My Name is Susan
I am an RN who's also a recovering(ed) alcoholic. I've found the judgmental attitudes of colleagues taking care of addicted patients disturbing. The purpose of this article is to, perhaps, get nurses to realize how powerful attitude can be when taking care of an addicted patient.
My name is Susan, and I'm an alcoholic. I'm also a registered nurse, hold a bachelor's degree in Human Services, and a Masters in Human Service Administration. I have diabetes, a cirrhotic liver, and haven't had a drink in fourteen years. And, in spite of my continued sobriety, accomplishments, and dedication to working in the helping professions, I am still considered a social pariah by many. I continually ask myself why the judgment cast on those with addictions by those who have dodged that genetic bullet is so harsh as to be venomous. I still can't seem to come up with an answer.
I'm not one to be shy about sharing the fact of my alcoholic history. I was a very functional alcoholic, never lost a job, got a DUI, had a marriage break up or any of the hundreds of things that one typically thinks of as "normal" for someone who drinks as much as I did. My consequence was ruptured esophageal verices, a condition that very nearly ended my life. I haven't had a drink since -- that was enough of a wake-up call for me. But, had it not been for one very talented, non-judgmental and supportive GI physician, I may well have gone back on the road to self-destruction. He put it to me simply, stating that if I drank again I would certainly die, perhaps not immediately, but before too long. His demeanor and non-judgmental attitude (which was not matched by his colleagues) made me think that perhaps I wasn't such a bad person after all. Maybe there was a reason for me to work on staying sober and continuing on with my work with severely mentally ill people. He didn't just save my life in the medical sense, he also helped me to see that my addiction didn't define me. It's a characteristic, not the essence of who I am. Without that support, it would have been much more difficult to move forward.
Those who have never lived with the shame, guilt and self-loathing of addiction cannot possibly understand how the words and attitudes of others, especially professionals, impact the potential for recovery. If an alcoholic or addict is being told, verbally or otherwise, that their addiction makes them less human than the patient in the next bed, it's a fair bet that message will only reinforce what the addicted patient already believes about him or herself: "I am worthless, so why even bother to attempt sobriety? I don't deserve anything more than the hell I'm already putting myself through."
In my nursing career, I've seen this on a daily basis - some of my colleagues don't even attempt to hide disgust when taking care of someone with alcohol and/or drug addiction. Granted, we who have visited that personal hell largely created our own problems. And, as such, the recovering among us (who number more than the average person may think) own that fact and keep it in the forefront of consciousness. After all, anyone who's escaped that madness intact and spent any extended amount of time living sober typically has no desire to go back. It happens, to be sure, but I can only guess that the push has to be enormous for anyone to consider revisiting the twisted existence that is addiction. The bigger issue, however, is the jaundiced (pun intended) view of the caregiver. There seems to be no shortage of self-righteousness among those charged with assisting the addicted person on a path to wellness.
I've heard my colleagues refer to alcoholic patients as "scum," "piece of crap," "waste of human flesh." I've heard pronouncements like "She did it to herself, I don't feel sorry for her." Often these words are uttered shortly before the person casting the judgment goes off the unit for his or her smoke break, an irony I would find amusing if it wasn't so hypocritical and the person so mean-spirited. Yet, this is a daily occurrence, and I don't see it changing anytime soon.
How, then, do healthcare professionals find a way to drop the judgmental attitude and start caring for a person at the core of their being, rather than seeing only the surface of the addict? I firmly believe that education is key - most healthcare professionals only get a smattering of addiction medicine in school, which is ludicrous given the number of addicted patients a nurse or doctor will see in a given year. Learning about the root causes of addiction: genetic, environmental, psychiatric and behavioral may serve to assist professionals in seeing addicted patients more as human beings with medical or psychiatric disorders as opposed to self-indulgent, lazy people who don't deserve the same care and consideration as do people with less "annoying" illnesses.
