Following the ED track board one night, there were 3 opioid overdoses that came in together, initially revived by narcan. ED RNs did 16&14g IVs. How do we stop this?! Our own colleagues feel it’s their job to punish people whose addictions have nearly killed them. #wtfentanyl

Well it seems I’m getting shit for this tweet so let me clarify my point. First — not a HIPAA violation. Do you know how many jobs there are in a hospital that have to review ED pts?

Second, staff viewed addiction as a moral failing & yes, nurses went larger for this reason.

I am not suggesting other reasons for large bore can’t be valid.

I am not throwing shade at ED nurses.

I am not saying these patients wouldn’t be resus.

I am saying that in this situation, for these three patients specifically, large bore WAS used punitively. Period.

If you believe this doesn’t happen, Idk what to say. Spend a few years working in an environment where addicts are literally punished by healthcare staff who deserved that treatment, and you’ll know that’s not a hard leap.

And yes, I know narcan doesn’t last as long as opioids. I also know a 14 g is unnecessary on an otherwise healthy pt. Standard of care is the smallest catheter that’ll get the job done is the one that should be used.

This isn’t even the point.

The point is that healthcare still has clusters of people who feel creating unnecessary pain is a reasonable response to a person who literally almost died and may be severely suffering from their addiction already. Punishing these patients teaches them one thing:

Don’t trust healthcare. Healthcare won’t help them. Healthcare will only hurt them further. Healthcare will judge & punish them. When they’re ready for treatment, healthcare will not welcome them with any sort of support, but instead will be cold and awful to them.

If you missed that point, then fair enough. I made a shitty tweet. But the point remains valid and SHOULD be discussed. If my tweet surprised you because you don’t see this where you work, know that I actually thank you for that. Dependence on drugs/ETOH needs compassion.

Now instead of @ ing me, lets discuss the real issue — how do we stop the pervasive judgment and punitive behaviors of doctors & nurses?

We had one doc who ordered morphine SQ because a patient asked for it. This patient had abnormal, pain producing, findings on his CT.

This stuff does happen. Lets fix it. #wtfentanyl