Monday, September 29, 2008

A Lesson Learned

I've been a nurse long enough that you'd think I could fish out the drug seekers vs those truly in need of narcotic intoxication within seconds. I know, I know - you'd think I could. I'd certainly think it.

Apparently, we both would be wrong.

48 y/o disheveled, dirty, matted hair, no teeth, 5 tattoos, holey clothes wearing man presents to the ER with a yelled complaint of "I need Vicodin! Badly!" He also happens to be holding his shoulder.

"Were you injured sir?" I ask.

"Yes," he replies. "I fell over the guardrail last Thursday when I was walking along the highway by the rest area. My shoulder has been killing me ever since."

Pulses present and equal, grips equal, no numbness or tingling, cap refill brisk - flashing neon sign saying "Drug Seeker!" flashing across his forehead. Well at least in my mind it was.

Triaged to wait a bit.

35 y/o woman dressed in a business suit with perfect personal grooming habits and a polite demeanor presents with the complaint "I think I have another kidney stone." She's slightly bent over and holding her left side. She dry heaves into an emesis bag I give her and her b/p and heart rate are elevated.

"I'm sorry but I just couldn't wait to see my primary physician on Monday. I've been dealing with the pain for 2 days now and I just couldn't take it anymore. I'm really sorry to even have to come in."

I admit it, I was sucked in by her politeness. It's such a foreign concept in the ER. Seriously - someone throws us a polite bone and we jump all over it like starving dogs.

"We'll get ya back just as soon as we can." I told her.

Apparently, I am an idiot. Yes, I am admitting it now.

The gentleman had dislocated his shoulder and it had been out of place for 3 days. 3 DAYS! No shit he had pain, eh? Our lovely lady friend was found to be a doc shopper and drug seeker from multiple hospitals over the ENTIRE STATE. She'd learned the game, and she'd learned it well.

I learned a huge lesson that day. It wasn't such a pleasant look in the mirror for me.


Anonymous said...

ah yes. I too have fallen victim to the same ploy of politeness. I,ashamedly have also doubted needy. The only saving grace is that I treat everyone with respect and give my professional best with each patient.What I wouldn't give to read minds.....Yvonne ED RN

Anonymous said...

It's the damn truth. We're so used to the people who are rude or socially clueless, that when we get a patient with a modicum of courtesy, our eyes glaze over 'cause we just can't process the "nice". I've been hook-line-and-sinkered by the exact same schtick, a lady who could be my mom or your mom or anybody's. And it turned out she was a doc shopper, on several hospitals' watch lists, and had the previous week stolen prescription pads from her primary care doctor's office.
How sad that it's just easier for us to comprehend the ones who call us names or spit on us.

tricia-rennea said...

Oh wow. To be honest I am not good at reading people, luckily I am not in your line of work.

In other news, you need to enter my contest (Not just mine, Melissa's, too), you could win a fabulous prize package, won't that make it all better?

Get your friends to enter too, that would make me giddy ;)