs. His problems all came from using drugs and that is why he was there, but this man was in no pain or having no anxiety attacks but requested pain medication around the clock stating no relief, mind you he was laughing, being disrespectfuly at times and wanted me to wait on him hand and foot. I refused to cut up his salad, because there was nothing wrong with hands. I took good care of him but i did not want to be really bothered with him as there were really sick people in the hospital that needed my attention. I just do not know why drug users are allowed to get away with this. The hospital is basically providing all their drugs. Was I wrong to feel this way?
I think from your op people didn't understand that you were looking for help on how to deal with this type of situation in the fututre, it just sounded like you were venting, that is how it came across to me anyway, and it came across as very judgemental which is why I think you are getting the responses that you are. I am one semester away from graduation, work in the field and have spent hours researching addiction, actions of the different substances, long term physio. effects of different addictions on my own and by picking the brains of our physician's and np and we all realize that there is a lot that we don't know about addiction. All of my nursing texts and the critical care nursing texts just kind of scratch the surface.As for tips on how to work with these clients in the future: 1. Set firm boundries, I can't say it enough, they are manipulative by nature and even with firm boundries they may still be able to manipulate you it's just part of the addictive bahavior. 2. Know that these people are getting judged and hounded by people on a regular basis, your not the first, just one in a long line. I think this adds to some of the behaviors, they get defensive, they give in and just "fulfill that prophecy". 3. Reflect on your own feelings, dig deep. And see if maybe some of your own behaviors came across to this person, did he get the feeling that you were "disgusted" because that is a pretty strong feeling to have toward someone and hide it, and that may add to someone acting out.
I truly hope that you are getting the help that you are looking for in this post and don't feel "beat up" by some of it, it's just a heated topic.
Good luck to you.
Dec 30, '06Joined: Jan '06; Posts: 86; Likes: 8Quote from KymmiI get ya', I come from a long line of alcoholics. By the grace of God I didn't end up an alcoholic myself. I have lived first hand with the devastation that it causes, my grandfather was a horribly abusive alcoholic who died in his 50's from cirrohsis and I have family members who are currently alcoholics and no where near ready to acknowledge that they even have a problem.Damarstyx---I understand what you are saying and I can appreciate where you are coming from. I admit that I have no experience with the psychological issues that go along with drug/alcohol addiction. I see the patients when they are in the acute phase in the ICU. Please dont misunderstand that I dont have empathy for those that are truly in need and are seeking help....I realize everyone has issues in their life and some people havent developed or been taught good coping mechanisms. When I say "fix" I am referring to those patients with medical problems whether it be a chronic disease related to drugs/alcohol or any other medical condition. I see alot of people that want no responsibility for their well being but they expect the medical profession to make things better and that is why I put the word "fix" in quotations. I have had family members and patients come right out and tell me that they know we can fix the B/P or Blood sugar or whatever seems to be ailing that person and then get upset when the problem is corrected and they go home only to return a week or two later because the problem returned because the patient didnt take their medicine or whatever the case may be and they blame the medical profession ie doctor or hospital for not being treated right the first time around but they fail to understand their responsibility in the disease process management.
I completely understand drug/alcohol addiction is a disease process....My ex-husband had a alcohol/drug problem and I have attended many AA meetings and therapy sessions attempting to help him thru but he wasnt able to accept his responsibility in the situation and whenever he didnt like what the therapist had to say he quit going because he felt the therapist didnt like him and was taking my side. I guess this is a touchy subject for me because I hold resentment towards him for always placing the blame on others and never accepting his responsibilities to me, his kids or himself.
I by no means want anyone to feel like I am questioning their empathy or skills as a nurse on this thread, I know people have so many different personal experiences with addiction, I know that this is a venue for people to vent, debate etc. I think that everyone should be able to voice their opinions just like I voice mine, and I really do like hearing where everyone else is coming from and what different experiences bring people to where they are at in life. And I am sorry Kymmi for what you had to go through in your marriage and probably still, it's a tough, frustrating road to have to go down.
