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Crolleen33 karma

Also, wanted to add that these people have no outward physical indications of the pain they have which makes it difficult for health care workers to quantify.

You got stabbed? I see the wound, how deep it is, what organs it hit, how much you're bleeding, and I can plan your care accordingly.

These people look perfectly healthy and come in saying calmly (because they're used to this) that they are in crisis and having extreme pain, pleas give me 100mg of morphine IV! (A dose that would kill another person but it's what works for SC after building up a tolerance). I can't see anything wrong with you because it's in your blood, couple that with the patient getting angry because they're stressed when you question them and you can see the misunderstanding happen.

This is just an example and not at all an excuse for the terrible way these people are treated sometimes and for the problems with the care they receive. It is only to put it into perspective for you.

Crolleen24 karma

Thanks for this reply. Working in health care I was pretty appalled that they seemingly dismissed a limb CRUSHED in a motor vehicle accident. I'm sorry this happened to you, I wish only good things to come from it

Crolleen16 karma

Aw downvotes :( haha. I think people are misconstruing my comment as judgement when it was only meant to explain a different view - thought I clarified that but oh well. I'm not aware if we do blood smears at my hospital, that sounds like a good practice. We have had SCD patients who are addicted to street drugs, have been rude or violent, etc and in a relatively small group compared to the population of an entire hospital or even one inpatient unit - it stands out. Again - one patients bad behaviour is NO excuse to treat others poorly or withhold treatment/judge them. Which is why I'm very glad to have this AMA and shed some light.

Crolleen16 karma

Thanks for doing this AMA - this disease is highly stigmatized and not understood enough. I've worked with sickle cell patients all of my career although they are not the majority of my patient population.

I have seen very drug seeking patients who probably give the rest of you a bad name. What confuses me sometimes is the patients who ask for gravol/benedryl IV PUSH. Are these medications necessary? I understand narcotics but why the others? And wouldn't it not matter how it was administered? To me, wanting an IV PUSH is just seeking a buzz. They often know exactly what times those medications are due, too and will push their call bell 1 minute before the hour.

Do you have any light to shed on this and do you think that there are inevitable behavioural problems associated with having a chronic illness?

I try to hold judgement and whatever medications are ordered I will administer without any "are you sure you need that?" Or exasperated sighs but if you have any advice on better care of these people on a one on one nursing basis that would be great!

My hospital did a trial on having a specified SC nurse to personally follow patients and advocate for them. I think better resources are sorely needed!

Edit: for clarity - IV PUSH over 1 minute as opposed to IV BAG over 15 mins

Crolleen9 karma

We supply Nabilone to our cancer patients which is a derivative of cannabis and why I asked since its available (I'm also in Canada).

Also asking because I'm genuinely interested in SC patients receiving better care and if I can suggest things in my hospital that might help I'd like to do so.

I think some of my comments seem like I have a bad view of SC patients but I was speaking more in a general sense of what I've seen in my experience, not necessarily my personal judgements.