Student Nurse, prn

Thursday, March 23, 2006

Drug seekers...

Not sure I should have used that title after the one from a few days ago ...this blog has gone to the gutter.

But seriously that is the subject today. I had a patient the last two days with a disease called
Crohn's (click on the link for a detailed description) but in a nutshell it's a very painful chronic inflammatory disease of the large bowel. She, the patient, (47 y/o, white) was in for the diagnosis of GI bleed (symptoms were massive blood in her stool). Her discharge diagnosis was listed as exacerbation of Crohn's. She has been to the hospital many times before because the disease can flare up and have increased symptoms at any time.

My RN that I was reporting to today was rather flippant that I chose her as a patient. Mumbling that there were better patients for learning experiences than a 'drug seeker'. Well, first of all when I chose her it doesn't exactly say on her chart/care plan "DRUG SEEKER". It lists her medical issues not the nurses perceived psychosocial ideas.


Now granted this chick was on massive doses of opioid drug derivatives but hey, she said she was in pain. The description of pain, we are told by our instructors, is exactly as our patients perceive it. Nothing more, nothing less. Pain is very SUBJECTIVE. And g
ranted I may have had my doubts but I certainly didn't treat this patient any differently because of her history. I mean has my RN today ever had Crohn's? --I don't think so.

I can understand how in the ER they get fed up with folks coming in with pain issues on a constant basis but this gal was in the hospital for days with pain.

I know I have lots to learn but I hope I never get jaded like my RN was today.

8 Comments:

  • I totally hate the term "drug seeker". My classmate is under tremendous stress; full time student, full time job, 24-7 single mom and she suffers from migranes and is anemic. She missed a week of school and work due to a migrane. She was in and out of the ER because they termed her "drug seeker". Finally one doc gave her a huge dose of some med (can't remember the names of these two drugs, one for nausea and vomiting and the other for pain). SHe went home and slept for 30 hours and woke up headache free! Geeze, is that a drug seeker???

    I've never had Crohns but have heard that it hurts....I doubt that I could ever question someone's pain tolerance...maybe I would stink being a nurse, I hate for anyone to be in pain!

    Have a good weekend!

    By Blogger Eve C., at 11:36 PM  

  • My mother has Crohn's and takes massive amounts of Vicodin for the pain. She needs the drugs just to be functional.

    It is unfortunate that nurses become so jaded that they can't see past their own predjudices and give patients the care they need.

    I'm not saying that there are not drug seekers, because I know there are. However, grouping all people that may need large doses of medications for pain, or whatever, relief as drug seekers, is just plain ignorant.

    W. :)

    By Blogger Wendy, S.N., at 6:13 AM  

  • You're so good...next time I'm sick, will you fly out to Michigan and be my nurse?!

    By Blogger Mona Buonanotte, at 10:32 AM  

  • I have never had Crohn's/Colitis but I have heard that flare ups can be devistatingly painful. And I think you're right, pain is what the patient says it is. However, I think there may be limits. This patient's pain appears to no longer be controllable with pain medications. Perhaps it's time for her to consider an ostomy.

    By Anonymous sean, at 8:05 AM  

  • I dont really understand nurses who want to without drugs from supposed "drug-seekers". Like you said pain is very subjective. it is how the pain is PERCEIVED by the patient thats important. And what does it hurt the nurse to give the drugs that are needed. she isnt there to "teach them a lesson" or make moral judgements. they are their to treat their patients and part of that treatment is to minimize pain. Whether the person is actually in pain or just says they are is not up the nurse to discern. If the drugs are prescribed by the doc, why not give them? Its not skin of your nose. Anyway, sorry to go off on a little rant, but i feel pretty strongly about this. Having a problem with chronic pain myself, i dont think pain medication should be withheld from any patient, unless contraindicated, whether you think they are a drug seeker or not.

    By Blogger ArizonaDB, at 12:12 PM  

  • PS for many years my mom suffered from Crohns so I know it can be a very painful and debilitating disease. The patients deserves the benefit of the doubt. Would rather go home at night thinking you maybe gave some unneeded drugs to a drug seeker or possibly withheld much needed pain relief from a person in horrible pain? I would rather err on the side of compassion.

    By Blogger ArizonaDB, at 12:16 PM  

  • Yeah - that jaded thing is scary. I also hope that I don't become jaded like that.

    By Blogger dog food sugar, at 11:29 AM  

  • Hello! it's nice to read the experience of other student nurse. I had a patient who has Crohn's, and yes, he needs pethidine all the time. Poor guy, he goes in and out toilet for many times.
    Eve C.: I think the problem of your friend is role overload, and maybe she should prioritise more what she really needs to do and eliminate the others.
    Arizona DB: I think the nurse gets jaded with 'drug seekers' when she is busy already, and gets annoyed with the patients who needs drugs all the time. But yes, a good nurse should treat the pain, no matter what.

    By Blogger Amy, at 3:43 AM  

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