Dec 30, '06Occupation: ED RN Specialty: ED ; Joined: Aug '06; Posts: 118; Likes: 28[quote=RN 4 U;1993294]Let me first say that i knew from your first post that you must have been a drug addict.
I would love to know how "you knew" I am in recovery...
"My pt was a drug addict, druggie whatever you want to call it, it is a fact of what he was."
so if a patient comes in who is obese do you say "I worked on a fatty today"? it is what it is, right?
"i have no lack of knowledge as i am educated, as i stated in my post."
you obviously do have a lack of knowledge. you stated in a later post that you have a degree and know all about addiction. sorry, my dear, you do not know all about addiction. you, in my opinion, have much to learn.
Dec 30, '06Occupation: rn Specialty: 2 year(s) of experience in ICU ; Joined: May '05; Posts: 7; Likes: 4I will graduate in May 07. I worked all summer has an extern and had about 5 patients which is a lot I thought I needed roller skates. The nurses told me that I spoiled the patients. I looked at all my clients has members of my family, the alcoholic that was dying of liver failure, the teen that needed a new heart, and the drug seekers. I took care of them equally, with care and lots of attention. That is my job; this is the reason why I will become an RN in May. All my patients' deserve my respect even the little old woman who cursed and tried to hit me because she was out of her mind. I figure "You never know what will happen to you, what situation you may find yourself in the future" I will keep on spoiling my patients, and maybe just maybe by giving that little extra care I may be able to make some of them better, because medicine alone can't do the job.
Dec 31, '06Occupation: Urgent Care RN Specialty: OR, MS, Neuro, UC ; From: US ; Joined: Sep '06; Posts: 203; Likes: 24All patients deserve our respect and care AND pain is whatever the patient says it is!!!! Please also remember that people who self medicated and are recovering have alot of issues with pain. Some of them have medical issues that cause pain that they've never felt and they end up in your facility actually needing pain meds and are not just drug seeking.
Jan 12, '07Occupation: RN Specialty: M/S/Ortho/Bari/ED ; Joined: Aug '05; Posts: 133; Likes: 23I think as a new nurse, like me, that your reaction is common. Learning how to deal with a specific patient population takes time. I even had a post-surg pt. 2 years ago whom we had to keep a stock of beer in the refrigerator for, because the doctor did not want the patient going through withdrawal in his current medical state.
The manipulation part drives me nuts, but I don't let it show, because they can sense it very easily, and I wonder how it would feel for me if I were on the other side of the counter and how I would want to be treated. We all have our weaknesses, but as nurses we can only do our best to assess, plan, intervene, evaluate, and educate. The rest is up to the patient.
Jan 13, '07Occupation: staff nurse Specialty: Critical Care, Pediatrics, Geriatrics ; Joined: Mar '05; Posts: 1,783; Likes: 108Quote from EricEnfermeroThis is the best post in this whole thread.Definitely sounds like a frustrating situation. Here's how I keep things in perspective: We have separate systems in the US that have different goals. In the healthcare system, we try to make people's physical and emotional problems better. In law enforcement, they catch and detain the bad guys. In the judicial system, they pass judgment on people and seek punishment for crimes. I just have to remind myself which system I work for whenever I feel the urge to do something besides try to make people better.
Since I work in ICU, I don't really get that worked up about drug seekers. Usually, they are so unstable to be on my unit anyway that if they didn't get their usual supply then it would send them into withdrawl and make their situation even worse. If they ask for it, it's ordered, and its a safe amount...then they get it. And I don't beat myself up about it. I work in ICU, not Detox/Rehab.
I helped a nurse take care of a ventilated pt with pneumonia a couple months back (as a tech) who was a drug addict (everything from valium to morphine to heroin). He was on an ativan gtt, prn morphine, prn valium, prn dilaudid, and prn haldol and still had to be in four point restraints. He was only about 30 and very strong! His poor mother knew about his habits and raised hades with the doctor when she found out that he was getting narcotics. The doctor simply explained to her that he was an addict, had a very high tolerance to narcotics, would go into dangerous withdraws if they were held which could kill him faster than the pneumonia, and that the drug addiction could be dealt with after he was out of ICU. That pretty much shut her up.
