July 14, 2006, 2:40 pm

Compassion For the “Frequently Flying”


Well isn’t’ that special?

She must have just returned from a transatlantic flight to Ireland

Not that that causes irregularity, mind you

I’m just sayin’


I’m sitting at Starbucks, continuing my boycott of Borders.

It was hard to boycott today.

The sent me a coupon for a free dessert at the coffee shop because it is my birthday.

Sneaky buggers…….


Oh geeze, Rascal Flatts is on the satellite radio here singing about a grandmother who has altzheimer’s so badly she is in a nursing home.

But ask her about Grandpa and she comes alive.

One of the lines goes:

“Tomorrow she won’t remember what she did today, but just ask her about Ellsworth, Kansas, 1948”

And I have a lump in my throat.

I must be extra sensitive. For some reason I miss my dad rather acutely today.

Well, it won’t do to cry in the middle of Starbucks, so let’s get on to our topic du jour.


She was young. Maybe 32-ish.

We saw her a lot.

Sometimes three times a week.

She had chronic pain.

The first time I met her I saw the staff roll their eyes when she came in.

Hmmm…..must be a regular.


As I got to know her during subsequent visits, it seemed to me that she was quite nice.

In fact, she was the kind of person who you would like to have lunch with.

Not your “typical” drug seeker, if there is such a thing.


As I do with everybody in her condition, I made sure she always had a dark room, private, quiet and with a warm blanket.

Some of my colleagues thought I was encouraging future visits by making her too comfortable and accomodating her needs.

So…..we’re supposed to not accomodate her needs because she was a “frequent-flyer”, as they phrased it?


What had this patient ever done to the nurses to deserve this kind of attitude, other than to be in pain?

She may have been a seeker.

How was I to know that? How was I to judge that she was not in agony?

I guess at this particular ER, you didn’t get compassion for that behavior.


One day she came in with wonderful news.

She had obtained the job of her dreams on the East Coast and was moving withing two weeks.

It was wonderful for her because she had to overcome some serious obstacles to get that job.

I wished her well at the end of the visit.

I’ll probably never see her again.


One day I was discussing her news with a colleague who informed me that our patient had a Master’s degree from Yale.

I was floored.

I was floored because it proves that we who work in the ER have no idea of what our patients are dealing with outside of their visits to us, or how they handle their suffering.

Some people can smile through pain.

I managed to count the number of patients in an ER where I was experiencing 8/10 chest pain because I could see the tracking board from my bed.

Some people double over at a hangnail and some display stoicism with a 100% blocked left anterior descending coronary artery.

You can rarely judge

I try not to ever judge, but I’m not perfect. Not even close.

But I try, and you get compassion from me no matter why you show up at the ER desk.

Guess I’m not burned-out!

And that’s a good feeling.


  • Dan

    July 14, 2006 at 9:57 pm

    I get the same attitude from the other nurses on our floor. I have always been the one to show more compassion to our “frequent flyers.” Most of the nurses scoff at the fact that I give them attention, and I too get the “You are encouraging them” talk. but I don’t care. I’m a nurse, I have no idea what they are going through, and I will help them. What’s the old saying “You don’t know a thing until you walk a mile in my shoes?”

  • Jenn

    July 15, 2006 at 9:06 am

    Happy Birthday 🙂

  • Jodi

    July 15, 2006 at 1:10 pm

    Hey…We have the same Birthday! How do I get that coupon? lol
    Hope your was good…mine wasn’t bad!
    Happy Belated!

  • d

    July 15, 2006 at 2:57 pm

    If you go there and get your free (read: out of their pocket) dessert and block a table from another (read: paying) customer, then it’s not really breaking your boycott, is it?

  • Too Fat 4 Ponies

    July 15, 2006 at 11:36 pm

    Happy Birthday! Loved the graphic. Too funny.

  • Sharon

    July 17, 2006 at 7:32 am

    Happy Birthday and Welcome back from your wonderful vacation!! I have one question…. I have looked back at previous posts and I guess I just missed it…. why are you boycotting BORDERS? I am a reading junkie and while I don’t go there often… I do occassionally stop into BORDERS. But, I would not like to patronize them if there is a problem. Can you re-tell the cause of your boycott? Thanks!!

  • surgeonin my dreams

    July 17, 2006 at 8:27 am

    I was so pleased to read this post. They are not all drug seekers and who can really tell? Goes well with the post on my site about my husband.

  • difficult patient

    July 17, 2006 at 1:09 pm

    Well, you know how I feel about this topic . . . don’t forget to screen for domestic abuse. I know from previous comments that you do that, Kim, but obviously others do not. *sigh*

  • Carrie

    July 18, 2006 at 7:38 am

    Happy Birthday, Kim! Thanks for writing this post, and even greater thanks for showing that kind of compassion, even when colleagues are critical. I’ve been in the hospital inpatient 8 times for severe, chronic headache and that’s also landed me in the ER on a handful of occasions. I try not to go to the ER very often, but it’s happened during times when the pain is out of control and nothing is working. I’ve been judged plenty of times. Once it took an abnormally long amount of time for me to be seen, and only later did I learn the real reason. The triage nurse had written that my pain level was 0 and that my pain had resolved upon triage. She had circled my actual pain level of 9 down at the bottom of the page on the Wong faces, but written all about how my pain was gone in the initial note. The doctor came in and said to me, “So I hear your pain is much better now?” as her first question to me after maybe 5 hours of waiting. I said, “No…if anything, it’s a lot worse now” as I was in the middle of an all-out cluster attack. 🙁

