Ethical question...give their alcohol back or not?

[ERnurse2001]

Your patient is in your hospital department because they are either drunk (ER) or admitted for DT's (floor). You or a co-worker find a bottle of alcohol in your patients belongings. Do you:

A) Keep it with the patient's belongings. It is their property and you have no right to dictate what happens to it other than to treat it like any of their other belongings.

B) Empty whatever is left in the bottle and throw it away. Your patient obviously has an alcohol problem and it is your responsibility to see to it that they abstain whether they like it or not.

Would love your input!

[AspergersRN]

This is going to get a bad response, but I visited a substance abuse floor and saw a detoxing alcoholic with medications to help. Plainly, some people will die without alcohol if they are an addict.

It would depend on the situation, but in life or death I would not the alcohol. Most often though, I think you can get an order to give an alcoholic some kind of alcohol if they are in a life or death situation.

Now would I leave a bottle of Vodka in a patients room so they can party it, obviously not.

Good question.

[Meriwhen, ASN, BSN, MSN, RN]

This is similar to if you take their bottle of alcohol and dump it out!!!! My friend lost her job

Fortunately the facilities I've worked in have policies that protect us if we do dump out alcohol--but only opened containers. Sealed are carefully noted on the inventory and locked up to be returned at discharge.

As far as the cigarettes, they're still the patient's property but like it or not they can't smoke them there: they are explicitly told upon admission that it is a non-smoking facility and smoking is not allowed. If they can't keep their hands off of their smokes, then the cigarettes are taken away and returned at discharge. Policies protect us on that one too.

It's not a question of playing moral or ethical police, or imposing on the patient what we think is best for them. It's maintaining a safe environment for all patients.

[FMF Corpsman, MSN, RN]

First off, I have a real problem when it comes to "morality police." I don't believe them for a minute actually. Those who are inflicting another’s morality on someone else are just as likely to be full of bull as the bull itself. Kind of like the Saturday night sinners and the Sunday morning Saints or do as I say and not as I do. They can always claim that you're the one with the problem, not me, so I can drink. But it comes down to this; What gives anyone the right to steal, yes, I said steal, anyone else's property. Do you go through their wallet and lift a few $20's as well? What? It's the same exact thing. I cannot believe this string. So many of my fellow nurses being so judgmental. What makes you so high and mighty? What if this person were a diabetic and came in with a diabetic crisis, would you steal from them as well? One is really no different than the other, Alcoholism is a disease, just as is Diabetes. It's just that one carries a lot less stigma than the other. Nurses that don't work in rehab/recovery don't know how to deal with those first presenting in withdrawal from alcohol, some may recognize that it is a life-threatening situation and unless there is effective intervention, this patient could very well die. Some ETOH patients suffer from seizures when they are withdrawing from alcohol, while others don't. Some just get a tremendous case of the shakes or DT's also known as Delirium tremens. You might just wish you had that alcohol that you poured down the drain back, while you are waiting on the Pharmacy to deliver your ordered drugs, because it might have saved your patient’s life. All it would have taken was a couple of slugs to hold him over for a half an hour, but you had to be so self-righteous and pour it down the drain. Now your patient is dead. Don't look at me as if I'm crazy, I've seen it happen.

One thing that Nurses need to work on is to not be so judgmental. The homeless, alcoholics, and addicts are usually not any different from you or I. There are of course exceptions. There are people living amongst us that are not on the street that I wouldn't give you a pile of beans for, yet those on the streets that I would give the shirt off my back too. In today’s economy, many are the victims of poor financial planning and they lost everything. There are entire families with tiny children living in cardboard boxes. Many of these men and women chose to dull their senses too reality by drinking and using drugs. I can't say that I wouldn't do the same thing if I were reduced to living in those conditions. Single women living alone have no protections against attacks by anyone who choose to have their way with them. The same is true with the men, or young boys, whatever the situation is. Life is horrible. Food is scarce. Who wouldn't want to dull the pain? Those of us who have had life relatively easy would definitely find it extremely difficult. To cut the pain would certainly be a welcome relief, if only for a little while, and then maybe again tomorrow. Pretty soon, it becomes the norm.

[Chamae01]

this has actually happened to me before. had a patient that was admitted very early morning, like in the middle of the night, for detox. by 8pm he still reeked of alcohol, usually wears off a bit after so many hours. anyhow i was cleaning something up by his bed and noticed a bottle of vodka, nearly empty, in his bag. i asked him about it and notified the charge nurse. we also notified the doctor and the charge took the bottle and emptied what was left in the bottle. why on earth would you want your pt that is there for detox to continue drinking and possibly becoming hostile? no thanks.

[Five&Two Will Do]

Better get rid of it before the staff gets into it........

[morte, LPN, LVN]

that is a whole different situation than the OP

this has actually happened to me before. had a patient that was admitted very early morning, like in the middle of the night, for detox. by 8pm he still reeked of alcohol, usually wears off a bit after so many hours. anyhow i was cleaning something up by his bed and noticed a bottle of vodka, nearly empty, in his bag. i asked him about it and notified the charge nurse. we also notified the doctor and the charge took the bottle and emptied what was left in the bottle. why on earth would you want your pt that is there for detox to continue drinking and possibly becoming hostile? no thanks.

[Andy Droid]

this has actually happened to me before. had a patient that was admitted very early morning, like in the middle of the night, for detox. by 8pm he still reeked of alcohol, usually wears off a bit after so many hours. anyhow i was cleaning something up by his bed and noticed a bottle of vodka, nearly empty, in his bag. i asked him about it and notified the charge nurse. we also notified the doctor and the charge took the bottle and emptied what was left in the bottle. why on earth would you want your pt that is there for detox to continue drinking and possibly becoming hostile? no thanks.

Shouldn't it have been put with the rest of his personal property, rather than being destroyed?

Obviosuly nobody is saying they should keep the bottle with them in their room.... that's just silly... but the fact remains that they're breaking no law, and someone on staff is making the decision to steal their property.

take the same scenario away from booze and see what it sounds like....

guy gets in a minor car accident and slams his head into the wheel causing him to get knocked out.... the car is relatively fine, but he's in overnight.

some random nurse figures that he injured himself with his car, and could have injured someone else... and may do so again if he gets back behind the wheel after discharge.... so they take it upon themselves to call a scrapyard, and have the guys car towed and crushed in the junkyard.

How well do you think that would go over?

[Guest219794]

That bottle might be the only thing between the patient and a seizure.

Now, when a fat guy comes in with a bag of Cheetos, I say dump them.

[MJB2010]

What is your hospitals policy? When in doubt, follow the policy. Leave your personal ethics out of it. My hospital requires security to get it, where it goes for there I do not care.