Jan 19, '07Joined: Jul '06; Posts: 34Addition is both a physical and emotional illness.I plan to work with addicts after I pass the state boards because I discovered in my clinical rotations that alot of my classmates had a limited insight and empathy for them. I found that I have no issues with understanding thier behaviors and I excelled at picking up the appropiate responses It is an important job but it is not for every nurse. Each one of us have special areas of intrest and skill.When we can find the correct position for ourselves the system works its best.
Jan 21, '07Joined: Jul '06; Posts: 557; Likes: 47Make no mistake, this patient was in pain. It is not a comforting situation to be addicted and have to invent pain, health problems, or inflict injuries to one's body to get drugs. I worked psych, spoke with addicts, have specialed patients in DT's, the pain and suffering these patient have is just as real as someone with cancer. I hope you learn ways to cope with this type of patient, ways to be the nurse they need, ways to help yourself see just how much suffering these patients and those who love them go through. I am sure in time you will develop these skills. Good luck.
(P.S. I do not think cutting up his salad was required of you and letting him know you expected him to be as independent as possible was not wrong. Addicts have unreal expectations of situations, other people, and themselves a lot of times, a reality check is generally o.k.)
Jan 26, '07Occupation: Nurse Specialty: 5 year(s) of experience in Emergency ; From: US ; Joined: Jan '07; Posts: 623; Likes: 544Dear RN 4 U,
I am a nursing student about to graduate. I also have worked as a nursing assistant in a hospital in my area. I have had the opportunity to work with several patients who were alcoholics and addicts. I also have family members who suffer from this disease (and it is a disease). I admit that these patients can be very tough to work with, and if you are not familiar with this disease process, it is easy to pass judgement on these clients. I am in no way criticizing you as a nurse, but consider this: If a patient states they are in pain, make sure you get as much info about the pain they are having. Research the drugs they are addicted to. Withdrawal symptoms of certain drugs can cause significant physical discomfort. Collaborate with the MD and other members of the health care team to formulate a treatment plan that will help the patient maintain an acceptable level of comfort without precipitating a withdrawal crisis. Also remember that they will be feeling very anxious and scared and alone. They typically cope with these feelings by being demanding, abusive towards staff, and constantly paging the nursing staff. Finally, remember pain is a subjective assessment, and you cannot dismiss this as just "drug seeking". Any complaint of pain reported by a patient must be believed. It is a patients right to recieve pain control if needed. This patients affect and behaviors could be a coping mechanism to deal with his pain from withdrawal symptoms.
Mar 26, '07Joined: Mar '07; Posts: 1I myself have crohns diease and had a major operation in 2006. where i had 3 resection operations within a few days of each other was so bad needless to say. i was on a demoral pump diludid for breakthrough pain and morphine shot.
and ive been admited to the hospital every month last year because i had one difficult of another infections leakages. abess that needed to be drain so i was on alot of pain meds in general. and i have a problem with addiction which is physical and it sucks. and i dont take offence to what she is saying it would be nice if i dident hear a lecture from nurses at the hospital saying that im addicted. something i already know i have actualy pain and the addiction on top of it. when someone has been exposed to pain medication like that for practically a year what does one expect.
im just sick of the insensitivy is all i wish some of them could have this diease for a day. i have a very very bad case of crohns and almost died a few times this year from infection of my port a cath the home health care system wasnt very clean dont get me started on that one. im only 25 i dealt with alot and i just hate when nurses say why are you crying your 25 years old grow up what kind of nurse is that a nurse i say should just quit when you get that cruel to someone that dealth with this diease since i was 10 it does not get easier does not at all. i just had my blood taken the other day and i have a picc line and she told me piccs are for medcation only im like no they are used for blood and meds that is why i have 2 ports a nurse by the way that knew jack crap about activace which i find very dishearting that i had to tell her how to do it and how to clean a pic properly. this isnt my main nurse she is to busy so hired and agency nurse i dident want anymore but said that she couldent change it so i guess ill call my insuracne company to tell them whats going on . anyhow sorry for the long rant im just tired like i said of the lack of bedside manner