Would you like a menu?

There are a few ER doctors I swear will give out narcotics like candy.  Hmmm maybe we need a Ativan salt lick and a dilaudid bubble gum dispenser in the waiting room.  I mean I actually heard one say to her patient.  We have lortab, percocet or we can start and IV and give you some dilaudid.  What would you like us to do?  WTH .  They wonder why the world has drug addicts.  The stupid ER doctors are giving them their start.  I know one patient that was on klonopin, percocet, morphine, xanax for all her medical chronic pain issue.  If I took that I would be dead or intubated. 
I was really impressed with my neurologist.  If he puts you on a narcotic you are drug tested twice a year and they count your meds.  If you don’t have it in your system he takes you off of it and if you pills are short because you are abusing them he takes you off of it.  I think all doctors need to do this.  I am so tired of patients arrive to the Er for a medicine refill because they took their meds incorrectly and have run out.  Take it as prescribed.  Yea I know I am a bitch and uncaring person.  But hell I have chronic pain,it sucks. Do people understand?  Hell no.  Do I take my meds like I am suppose to?  Yes.  I also do this without the use of narcotics.  I still work full time.  I still had back surgery.  I still have stupid patients who pretend they can’t transfer from the chair to the bed, but will walk out on their own when they are discharged.  They don’t care the nurse is straining their back to help them.  I will still give you your pain meds but at least have the courtesy not to injure your nurse.

I Can't Breathe!

It never fails.  When you are going to have a bad case it always seems to arrive the first hour of your shift or the very end of it.  This one showed up about and hour before quitting time.  Unresponsive.  Vital signs are great and he snoring.  So I am cutting clothes off, while triage nurse gets info, someone is starting a line and getting blood and then I alert the ER doc.  Who isn't happy that we waited this long.  That would be the triage nurses fault since he is also the charge nurse.  But what do I know.  Anyway.  The doc gets history from family which doesn't help.  No one seems to know what this guys  new depression med is or if it's a narcotic.  So the doctor orders Narcan to reverse possible over dose.  He has had 2 rounds of it no luck.  Doctor orders Remazicon just in case it's a benzo over dose.  I on the other hand would like to shove a catheter in this guy so we can get a temperature and output.  Before the ER doctor wakes him up and I can't get a Urine to find out what the hell he has taken.  Nope off to CT scan where the dude wakes up screaming.  I can't breathe!  I can't breathe!  All the while thrashing around on the CT table.  Needless to say  he was breathing just fine.  Now the unresponsive is acting like a full blown bath salts patient.  Fantastic.  No Urine now...and no CT.  Back to the ER to sedate the patient because he is still thrashing and yelling at the top of his lungs.  Apparently the Remazicon worked.  So lets put more drugs on board.  Makes plenty of sense to me. Now the doctor is thinking about intubating the patient.  Wouldn't that have been easier in the beginning?  She then mentions remind me to intubate first ask questions later...Welcome to the night shift rodeo.