CIWA woes - page 5

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  1. I think there is a difference between judging how people take care of themselves and judging how a person is in general. I don't pass judgement on patients who continue to drink, smoke, or eat fast food. I understand that disease can consume someone and cause them to make mistakes. However, I do judge a patient when they spit on me, hit me, urinate over the side of the bed because you won't get them a cab voucher, cuss you out because you didn't inform them that their girlfriend is here at the same time as their wife, request only white nurses because they are racist, or pull out their IV and throw it at your face because you didn't let them leave with it, so it can be used to mainline the new oxycodone prescription. My judgement comes from who they are as a person. It doesn't change the way I care for them or get in the way of doing my job. It's hard to not be judgmental when you are caring for a pt who is handcuffed to the bed because they were arrested for murder. Or, caring for someone who got a laceration from a wife that was defending herself while he was beating her. Not everyone that comes through the hospital door is a victim of misfortune.

    I think the OP had a very bad rotation. It was very stressful and she needed to vent. She had some opinions that she felt needed sharing for her own sanity. A lot of the feelings we have to deal with as nurses can be overwheling. In my humble opinion, I don't like the fact that a nurse wanted to share her opinions and other people responded with "how dare you." If anything, she needed constructive criticism or a pat on the back. I felt the same way years back. I was frustrated seeing frequent flyers or people who just didn't care. As the years have gone by, I have learned to just roll with the punches. There are things in this world that I can't control. It's probably funny that we cope with ETOHers at work by cracking open a beer at home after work.

    I can't say that I've never judged a patient and I think it's ignorant to say how dare you pass judgement. That's too much of pointing your finger on top of a soap box. Almost the pot calling the kettle black. Maybe the OP had a really bad experience with other alcoholics. I don't mind that people have opinions about patients or want to vent on a forum. I don't always agree with others.

    So, to the OP....As your career moves forward, you will learn to deal with your feelings toward others. You'll see that there are things are you can't control. ETOHers can have a wide range of behavior. Some are just severely altered and don't realize whats going on and there are those who are just mean and abusive in general. They do ingest alcohol, knowing it's something they can change, but there are so many other factors that are literally controlling their response to ETOH. One thing that might help is talking to them after the withdraws have subsided. If you find out that the drinking was a mechanism to cover the pain from an abusive past, it might help you gain a new perspective. Don't worry about other people on this forum....um...passing judgement on you for passing judgment. For every person that looks down upon you from their soap box, there are a dozen who are here to listen and lift you up.
    fireball78 likes this.
  2. Ahh, well thanks Hodgie, that was really sweet. I'm just gonna let this discussion fizzle out if it will be kind enough to do so...
  3. I love working in Substance Abuse detox and enjoy working with this population of people who need someone to care for them while they are in withdrawal. Guess it's not for everyone, but it is for me. I've only had 1 problem in the 3 yrs I've been doing this. Even when my patients go into DTs (Delirium Tremens) it's okay. We help them to recover, put them back on their feet and refer them to aftercare. CIWA is an Alcohol Withdrawal Assessment Scoring Tool that nurses, doctors and clinicians use to assess where the patient lies in their detox from alcohol. Hallucinations "can be" a part of their withdrawal symptoms, but this does not apply to most. Ativan doesn't work on someone with DT's, they need a stronger Benzo than that. Imagine giving them Ativan for anxiety versus Librium 25mg/Q4hrs with a sleeping pill and sometimes even Vistaril...or Benadryl. Ativan is for you and me (if we ever needed to take it). It's not for someone hallucinating r/t: DTs. Hope this helps.
  4. Quote from Indy

    It's not luck, I chose to not marry one. I'm sorry you had a rough time with your family. Mine was not fun either. I just didn't want to talk about my family in this rant, but it is relevant I guess, in that it taught me early what to avoid later on.
    "Growing up around them" doesn't imply marriage. It implies that relatives, maybe even parents, were alcoholics. You don't always get to CHOOSE.
    Anoetos likes this.

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