Thursday, September 13, 2012

More Fun with Drug Seekers

Another busy night with the oh-so-wonderful Bobo was the usual  freak show.  We gave out 30 Percocet because certainly every single pain deserves to go home with at least four pills.  Right.  That was dental pain, chronic back pain, and various atraumatic aches and pains.  What a tool.  I had to get in his face and advocate for narcotics for a patient with a bad wrist fracture who really needed them; then she said she hated that stuff and wouldn't take anything stronger than ibuprofen unless she really, really couldn't stand it.  Sheesh.

I had to retrieve Drama Mama from the parking lot.  She had been hit by a car, having been standing in front of it when it accelerated. Three hours prior to arrival.  She arrived by private car without swelling, bruising or a mark on her.  "I can't stand up!"

 I won't go into the booooooooring detail here, but let's just say the mechanism of injury, while consistent with the degree of 20/10 pain the patient stated she was experiencing, was not evident in the exam.  In other words, she had pain everywhere but not so much as a ding.  And then there was the healing abcess on her forearm and that history of IV drug use that she denied and said it was from a fish hook.  She was so high on the last 2 visits that forgot her own story.

It seems the Dilaudid train had left the station without her.  She had been getting daily wound checks/packing/IV antibiotics (of COURSE she was not sent home with an IV, duh!) and multiple doses of narcotics at each visit because of her histrionics. Bobo, to his credit, was not convinced with Drama Mama's appallingly sub-standard over-the-top acting.  Apparently yelling about your pain (between cell phone calls to yell to yell to friends and family about life-threatening pain) is considered to be the ultimate test of veracity.

Bobo: Don't put an IV in her
Me: Duh
Bobo: Just go ahead and give her 1mg of Dilaudid IM

Drama Mama got her shot; moaning, sobbing,crying (without tears of course) she managed to very calmly ask me what side she should roll over to and then EFFORTLESSLY proceed to do so.

Eight minutes later she was on the call bell yelling hysterically: "It's not working!  I need more medicine!"
Me: "It will take a little longer than eight minutes to work.  But I'll tell the doctor"

Bobo was informed, at the 10 minute mark when he was done with...whatever he was doing, that I had given the shot exactly 10 minutes previously and she was refusing an x-ray until she gets more medicine.

He told her nothing more and that she needed to give it 30 minutes.

Ding!  On the call bell again (which, but the way, she had to get out of bed to retrieve because I failed to give it to her bad nurse that I am).  "As long as I have to wait a half hour I might as well have an x-ray"

Me: "Peachy!"

She managed to get another 1/2 mg Dilaudid out of Bobo before even he got tired of her and kicked her to the curb.  Drama Mama walked excruciatingly slowly with her enabler/handler/boyfriend twice her age to the doorway, yelling at him the whole time to "hold me up!", accompanied by much moaning, sighing, wailing and gnashing of teeth.

End of story?


She was in the next day as I came to work, same complaint except this time she had embellished her story and added theft of her daughter's back pack and some oxycontin's, and that she had tried to stop them from taking the vicodin we had prescribed the night before by standing in front of the vehicle.  Not realizing the lie that she was hit by the car BEFORE she came to the ER.

And we didn't prescribe any vicodin.

Which proves that time travel IS NOT possible!