I don't really have any complaint with the CIWA protocols, I am grateful they exist and enable me to sorta get a handle on the ETOH'ers when they decide it's time for withdrawal. It's a lovely thing. What I really dislike are the patients!
This is a vent and if you think I'm a horrible person, just think... there are probably people you don't like either. The pattern for me has been that when I show up to work, it's magically day 3 for this or that one and that means it's freak out night, they look fine for dayshift and by midnight it is ON like donkey kong. They are tied up, spitting, yelling, cursing, hallucinating, wriggling, doing all sorts of damage to equipment and themselves, and I am giving ativan every thirty minutes until they snore.
Sigh. It's so predictable. And not one of them ever has a different presentation when the DT's start, although some are more severe. No one wakes up nice a few days later. Nope, some of 'em put cheerios in their hair and ears when they have regained control of themselves. And you never know when you will go to do something simple to a properly medicated, snoring, limp patient and have all heckfire and brimstone erupt. No matter how much you bathe them, the stench is amazing. Also you can't actually bathe them until you have medicated them into a somnolent state. While they are wiggling, they are gonna be icky because of the safety factor. I need my skin intact, thanks.
I dislike people who have gotten themselves into this mess by deliberately ingesting poison for years on end. It gets you drunk, yes, that is how you know it's poison. That's your liver working overtime to get the crap out of your system. There are folks that just don't care, about life or other people, or apparently about the humiliating extremes that they can wind up in when it all goes south either. Most of these folks have relatives that would have a duck if they saw the stuff their loved one gets into, and since ICU doesn't have a rubber room, they are restrained while going through the worst of it. I would be horrified to see a loved one in that situation, maybe that's one reason I choose not to surround myself with alcoholics. I do not understand this patient population, and to be honest, I don't like them either. Ok rant is done.
