Detox Units

[RNin92]

I was just wondering...

Anyone's hospital have an inpatient 72-hour medical detox unit?

Ours does, but it seems to have a revolving door...that just keeps spinning!

I know it was initially started more as a money SAVER rather than a money maker. But it is causing havoc with the ER! I do not remember soooo many people coming in requesting detox...again and again and again and...well you get the idea!!!

Some of them aren't even out of the unit 24 hours and they are drunk and back again.

Now, I can understand the nature of addiction. I know how difficult it is. But it is usually the ETOHers...and not even 24 hours?!!? I think the unit has become a halfway house for our chronics and the addicts who truly want help are denied entry because there is no room.

So I wondered how it was outside of the area with the town that boasts "more taverns per capita than any other in the country!!!"

[veetach]

we dont have an in house detox, ours is down the road, BUT we usually get them if their ETOH level is above .2 . If they come in to the rehab center with a BAC higher than that, they dump them ( sometimes literally) on our doorstep. AND then they have to sleep it off in one of our rooms for hours. When they wake up sober the next day they usually sign out and go home

how dysfunctional is that?

We do, however have a large behavioral health unit, (the only one in a 4 county area) so we get the mental health patients too. The problem with this is that it takes sometimes 4-6 hours for our crisis counselors to get authorization for admission from the insurance companies of a lot of these people and while they are waiting they are taking up ER rooms. what a vicious circle. We have a lot of repeat offenders in this area too.... its pretty bad when we know them on a first name basis.

[Nurse Ratched, RN]

The director there has finally started refusing a few FF...but then we have to keep them in the ED until their levels are low enough to release them. If they have someone who can pick them up we can release them at that time, too.

If we kept our FF's just until their levels were low enough to release, that's the point they'd start going into DT's. I've seen some of our folks getting jittery when their BA hits 200.

[RNin92]

If we kept our FF's just until their levels were low enough to release, that's the point they'd start going into DT's. I've seen some of our folks getting jittery when their BA hits 200.

No kidding!!!

Most of the chronics-their baseline IS 200.

So here's the goal...decisional but still enough ETOH in the system to prevent seizures...

It is such a bad situation.

No answers here...only more dilemmas

[RNin92]

we dont have an in house detox, ours is down the road, BUT we usually get them if their ETOH level is above .2 . If they come in to the rehab center with a BAC higher than that, they dump them ( sometimes literally) on our doorstep. AND then they have to sleep it off in one of our rooms for hours. When they wake up sober the next day they usually sign out and go home

how dysfunctional is that?

We do, however have a large behavioral health unit, (the only one in a 4 county area) so we get the mental health patients too. The problem with this is that it takes sometimes 4-6 hours for our crisis counselors to get authorization for admission from the insurance companies of a lot of these people and while they are waiting they are taking up ER rooms. what a vicious circle. We have a lot of repeat offenders in this area too.... its pretty bad when we know them on a first name basis.

It's the same here.

The crisis people come in quickly...it's the insurance authorization that holds everything up 3-4 hours.

I don't get it...

Medical screening for psych eval...emergent...hospitals cannot refuse to treat

Mental Health TREATMENT...not emergent...hospitals CAN refuse to accept...based on insurance.

Go figure.

:uhoh21: