New job as addictions nurse need advice

[czerwodl121]

Hi everyone. So quick background to my current situation. I have been working at the number one trauma hospital in my area on a med surg/tele floor. I have gotten amazing experience and have learned a lot in the short time I've been there (7mo) but have gotten the opportunity at my dream job working as an addictions nurse in a new detox center in my area for teens. It is a well established and reputable program and I'm beyond excited to start this new avenue in my nursing career. So problem...I am still a very new nurse..I only have the 7 mo of experience in the hospital I am currently at. I was lucky enough to get good experience working with patients who were actively detoxing and going through withdrawal since our floor gets everything! However, I do not feel prepared enough to go into this situation with the little amount of experience I have. I am a person who wants to be prepared (or as prepared as I can be...we all know nursing is a learn as you go no matter how prepared you are kinda field). I want to research and learn as much as I can about my role as an addictions nurse. I am worried because I do not feel I am going to get adequate training or orientation taking this position because the detox center is new to the campus and I think they are still feeling out and finding out how to go about everything. So I guess my question is what books or resources can I get my hands on that will help me in my situation. I have purchased The ASAM Essentials of Addiction Medicine and also Addiction for Nursing by Hussein Rassool...Any thoughts on these as resources to get myself started and a better grip on addictions nursing as a whole? Any advice would be greatly appreciated guys! I want to be on my A game and be the best at this position I can be for these kids:) Also please..I am looking for positive advice and comments..I've seen some people post on others looking for advice and I'm not really looking for criticism saying "why are you leaving the hospital after only 7 months you should stay and get your experience" Everyone's journey is different and I feel this is where mine has led me for a reason and purpose

[hppygr8ful, ASN, RN, EMT-I]

Welcome to the world of Psych/addiction nursing. I have been working in this field of nursing most of my career though I have branched out from time to time. It can be extremely rewarding to see a patient successfully detox and go on to the next level of treatment. Some we never see again and others we see all to often as lass than 15% of patients who seek treatment for addiction achieve lasting sobriety. These patients will challenge you in ways that you can't even fathom at times so make sure you have on your "Big Kid" pants when you go to work every day. A person who trained me used to say 'These patients are not bad people they are sick people who need to get well." remember that when an addict in detox goes into full on Axis 2 mode they are often not trying to be difficult they are simply trying to survive in the only way they know how. It is our job to help them change their mindset but that only happens after the physical discomforts of detoxification have subsided.

It's good that you have some clinical skills as good assessments will help you differentiate between somatic and non-somatic illness.

As I said these patients can be very challanging and they need empathy and kindness. Welcome to the fold.

Hppy

[czerwodl121]

Thank you so much for your kind and encouraging words. It is nice to hear nurses positively post about their job experiences with empathy, compassion and yet reality of things lol

[Neats, BSN]

Agree with everything already said.

I would also do this, practice good boundaries. Be firm, Fair and consistent. Axsis II diagnosis are the hardest to deal with you will almost certainly get worn down from dealing with this diagnosis. The rewards are great. I have had some real discussions with patients who once in a while I have run into while out with my family, some come up to me and Thank me, that is reward enough.

How I learned to deal with the axsis II diagnosis I watched real bartenders and waitress work their comebacks. I was also trained by multiple correctional training center in verbal judo. Your verbal skills can resolve most patient interactions. Practice scenarios and how you would verbally respond.

Good luck in your new position.

[Tippyrn]

These kids are very fragile and have very low self esteem, it can be sad some shifts, but also can be fun. They don't trust adults so they can be very hard to reach as well as violent, so don't let your gaurd down.

[angeloublue22, BSN, RN]

I have 8 years experience in addictions and psych. 80% of the job is milieu management, addressing behavior issues, and boundary/rule setting. Trauma informed training is a must and there are some really good youtube videos on how to de-escalate and how to do motivational interviewing. Our motto is to be "firm, fair, and consistent." (see a trend happening here?) Consistency is huge in this field. You would be amazed how one tiny exception can blow up. Humor goes a long way and not escalating your behavior when the pt does is also key. Lastly, don't be afraid to show you're human. This will definitely very much be a communication job, so brush up on the therapeutic communication skills. You'll do great and welcome to the world of addictions!

[NuggetsHuman, BSN, RN]

I'm breaking out the popcorn here and hoping to see an update about what you've decided!

Would love to hear from you about whether you decided to go for it, if you did, and how it's going.