Meaning And Drug Perceptions

Running Head: MEANINGS AND NURSING PERCEPTIONS OF THE DRUG SEEKING PATIENT

Meanings and Nursing Perceptions of the Drug Seeking Patient

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Abstract

Stereotyping has been a word common in the social world but has with time found its way into the medical fields here it has been used by nurses to denote something that has been not fully integrated within the medical fields. Stereotyping of patients has been common especially with the drug seeking trend exhibited in the past twenty five years at least per documented quotations. It is the reason for this stereotyping by nurses on patients as drug seeking that is the subject of this research. Much of the data gathered in this research will help in understanding drug seeking, what contributes to it and provide an insight on the main subject which is how patients are stereotyped as drug seeking by nurses.

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Introduction

Stereotype is a general believe held by a certain group of people either social or even economic, actually for something to be regarded as a stereotype it has to be generally accepted by these individuals as the actual thing that happens in a given set up.

There occurs some difference though between stereotype and prejudice with the stereotypes they are mainly founded on certain on factual statements held by individuals. Thus it has an element of truth unlike with the prejudice which may not necessarily have a factual base.

Drug seeking

Drug seeking is a term that has become common with time especially in the past quarter of the century, the term has mainly gotten fame around the medical fields and has mostly been popularised by the nurses, it is mainly used to describe patients who come for refills or are constantly asking for additional medication especially the painkillers, to be exact the opioids.

To have the topic fully introduced it is quite in place to examine the types of nurses involved in these processes and whom are mainly regarded as the users of the stereotypes.

Mainly we have three types of nurses:-

– Pain management nurses

– Emergency nurses

– General nurses

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Reasons for nurses stereotyping

Mostly nurses will stereotype patients due to either a misguided conception of the patient’s behaviour or other factors that maybe referred from the past medical history of the patients. When it comes to the past medical history most of these physicians and nurses will rely on information gathered and put down by past medical personnel who may have handled the patient. (Carlere 2009).

It should be noted though that while some cases that these individuals refer to as drug seeking are true others are informed from an ignorant angle. This is in alienation of the fact that the description or definitions of these words still remain widely relative to most medical personnel.

Drug seeking is exhibited by certain behaviours which are going to be described later on in this study, these behaviours are the bases of the nurses or physicians conclusion on the patient, it is however essential for the nurse or physician to be properly informed on the situation and past patients history, this will prompt him in making sound decisions on prescription of these drugs which are subject to drug seeking or an alternative drug or failure to prescribe a drug altogether. These three have an effect on the condition of the patient as actual problem may be dismissed as a drug seeking case which will put this patient’s health in jeopardy. Such are the concerns that require considerable care when examining the conditions and behaviour of these patients.(Jones 2008).

These three types of nurses have different aspects that will make them stereotype a patient as drug seeking patient this is because they handle different types of patients but then the fact is that these nurses will always look out for certain behaviours that will determine whether they refer to a patient as drug seeking or not.

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It is though worth mentioning that the reasons why some nurses may refer to a patient as drug seeking maybe different from those that a physician may term a patient as drug seeking this difference is not yet discussed and thus no clean cut description has been offered on the same, thus that may offer another ground for further research on the drug seeking issue.

Behaviours exhibited by patients that may lead to stereotyping

As indicated there are various behaviours exhibited by a patient that generally leads the nurse to stereotype the patient as drug seeking.

– The patients may seek the pain relievers frequently and on different emergence rooms, or visitation of different departments seeking the same medication.

– Having different narrations on their medical histories, with regard to pain experiences in the past.

– Frequently asking for a new dose of opioids citing loss or theft of previous doses administered to them.

Examination of the behaviours

Seeking medication emergency departments

The visit to emergency departments is not supposed to be the only bases of determining whether the patient is drug seeking or not. This is for the reason that these patients may seek different examinations from different department’s which is not a reason enough to stereotype these patients as drug seeking.

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Secondly the individual’s earlier physicians may have not administered the proper drugs and this patient seeks alternative medication which is available within other departments this may not be a reason enough.

The last reasons the cost of medical insurance which has increased with time living these individuals with only one option of accessing the medical services which is the emergency departments.

Thus for a nurse to stereotype an individual as drug seeking on basis visitation of emergency departments then he/she has to examine several aspects of the patient as it is not necessarily true that they seek opioids as an abuse.(Goldman 1999).

Inconsistent narrations

This should be noted maybe as a result of several reasons, which are mainly as a result of problems faced by these individuals either in the past or even currently.

