Background: Treatment room with 4 beds, no monitors. Ideally this room is used for fast track, MSK and lacerations. However lately it has been another room to hold admitted patients who are not sick enough to be directly by the nurses’ station in a monitored bed.
The night I was there was LOL night (lol=little old lady), where most had fallen and needed various pain workups. One had fallen a WEEK prior, but wanted pain control. This particular lady was elderly, from a nursing home, had fallen a week ago, and surprisingly instead of sending her to Emerg on that day, they properly assessed her, determined she was ok, and didn’t send her in. However the family a week later stated that she said she was in more pain than normal (she has chronic pain) and they wanted her assessed. Into Emerg she went. This lady was already on TWO 250mcg fentenyl patches, plus Dilauded for breakthrough pain. AND SHE WAS STILL COMPLAINING OF PAIN. Medically there was nothing wrong with her, she needed to have her pain meds changed, and to have attention so she would stop whining. I think the nursing home staff got so tired of her whining that she was in pain that they called the doc, and over time they would steadily increase her pain meds. The amount of narcotics she was on could tranquilize a horse. But her vitals were stable, and her pupils weren’t that pinpoint, and when she wasn’t whining, she rested in no apparent distress.
This lady was one of those patients that if you went to do vitals on her, or draw blood, she would keep you in that room for 30-45 minutes and suck you dry of all your nursing-type caring. “can you do this for me can you do that for me, and o my leg hurts, and I think I have to go to the washroom, and I need something to drink, and o I’m in such pain is there anything you can give me”. I’m thinking that her MD must be the sugardaddy of drug dispensers for the amount of narcotics this lady received. No wonder she was complaining of 9/10 stomach discomfort. She was completely FOS.
She drained me dry, and I had 3 other patients to look after.