Long time reader, first time poster. I work in a pretty poor, city that's about 55% white, 35% black, and the balance a smattering of people from all over the globe.
I can tell you for a fact that I administer analgesic relief for black people less than for white people. I'd be a liar if I wasn't honest about that. It's not by intention, since I don't sit there and try to find ways to cheat people at every turn, but it comes down to honesty. It's not a color thing. It's a poverty thing. And since minorities tend to be poorer where I work, that's how it plays out. I have noticed this when I critique my work. I, for whatever reason, feel like poor people are trying to cheat me and lie to me more often than wealthy people.
Yeah, criticize all you want, but really think about how YOU interact with patients before you judge me. Do you wipe your shoes better when you walk into a expensive house vs a poor crappy house? Do you shut the door all the way in a crappy house as often as in a big mansion? Do you cut across the grass when walking up to a shanty? How about when you're walking into an immaculate million dollar apartment? Do you pick up all your trash when running a code in a ritzy part of town vs the ghetto? If you're in that 99%, you probably don't.
I had this guy the other day tell me that the cut on his finger, mind you a teensy cut, was 8/10 pain. I was like, "That is 8/10?" Mind you, this was guy who had been SHOT in the past. Liar, plain and simple.
Then I get the people with chest pain. We pick them up from jail. 10/10 chest pain. I say, "10/10 is the worst pain you could POSSIBLY imagine. That would be the worst pain you have ever experienced. Like being burned alive while getting stabbed in the stomach." They reply, "Yeah, 10/10." I make sure, 'This is the worst pain you have EVER experienced in your life?" Yeah, 10/10. Then they proceed to fall asleep. Liars. No morphine for them.
I don't know if it's a cultural thing or what, but it seems like black people say everything is 10/10 pain. 8/10 pain is a splinter or less. I have gotten a 7/10 once. That was the lowest I remember in 3 years of work. I don't know if people think they won't be taken seriously or what if they don't make some BS claim.
White people can be just as bad. White people are more cunning. "I'm alergic to aspirin, codeine, morphine, fentanyl, ibuprofen and toradol." I say, "Oh, so you can take Naproxyn for pain. You know, alleve?" No, I'm allergic to that too, I just forgot to mention it. "Oh," I say, "YOu didn't mention tylenol. Are you allergic to that?" Yeah, I forgot to mention I'm allergic to tylenol too. "So what works for your pain, since you're obviously allergic to nearly everything commonly given?" Oh, I don't remember. Some D- drug. Doofalid or something. I don't remember. "Dilauded?" Yeah! that's it. Dilauded. Nothing else can touch my pain. It's 11 out of 10! My pain is horrible!
Liars.
The most common presentation for drug seekers I see is "back pain" typically "my sickle cell is killing me!" Yeah, right. And it was killing you yesterday when we ran you, and last week when we ran you, and the 10 days ago when we ran you. You must have some Discovery Health Channel "worlds most painful sickle cell EVAR" medical mystery disease.
I need to talk to some nurses who work in ghetto ERs to figure out how they assess patient pain. They have to have some tricks I don't. This catch all 10/10 crap I get is a waste of time. Anyone have some suggestions? I just want people to be realistic.
