New nurse hired for inpatient detox facility

chevyv, BSN, RN · Jan 25, 2014

I would go for it! But, I would also advocate a little on the training if you feel it's not enough. We do a lot of detoxing where I work and it's not so difficult. A lot of CIWA's, meds, support, and sleep is what I find so far. I watch my detoxing pts closely because most have been through so much and it can be rough for them and on you. Many are not always nice, some are lost, some are scared, some are just alone, a few are not ready.

My place of employment deals with more than just detoxing. For my detoxing pts though; I start with report to get a feel for where they are at, when the next CIWA is due, food and fluid intake, labs, etc. I then physically lay eyes on each one, listen to heart, lungs, bowels, ask about pain, cravings, AVH (auditory/visual hallucinations), SI (suicidal ideation). Above all else, I care, I listen, I don't give lip service. I change their linens when they get up because a fresh bed makes me feel better when I'm not well. Offer fluids, extra blankets, whatever they might need. Some have no home to return to because they've burned so many bridges. Many seem to want to be left alone that first day or three. Most of my pts will watch the way I interact with other pts. Not sure why, but I have a feeling they are sizing me up to see if I do care because after a day or two they open up to me pretty well.

Good luck in whatever you decide! I hope this helps a bit.

nurseash412 · Jan 25, 2014

Thank you so much chevyv! This has been very helpful I think I'm going to go for it!

iceangelred86 · Jan 26, 2014

Nurseash- I was so happy to see this thread! I'm in a somewhat similar situation to your own. I graduated nursing school in August of 2012 and ended up in a long term drug and alcohol rehab shortly thereafter due to my poor choices. Now I'm out and was offered a job at a local inpatient detox. I admit to being super nervous about the position but being an addict myself (with 13 months clean) I feel like I will be able to relate to and hopefully make a positive impact on the patient there. Best of luck!

empatheticRN · Jan 29, 2014

this such a great thread. I am interested in drugs drugs/detox and psych nursing also. I just just got offered s job in corectional and I start next. I am super excited but nervous too. chevyv I will def be using some of your tips

chevyv, BSN, RN · Jan 29, 2014

This is a great place to come for tips and support! I have learned so much from other nurses here. I hope other nurses pipe in because I'm sure there is so much more experience out there!

Again, wishing you all the best of luck!

chevyv, BSN, RN · Jan 29, 2014

empatheticRN,

I did my preceptorship in a womens prison and loved it! They tore me up the first 2 weeks but then I gained some confidence and did well. They can smell fear, I swear, lol.

Corrections nursing is a lot of psych too. I can't tell you how many times I heard "I want everything I can have" Why anyone would want tylenol, ibuprophen, bowel stuff, etc is beyond me but the ones in max always requested everything.

mangopeach · Jan 30, 2014

Congrats on the job!

As far as what to brush up on. I would say, brush up on WD symptoms from various substances. Wouldn't hurt to do a little research on slang terms for various substances. Sometimes I admit a patient, that tells me something like "I've been Robotripping, Popping Mollies,Leaning and eating Bars. Or you may overhear that type of language in the Mileu. Definitely brush up on your psych meds. Many of my detox patients also have a psych diagnosis.

I usually start my day with my first set of assessments/ CIWA/COWS. - These are typically 3-4 times a day for CIWAS and 2-3 times a day for COWS. (Depending on the protocol or MD orders). I work in a psych hospital and the same rules apply on the detox unit. Patients are expected to participate in the mileu and go to groups for most of the day. The first 24-48 hrs can be rough on some patients and some may be unable to participate because they are too sick. I have to do more frequent assessments on those. Possibly call the doc to get new orders if the protocol they are on is not helping.

I do a lot of charting. (Sigh) - A good amount of my day is spent doing paper work. However, I still get out in the mileu and talk to my patients so I know what is going on with them. We are a busy unit. I do a lot of admissions and discharges. The admission process and the documentation that has to go with that is time consuming.

A necessary skill to have IMO, for this area is how to deal with manipulative patients. This skill will come in time though so I would not worry about it right now.

There are some nurses in my hospital that despise working on the detox unit because of this. They prefer to work our Stabilization unit with the most psychotic patients than to work on the Detox Unit dealing with the manipulation from addicts.

As Chevy mentioned, Compassion and Genuinely caring will go a long way. From time to time I have a pregnant patient trying to detox. For some its their 1st time in detox so they don't know what to expect. For others its the 3rd or 4th time and their other children were born addicted to whatever substance they were abusing. You have to be able to leave your own judgments behind.

Good luck!

empatheticRN · Feb 9, 2014

@chevy I'm gonna be at a female prison also. .. Thanks for the heads up because I need it

mmaibaue · Feb 11, 2014

Thanks for all that you do. You have a tough job. And you are right, many have no one left to help them through. I remember what my son said to me a few days after he got out of ICU and a several days into his inpt recovery program. "Mom, you have come to see me everyday and I have been so mean to you. You are the only person that has come...... No one else, not even my friends." My son and I could not have made it through without the support of people like you!

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