I Refuse to Leave

I'm orienting a new nurse, he's very smart and will make a great ER nurse someday but is still filled with the sweetness and light that they instill in nursing school and it is hard to watch his shining idealism take a daily pummeling.

Take for instance today, we had a patient who lived 45 miles away and had bypassed 4 other hospitals to come to our ER for treatment of their chronic back pain. RED FLAG! I don't care what lame ass excuses you give us - if you passed up 4 other hospitals we will immediately assume you have worn out your welcome at the other three. Sorry but that is just the way it goes, normal people don't drive long distances for no reason when there are other hospitals, clinics and urgent care facilities with in easy reach.

So the initial story was that the narcotics had been stolen but no, the police had not been notified. I offered to call the police so that a report could be made and the story changed. The doctor offered a small dose of narcotics if the patient could produce a ride. Multiple stories we given about rides coming that never showed up. I sent him to the waiting room to find a ride and told him to let the greeter know when he had one. A little while later the greeter called to tell me that the patient had a ride so I brought him back to the room. I was questioning the woman that he brought in when I started getting a funny feeling about how she was acting. When confronted she admitted that she didn't know him but had been offered $20 to say she was his driver. At that point I confronted the patient along with the doctor and the patient was told to scram. He refused.

My orientee stood by, wide-eyed, as our off duty police officer came to escort the patient from the premises. Instead of going quietly like a reasonable person would when faced with a six foot, four inch armed police officer he put up a fight. Next thing I know the patient is being tasered in the middle of the ER hall, four cop cars show up code three and the patient, I mean prisoner, is subdued, hog-tied and taken to jail, screaming profanities and spitting all the way.

Drug seeker-1, Wide-eyed idealism-0

The sad thing is that we in the ER face these situations on a regular basis. These drug addicts easily obtain narcotics from various doctors, clinics and ER's. They quickly become addicted and they visit more places to obtain more drugs. Slowly they find themselves cut off from source after source. Increasingly desperate they become dangerous to us, not all ER's are as fortunate as us to have off duty police in the department. In addition to being a threat to our safety they divert resources away from the truly ill and cost the taxpayers billions in health care dollars for unnecessary visits.

Sad, isn't it.