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March 25, 2004



Well written, although I disagree. Most of the patients I see doing this have learned how to work the loopholes of an over-burdened and under-financed acute care system, and most have gotten that way because they have made a choice not to seek appropriate treatment for their psychiatric condition, instead going to the ER for a fast dose of some narcotic. They are rude, obnoxious and abusive, and it takes time away from patients who are making appropriate and proper use of the system. However, I applaud you and your effort to communicate on such an emotional level with these difficult patients.

I took the liberty of deleting your two follow up posts, they seemed identical to your first. --eric

Kevin Crigger, RN

There really is such a thing as 'hopelessness'...a point in life at which people really have no reason to care what happens to them. I have to wonder where the compassion for drug seekers has gone as we in medical profession must realize and accept that the majority of these people are addicted because the physician originally prescribed a narcotic rather than counselling, or because the nurse simply kept giving out the prn meds rather than sit and talk his/her client through a difficult time and taught that client ultimately that drug use to keep calm and quiet is acceptable. I work with attitudes such as the one in this article, and I work hard to change those attitudes. If I bought into that garbage I wouldn't be a practicing professional today...and if I hadn't had an RN sit for one whole night with me in detox clinic I would have gone back to using, rather than start to believe that I will get better..."but a moment in your entire life" she kept insisting. As an ER nurse, I'm proud to say that I've never had a drug seeker leave my department angry because they couldn't get what they wanted. Our community does not have drug rehab...it's three hundred miles away. Even if we had it, the ER is the first line for many people in crisis and when the nurse turns his/her back on those people they often will seek no further, and our negative attitude towards them simply reinforces their own poor self-worth. I understand the frustration of having to care for people who chose to create the conditions in their life to end up dependent on drugs and on a system that lets them down continuously...I also understand how one look, one word, or a simple touch of compassion and genuine empathy can turn a persons world into a more beautiful place...all of sudden, there is a reason to try! I hope the author of the March 25th letter regarding drug seekers does not continue to make the mistake of assuming that he/she knows best...you don't. Our lived experiences are our own, and you DON'T KNOW! I wish those patients in your dialogue a better nurse next time they reach out for help. You might not say it to them in so many words, but attitudes are felt at a much deeper level, and trust me, they can do more damage than words...they can also give people a reason to want to try for just one more day, or one more hour, or one more minute...you remember that.


We usually have a ratio of 5 patients for every nurse. I've worked elsewhere in Phoenix where the ratios on telemetry were as high as 7 (which I feel is dangerous).

The big problem that is coming about now with these lower ratios (we're actually working on getting 4:1 ratios on dayshift) is that it backs the ER up. One ER nurse in town reminded me of the fact that ER nurses could end up with as many as 5 ICU patients, because their ratios are not as well defined. So there is still some serious work to be done. It's still just as lethal and dangerous overall if all you end up with is an ER basically taking care of nothing but overflow patients.


You have no idea how excited I am to have the opportunity to leave a comment for every entry. NO IDEA.

What are the patient/nurse ratios at your hospital? I mean, I understand why you took on four patients, but that's hardly fair to you OR to the patients. UCD tries to keep the ratio at 2:1, but California is still suffering from a HUGE nursing shortage (the subacute ER section *still* consistently shuts down every Sunday!).

Enjoy your three days off.

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