Unless a migraine is intolerable, a migraineur won’t go to the loud, bright, frenzied ER. Who would willingly subject themselves to that without desperately needing pain relief? But for most migraineurs, the visit is a harrowing back-and-forth between patient and staff. They don’t get their pain treated adequately and they leave furious with doctors and nurses who question the legitimacy of their complaints.
While patients know what their own pain is like, ER staff don’t know the individual, but the patterns of many people. Some of these patients are truly in pain and others are looking for a fix. The patterns leave an imprint so that even the most compassionate doctors and nurses struggle to be caring, not naive, and cautious, not cynical.
Using migraine patients as an example, Kim from Emergiblog, who has been a nurse for 27 years, fights to balance this contradiction. Although she is sympathetic to chronic pain patients, she can’t forget the times that she’s been fooled. She illustrates the dilemma eloquently and has terrific tips for chronic pain patients to get better care in the ER.
[from Jessica via Migrainepage]
I remember going to the ER for my gallbladder attacks, which were at that time still undiagnosed (though I figured that was the most likely explanation). One time they did so many tests and things that by the time they offered me pain meds the attack was subsiding and I refused them. The nurse tried to insist, and I looked at her in amazement. I said, “I came here to get help for the pain, but now it’s gone so I don’t need anything. I didn’t come here to get high.”
I never go for migraines because I can’t take migraine meds (heart disease, can’t constrict my arteries) and really don’t want narcotics. I already have vicodin and I don’t want to get any higher than that.