    Why do people feel the need to be uncompassionate to those with chronic, severe pain that need our help? I’ve never been able to figure this out. It isn’t just due to the theory of drug seekers. I’ve met plenty of health care workers myself who knew I wasn’t a drug seeker but still treated me like absolute crap. Maybe it’s because they thought I was being a baby or that my pain couldn’t possibly be that bad. I’ll never know. It’s a question I still grapple with as I do wonder why people behave in such a way. I have never done that…. I often feel it’s equivalent to me getting angry with someone who has hypertension or arthritis – is it their fault? Is it my fault that I got a headache one day that never left and has become severely disabling? No…I didn’t ask for this. So why, even by employee health at my own job, am I treated like I should be punished for something I never asked for?

    Sorry to go off on a rant! Obviously, I have very strong feelings on this topic… I used to start any ER visit for the severe headache off with the fact that I used to work in headache research for a prestigious center and am a member of the American Headache Society – hoping that it would buy me slightly better treatment than I would receive otherwise. It’s a shame it has to be that way… Bravo to you for acting with compassion towards those in chronic, disabling pain!!

    Carrie 🙂

  • holly

    July 19, 2006 at 9:29 am

    I have headaches that are severely disabling as well. I would rather go see a veterinarian, faith healer, or a shaman before going to our local hospital’s emergency center. Last time I was there they over sedated me, then gave me zofran, which my chart SCREAMS that I am allergic to, pushed it in my IV and left. I had a fifteen minute seizure that was finally noticed when I fell off the gurney and knocked over the stainless steel surgical tray and cut my head open (four stitches) then they gave me another push of morphine, told me to get dressed, and I went over again. All this was happening while I still had greenish foam stuck to my face. When I asked for a towel or something to get cleaned up, they threw a moist washcloth into the vomit basin. I was so paralyzed with grief, rage, and embarassment I didn’t ever go back. Oh, and I worked in the Lab at the very same hospital. I didn’t go back there either. I wrote editorials, complaints, etc and know that the Docs that work in that ER are burned out shells of the formerly caring practitioners they once were.

  • Intelinurse2b

    July 19, 2006 at 4:17 pm

    I sent this post to my 1st sem nursing instructor. She tried demonstrating through telling a story then taking a poll how we as nurses will bring our own biases about pain to the floor and they will rarely change. I hope this post is yet another elbow in the ribs that we need to take pain reports as the patients honest account of their pain and stop worrying about who’s addicted, who’s a seeker etc. etc.

  • Barb

    July 19, 2006 at 5:58 pm

    Chronic pain…being dismissed…I could write chapter and verse. I complained of pain for years and years – mentrual, mostly – endometriosis, predominantly…over and over…surgeries, D&C’s, pills, hormones, ovarian cysts…

    So many professionals assuming that I was being a “baby” – looking for attention, wanting to be pitied, yada, yada…on top of IBS, cluster migraine, etc etc etc…ahhhh…actually got a look at my full chart once when they weren’t looking, the intimation being that I was simply a chronic whiner.

    For 22+ years, I regularly assessed my pain at level 5, cyclically rising to a 7 or 8. Assumption: that can’t be possible and function normally, much less with the smile I tried to keep on my face.

    Until a 7cm tumor on my remaining ovary enabled me to convince my OBGyn to (finally) perform a hysterectomy (abdominal). Imagine his surprise when, 18 hrs after surgery I had not hit my morphine dose in 9 hours, and my pain assessment level was 2.

  • Lindy Boyersmith RN

    August 5, 2006 at 8:15 am

    I am an RN with a chronically ill son (he’s 22 yrs old). He lives with a bone marrow disorder, chronic pain and fatigue. He got sick when he was 18. I worked in critical care, trauma and flight nursing. My nickname was Mother Theresa to some; I am one of those nurses that was nice to the chronically ill frequent flyers; now I am immersed in it; my son and I have been treated badly by ED and hospital staff. I can so relate to the chronically ill and crazy. And what a profound shocker to be treated badly by the very system I’ve worked in. Now I work with the good, the bad and the ugly in the community medicaid system; and I’m making headway! It’s so incredibly rewarding; and my experiences with my son have helped me be more effective with my patients; but I admit; I really miss working in the high adrenalin areas of nursing. I wish I could lecture all those onrey ED nurses and stressed out floor nurses – they are going to be ashamed of themselves someday. I pity them all for their bad attitudes.

  • sharon

    November 30, 2006 at 7:28 pm

    I am really glad someone posted something like this I have been labelled as a ‘Frequent flyer” and I found that out when I had to go to the ER when my mom died about a month ago. I was in horrible pain my head felt like it was spitting into. I do suffer from migraines and I have had to go to the er to get them under control and I was so mad when that doctor came in and had the nerve to tell me your charted as a “Frequent flyer” I’m sobbing crying in pain and he tells me that. If some of these doctors had a family member who was suffering like that I wonder if that’s what they would say to them or if they themselves was in such pain I wonder if there colleges would judge them

  • Ann Ward

    August 5, 2008 at 6:42 pm

    I’m Lindy B’s mom, and maybe I’m not supposed to be here, but if there is a God, he’s gonna want her for his RN!!

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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