If one sits down and has a conversation with an addicted person regarding the problem I think there would be one universal truth communicated. That is, no one sets out to become addicted to anything. It's not a goal one strives for. It's an insidious problem that wraps itself around the brain, and before the affected person can think twice, it's there. The fact is, people with addictions to substances don't possess an "off" switch. If we did, we could drink like "normal" people do - a glass of wine with dinner, a cocktail before bed - but we can't. And an enormous piece of recovering is regaining a sense of self-worth, a feeling that maybe the hard work ahead will be worth it. Finding people to support this process isn't easy. But each and every healthcare professional who cares for an addicted person can make a start. By treating the alcoholic or addict with the same respect and kindness shown to someone with a more "conventional" medical problem, there's a chance the message "you're worth my time, so you're worth making the effort to overcome this" may be conveyed. I know that message came through loud and clear to me. Without it, I wouldn't be here.Last edit by Joe V on Apr 3, '13
Susan Gibbons, MS, RN, former social worker, currently working on a med/surg unit in a small community hospital. I've been sober for fourteen years, and credit my desire to move forward with recovery to the doctor who saved my life. He never judged, only supported.
suejgee has '4' year(s) of experience and specializes in 'Certified Hospice and Palliative Care'. From 'Williamsville NY'; Joined Apr '13; Posts: 10; Likes: 62.Apr 3, '13 by CackalackyI completely agree. ALL people should be respected and treated as though they're worth something, because they are! I found this to become even more apart of my beliefs about how a person should be treated after working at a psychiatric hospital.
I think what helps me to respect everyone is not allowing myself to see someone as a diagnosis, or anything else that is only a characteristic, or an aspect of their life. I am also determined to treat everyone equally. I remember that there is someone who loves this person and cares about this person and they're worth the help that I can offer. If they feel as though no one cares about them, that's something that I can help with; I can show them that I'm willing to help and I care.
I will never forget my first patient in nursing school. A woman addicted to pain killers. She was obviously down and out and had given up because "no one cared." Being a student, I was able to sit in her room and just keep her company. She didn't say a word to me, but I got a smile out of her before I left for the day. A smile! From a woman who wouldn't even look me in the eyes when the day had started!Apr 3, '13 by SuzieVNEverybody is addicted to something- food, booze, candy, smoking, drugs, sex, tattoos, work, 'god'...everybody, something.Apr 3, '13 by tewdlesWe are educated to be patient advocates, not judges. None of us are perfect enough to stand in judgement of the weaknesses and failures of others. We should treat our patients with unconditional regard, regardless of their affliction(s).Apr 3, '13 by jadelpn, LPN, EMT-B GuideAlcohol. drugs, pain, poor diet, no exercise, too much exercise, starving---chronic disease is the reason we are all working. One's drinking is no different than one's smoking, eating garbage food, uncontrolled diabetes, prescribed meds for chronic pain, melanoma from sun exposure, uncontrolled high blood pressure....one could go on and on.....
And one could consider all of these "doing it to ourselves".
How many threads do we see about "A&Ox3 is a jerk"? People pick their poison. Part of our job is to help people cope with a disease--and alcohol addiction is a disease. No better or worse than any other....
Addictions nursing is one of my favorites. May you see the light, follow the sun, and find peace.Apr 3, '13 by EaglesWings21, ASNI am not sure why but I have seen a handful or more of health care be very judgemental of others. Once you have walked through that person's shoes, you do not know what their life has been like. EVERYONE is DIFFERENT! Congrats on getting your life back together and taking care of your health! Whether you believe in the Bible and God or not, it is true that those who are humble will be exalted and those who are exalted will be humbled...Apr 3, '13 by doxielover304, ASNThank you for sharing your story. Very inspiring for many, I'm sure. Im going to be a Nursing student in the Fall and I can't wait. I'm more excited than anyone knows. I completely agree with you.... everyone should be treated equally no matter what is wrong with them. To the other commenters, you're right- Everyone has an addiction of some kind. Mine is makeup and sweets. Lol. If only this world had more non-judgmental people in it. It's such a far-fetched thing to think about that it's even difficult to imagine. I can't believe your colleagues actually say those mean, terrible things about patients. Wow. That tells you right there that their heart isn't all about helping people. All they are doing is faking their concern and care for their patients. Their smiles might go a long way, but what's real is what truly matters. I don't think I could feel good about myself if I talked about my patients like that behind their backs. But, I enjoyed reading what you had to say because I agree with every word. Im happy to hear of your sobriety. That shows that anyone can quit their addiction if they truly set their mind to it. You have to believe you can do it. God Bless.Apr 3, '13 by twinmommy+2, BSN, RNI wanted to thank you for telling your story, that must have been hard to put that out there.