These include.

– Psychiatric problems resulting from the individuals current or past, this affect the consistence of information given by these individuals.

– Impairment which is mainly cognitive this again affects t he way an individual delivers his oral narrations.

– Lastly individuals may have some diverse effects caused by medication this may affect the individuals consistency.

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All these are factors which are medically related and which should be traced before a conclusion is formed of patients being drug seeking. It is also should b noted that the clarity of information given by a suffering patient may not be the same as those of others who come for normal checkups thus it is always important to properly evaluate the signs and he trend of an individual and at the same time insist on examining the written medical records in order to come up with actual and proper conclusion to explain the patients behaviour.( Fisher 2004).

Other issues that may result in cases of trying to evaluate the consistency of speech is the language of communication it is quite obvious that individuals who take English as a second language will always have problems explaining some aspects of the pain as he may not have that language depth this may cause inconsistency in speech. Where these patients are handled by nurses or any other medical personnel not good in record taking then it obviously leads to an inconsistent report.

Asking for refills

This may be as a result of several factors which are hereby discussed.

– Patients who are reported to have cognitive impairment will in most cases misplace their prescriptions.

– Other patients maybe ignorant of the value of the drugs thus they may never to take adequate care for them thus they keep getting lost.

– Misconception that they are ever present in their respective hospitals thus they may keep on getting lost thus visitations for frequent refill visitations.

Thus against the common misconception that patients who exhibit the earlier indicated behaviours are exclusively drug seeking may be disapproved by the fact that these individuals

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may actually have genuine problems that lead to the highlighted behaviours.(Kanner 2003).

Best practices

These are in respect to the nurse’s response to the conditions or behaviours exhibited by the patients. These are aimed at ensuring that before a patient is dismissed as drug seeking proper evaluation of similar and related factors are examined so as to form an informed decision or conclusion.(Kanner 2003).

Just as may have been earlier on highlighted it is always essential to ensure that the conditions are properly examined, the behaviours properly analysed to make sure they are not confused for simple conditions that maybe a mere coincidence. This situation maybe described by an individual taking one of the behaviours earlier one described and using it to dismiss the patient as drug seeking, this would not only affect a genuine concern of the patient but has also an effect on the activities of this particular individual.

Some cases such as noted inmost researches carried out on drug seeking are very critical and are as a result of improper diagnosis where the individual is left with persistent pain as the proper treatment was not given. For these individuals the temptation of constant visitations to emergency departments, constant requirements for opioids and in an extreme case the individual my have an inconsistent medical history in case of prior records kept or put down by uninformed medic. This is a combination of a likely case where the patient exhibits all the possible behaviours of a drug seeking patient.

In the above case the behaviour exhibition is there but the truth of the matter is that this patient acts so from the pain he/she is suffering from thus in search though isolated cases comes the requirement of best practices which will require the medics to fully examine the patient and alienate all the possible assumptions to ensure the actual summary is resulted to and which is

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as a result of objective patient scrutiny.(Fisher 2004).

How to change the practice

The practice is currently quite deep rooted within the health institutions and would require a spirited fight to stem it out. Among the likely ways to ensure this is by:

Ensuring the nurses is properly informed on the likely behaviours and the most confused with behaviours which may lead to a misconception.

The patients should also be informed on the long and far fetching consequences of abusing these pain killers, the best suited people to make this happen are the nurses and the physicians treating these people.

Lastly the hospitals and the departments should properly examine the records and teach their staff proper history taking to ensure that the patient only gets those prescriptions he requires and knows how to maintain these prescriptions, to avoid recurrent refills which may prompt stereotyping. (Goldman 1999).

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References

Carlene, H. (2009). Medical office Complete Handbook. McGraw Hill New York.

Fisher, F. (2004). Interpretation of "aberrant" drug-related behaviours. Journal of American Physicians and Surgeons, 9(1), 25-28.

Goldman, B. (1999). Diagnosing addiction and drug-seeking behaviour in chronic pain patients.

In M. Max (Ed), Pain (pp. 99-110). Seattle: IASP Press.

Jones, G. (2008). Comprehensive Medical Terminology, 3rd edition. Delmar, Cengage Learning

Kanner, R. (2003). Addiction and pain management. In R. Kanner (Ed.), Pain management secrets 2nd edition. (pp. 210-213). Philadelphia: Hanley and Belfus, Inc.

Smith, W. and Safer, M. (1993). Effects of present pain level on recall of chronic pain and medication use. Pain 55, 355-361.

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