Why Are We Treated With Indifference by ER Staff?

All of us who suffer from "Invisible Chronic Pain" know what it is like to visit the Emergency Room! It is absolutely the worst place for a chronic pain patient to be! Sometimes it becomes inevitable, and circumstances that are beyond our control lead us to this place that should be a healing place.
I understand that ERs are for accidents, injuries, and serious medical events. Unfortunately, as a chronic pain patient, our pain levels can get out of control and it becomes a serious medical event. Our pain management physicians will send us to the ER when they know that nothing else will help, but the staff there has other ideas about us.

My recent experience was caused by my physician trying a different medication for break through pain. It caused uncontrollable nausea and vomiting. When you are dependent on pain medications, and you are unable to keep anything in your system at all, you quickly can get into a “pain crisis mode.” I became severely dehydrated and was experiencing excruciating pain because I had missed both my narcotic pain meds and nerve pain medication for over 12 hours. This left no other choice but to visit the healing place, the ER.

When I arrived, I informed the triage nurse that my pain management physician had sent me there. She took a brief chief complaint, and took me directly back into a treatment room. I was fortunate to have gone when they had a lull in the ER and would be seen quickly. I was left in that treatment room for over 2 hours before anyone walked in again. I had to search for my own basin since I was there because of the non-stop vomiting.

Finally, a physician came in. Asked what was causing my vomiting and I told him about taking a Percocet for break through pain. He said, “Ok, I’ll get you something.” and left. A nurse appeared to put in an IV and inject medication.

 “What is in the syringes?” I asked.

She said, “Nausea med and pain med.”

“No, I asked a question.” I said. “What is in them? Your triage nurse and your ER physician have not bothered to ask what medications I am on.” I handed her a list of my meds which she looked at. “Will any of these meds interfere or are contraindicated?”

The nurse said, “I don’t think so, but I guess I had better check.”

When she returned, the nurse said, “I entered the meds into your record. You were right. We didn’t ask. The doctor said that it is fine to give you Zofran for nausea and 4 mg Morphine sulfate IV.”

I asked, “Did he order fluids?”

She said, “Nope.” The nurse injected the medication into the IV line, and left again.

Two hours later, the physician returned. He said, “How are you doing now? All better?”

“No,” I said. “The nausea has stopped, but the pain has not.”

“Ok,” he said. “I guess I can give you a little more morphine. Why are your lips so chapped and dry?”

“I told you that I had been vomiting for 5 hours when I came in, not including what has happened here. I am so dehydrated that I can’t blink my eyes without scratching them and my tongue is sticking inside my mouth. Since you are not starting fluids, can I start drinking?”

“Well, I really can’t give you anything to drink. It would probably start the vomiting again. I do see now that you are very dehydrated, so I should get some fluids in you first.” Again he left and the “happy” nurse returned.

“I’m starting fluids and giving you 2 mg more of morphine sulfate,” she said.

 Before she left, I asked, “May I have a blanket? It’s cold in here and the IV fluids are making me even colder.” She didn’t answer because she was imputing into the computer. Instead, she held up a finger to me, motioning for me to wait a minute. Little on the rude side, but I didn’t say anything. She left the room again. The IV was finally running after being in the room for over 4 hours. Why didn’t the physician start it when I came in so dehydrated?  It seemed that he just didn’t care about my condition. I was trying to be optimistic, not assuming that it was because I was a pain patient.

Thirty minutes later, the same nurse walked past my room and I called out, “Nurse, can you please get me a blanket?” Oh, there was that finger again, signaling for me to wait just a minute and she kept going.
Thirty minutes later, another nurse finally came close to my room. (I was in the far corner of the ER) I called out, “Nurse, would you please get me a blanket?” She came in with two blankets and covered me. “Thank you so much!” I said. “Sure. You’re welcome,” she said.

My IV completed, but no one came in to check on me. Another hour passed. The nurse had put the rails up on the gurney. I couldn’t get up on my own. I was too weak to get up anyway. There was no call button, or any way to get in touch with any of the staff. I thought about calling them on my cell phone! But just then, my heart, BP, Pulse monitor started to alarm. Finally, the doctor came towards my room. He stood in the hallway, texting on his cell phone, and then approached. “Why is that going off?” he asked.

“I’m not looking at it. I don’t know, but I’m having chest pain along with my neck, jaw, and the middle of my back.”

“Well, your BP is dropping really low, setting off the alarm. That’s from the morphine I gave you. Let me listen to your heart,” he said. This was the first time the physician had actually touched me! I had been there for over 5 hours and he hadn’t examined me at all! “You’re having palpitations. Oh it’s the morphine and I can’t give you any more of it now,” he said.

“I don’t want any more. I just want to feel better so I can go home,” I said.

“A….hmmm….sure,” he said. “You can go home.” And there it was! He said it all without verbalizing it. There is another addict in my ER.

“Happy nurse” came in next. She handed me a script for Zofran for nausea and vomiting and said, “You should see your pain management doctor. He should be the one to change your medications, and you shouldn’t come here for that. We can’t help someone like you.”

I had my very own “Nurse Ratched” from One Flew Over the Cuckoo’s Nest! “I didn’t come here for that, dear nurse! I came here to stop the vomiting so that I could keep my pain meds in me and control the pain,” I said. “But my pain levels spiked because I hadn’t taken anything for hours. Once pain gets out of control, it’s difficult to get it back down. Don’t they teach that in nursey school anymore?” I declared with attitude!

Nurse Ratched looked at me and said, “You can leave anytime you’re ready.”

“And what do you mean by telling a patient that you can’t help “someone like me?” I asked. “Just because you can’t “SEE” someone’s pain or illness, doesn’t give you the right to treat them any differently. I don’t visit your ER chronically. I came because I was in a crisis and my doctor sent me here.”

“Sure,” Nurse Ratched mumbled. “Anything you say.” That was the last time I saw her. As I left the ER, the doctors and staff were sitting around the station, talking, texting, etc. It was a slow night in the ER, but unfortunately that didn’t help me at all.

This place of healing had been turned into a cold, heartless place. I have worked in the medical profession for over 30 years. I know what it is like to care for the ill, sick, and injured. I’ve even worked in the ICU too, and I’ve seen my share of sorrow and suffering, but I never lost my empathy for patients. I never tried to humiliate my patients even when some of them were in fact, unreasonable.
When people are sick or injured, they are scared, frightened, and hurting. They need compassion and comforting, which goes along way towards recovery and healing.

 I’ve had the pleasure of working with many caring nurses and many of them are my friends. I’ve encountered countless nurses and doctors who give so much more with their gracious hearts and altruistic approach to patient care. They are the ones who are a credit to the medical profession, while apathetic and callous doctors and nurses are nothing more than a debit.

**I’m planning on sending a copy of this blog to the administrator of this hospital. I’m not sure if it will help, but maybe the next patient who comes in suffering from chronic pain will be treated appropriately**