People come in to the ED for so many reasons. We get people who are in physical pain and need treatment, but we also get people in emotional and spiritual pain as well; often the three overlap.
The patients who apparently seem to come in for their next ‘fix’ are seen as drug-seekers by many, and the underlying pain is often times so well-masked by the addiction that takes a conscious effort to find the real source. People come in demanding this-or-that narcotic in this-or-that dose, and are immediately thought of as having ’seeking behaviors’, This may or may not be true; what we under-treat in health care is the deeper reason that the person has the need for the drug. Deeper than the addiction, we miss the root source of the addictive behavior.
One can argue that in the Emergency Room, we just don’t have time to delve into the psycho-social issues behind a patient’s problems, and that is a very true and valid point. But in my own practice as a Registered Nurse, my goal is to at least try to understand the patient, to see behind the barriers they have erected (often to shield them from the judgments that are made against them) and to find the person within–the person behind the addiction. That is when I feel that the true treatment begins. Validating a person who is seen by many as a label, and giving that person a real chance at human kindness, is what makes me feel like I’ve made a difference. Even if it’s a turkey sandwich or a glass of juice, it’s that human connection that is needed most by these types of patients.
I have a hard time when a person is judged and labeled a seeker even before he or she has been seen by a provider. There are real pain conditions that don’t show up easily on lab tests, and there are real pains that are unexplainable. I have a hard time when I hear a provider say something along the lines of “Oh yeah, fibromyalgia and depression. Probably just looking for narcs.”
Pain is pain; that’s nursing 101. I believe my patients have pain, no matter if they have a diagnosed medical condition or not. I just wish that others would see that the pain doesn’t always have to be quantified, and that it doesn’t always have a root in the physical body.
We owe it to our patients to see beyond what appears to be drug seeking behavior, and to find that essence of humanity in each and every person that we are privileged to care for. I am not saying that there aren’t people who use the ED as a place to get a fix; that most certainly does happen. But even with the people who come in with demands and dosages deserve our best care. In fact, I could argue these are the people who need us most, because their pain is so extreme that they are using physical means to block it.
Just something to think about, as you go about your practice as a nurse…
Tags: addiction, Doctor, ED, nurse, patients, rn
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I just want to thank you for publishing this…. I consider it somewhat providential since I stumbled here for something else…Both my husband and I have chronic pain (him fibromyalgia et al. I have scar tissue problems and sciatica.) Neither of us are able to be prescribed any painkillers whatsoever because of a rampant addiction problem in our area. We are immediately suspect, and the unfair irony is that neither of us would take our medication inappropriately. I had a bit of bitterness towards those “pillheads” who make it more difficult for my husband to get relief, let alone myself. I needed to be reminded as well that those people need help, they are in pain, too. Nurses rock
Thank you Samantha! I am sorry you and your husband are having such a hard time finding services. Do you have a local ‘pain clinic’ or pain treatment center? That might be the way to go with your chronic conditions. There are alternative pain therapies out there—I am not very familiar with them, and you should of course speak with your doctor first—but I have heard of TENS therapy, accupuncture, swimming, and yoga to be gentle means of pain relief. Perhaps you might want to ask your doctor if these types of alternative pain treatments are appropriate for you and your husband. Good luck to you and I hope you both are able to find the pain relief you deserve.
WOW. If only all medical people thought the way you do! I am a registered RN with Chronic back pain due to years of abuse to my back on the job. Starting as a nurses aide in junior high school, ending in years of critical care/burns ICU. After 2 back surgeries 1 week apart, and alot of hardware in my body, i take medication on a daily basis, (enough to knock out a horse). I cant tell you the hassle i have recieved over the years trying to “explain” myself, during simple apts. I have been looked down upon, and treated like a corner drug addict. I only fear the day should i need surgery for something, and not be given enough pain medication due to the high doses i am accustomed to. I have tried a gazzillion alternate therapies, doctors, procedures, ect…. nothing works to take my pain away. i think my “pain issues” are what ended my 26 year marriage also. I can easily understand why pain pts. consider suicide. The whole scene gets old after a while. i just want to live a normal, pain free life. I gave up my life to take care of others. it just doesnt seem fair sometimes. i can only wish my fellow pain sufferers relief and support. and remind my fellow medical staff to use their hearts and knowledge before they judge anyone.
I appreciate the empathy that you have expressed for seekers and I agree that they are entitled to respect like all others. I am ashamed that our society says addiction is a disease but treats people with that disease as criminals. Maybe if the war on drugs was focused on the teatment of the addicted insted of the incarceration of the small time dealers and users we could make some progress. Every seeker I have met is a person that for one reason or another was trying to relieve their emotional or physical pain.