I myself have a close family member who is a recovering alcoholic so I think I empathise better to those who are suffering from addiction. But I can't help but think that the problem lies with medical providers needing to seperate themselves from their clients, that no matter what they would never do what that person is doing. And for that reason, they don't have the ability to place themselves in the clients shoes. If they did they would find out more than they want to know about themselves and thats an uncomfortable experience.Apr 3, '13 by VivaLasViejas, ASN, RN GuideI'm a recovering alcoholic with 21 years' sobriety here, saluting YOU for this great and inspiring article!! BRAVO!!!Apr 3, '13 by BCgradnurse, MSN, RN, NP GuideCongratulations on your sobriety and for a wonderful article.Apr 3, '13 by caringfornursesCongratulations again. I know it could not be easy. I know that many days I have gone home and wished that I could do something to help my patient's addiction. It seems almost impossible to believe that we can't help them. Over time, we have seen it more and more. But it is all up to the patient to do this for themselves. And that has been hard for me. Especially when a patient comes in to get help, say like for cirrhosis and we know that drinking is making it worse. Even the patient knows. But they have somehow lost the ability to control the urge. Or smokers with COPD. It is certainly no one's fault that they have a disease. But at some point, it does become their responsibility to try to help themselves too. It has to be a team approach. It can't be onesided. We all have to do our part if our patient is to become healthy again, physically and mentally. We do treat addiction like it a choice. Because, at some point, the patient does have a choice. Do you want to live or do you want to smoke? drink? use drugs? And that is the choice you made. Some people, even given that choice have no self worth, and no way of putting themselves into the equation. I am so glad you did.Apr 3, '13 by nursel56 GuideThanks for this article. It rings so true. Taking off the nurse cap for a second, I want to say that as the daughter of someone who drank again a year after his surgery for esophageal varices, somehow managed to live for 10 more years and passed away inside a CT scanner in a local ED for a head injury while I was two states away . . .
. . .he looked like a homeless bum I'm sure, way beyond his actual age of 59 years. I just wanted to know what happened, and finally my unspoken prayer was answered. I chanced to have a nurse answer the phone who was there that night, who's voice was of concern, not the blow-off, who remembered my dad, who let me ramble and answered all the fragments of sentences and thoughts running through my scrambled mind. In 10 minutes she gave me a measure of peace that has lasted all these decades.Apr 3, '13 by missej2002Love the article, but I have encountered numerous addicts. I do not feel sorry for them, and at times I do judge them, the addicts that won't buy their seizure medication, or Tylenol for their child's fever because they can't afford it, but they smoke two packs of cigarette a day, just bought junk food from the vending machine, brought their pain medication, or they drink daily. They are on dialysis, have DM, do not control their glucose still smoking and does not know why their wound will not heal or why they are losing another toe. I am not sorry for feeling this way, we can not enable addicts, I am not here to baby them, addicts need to stop feeling sorry for themselves, attempt to get help, and stop blaming others. We all have choices, that we make, we are not perfect, but when we make the worry choices, we have to face it, fix it and move on. I have many addicts in my family, drunks, smokes, drugs, comfort eaters, etc. The ones I feel sorry for is their family-their parents their children the spouse, and etc.