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…