chemical dependency/addictions nursing

MQ Edna · Aug 29, 2006

Hi there,

I'm a LPN , just getting back to finishing my RN now that the kids are grown. I've been in the substance abuse field on & off for 18 yr.s & I love it-hate, it's extremely stressful,heartbreaking,rewarding,frustrating & if you are the type of person that always tries to help the under-dog & have a LOT of patience you'll probably love it too :0)

I tend to get a little burned out after a few yr.s then go do what I call easy money nursing (pass pills, chart, go home) for a yr for a break but I always gravitate back to psych/substance abuse. Most likely because it has been such a huge issue in my family I naturally go there, kwim?

Right now heroin & crack cocaine is such a epidemic here in MI with Meth-amphetamine close behind, it's moving here quickly & I believe we are very ill-equiped here in Michigan to deal with it along with the rest.

The only way to find out if you like it is to try it, I say if you find it interesting try it for 6 months to yr & trust you will know if it's for you!

The nurses I work with have all been in substance abuse/psych nursing for many yr.s so I guess just like pediatrics or other specialties it has it's pros/cons. What is most frustrating for me is lack of funds/insurance for those most in need & frequent flyers pt.s who have the funds/ins but are really just there to detox so they can use for less $, or stay out of jail. They take up a bed that could be used for someone who really wants to stop.

Also when management approves an admit for a board members family member & they stay a month free of charge when in the same week we have a addict that has insurance coverage but has a $2500 deductable they can't pay and they are begging for any help we can give (this actually was one of my sons best friends, can you imagine I was the nurse on duty when he came in?), they won't make payment arrangements & turn them away, yet the other rich person gets a free ride. It's everything that is WRONG with our system....it really pixxes me off to say the least. The motto os "no-one is ever turned away" but that's a lie.

So anyway, if you can deal with this level of frustration on a daily basis-Welcome aboard! Lol.. I work only 3 days aweek, and come home and just cry some days. Our management is pretty abusive to staff where I work & very non supportive.

There are no de-briefings after assaults, or twice after involving weapons, we have zip for security only rent a guards who are not to physically restrain a pt in any way even if we are assaulted. I have been physically threatened by pt.s, & a bi polar staff member & they do nothing so my advice to you is be sure where you work is #1 Safe # 2 suppprtive to staff, because substance abuse/psych is emotionally draining anyway you have to have a good support system. Talk to the other staff where your considering going to work before you do.

Guess I'm not exactly taking you into it, but if you really care about addicts & the under-served, you can't beat it..

Good luck & I hope my post helped instead of scared you away :wink2:

-Sara

Sistermoon · Aug 29, 2006

I'm orienting on an inpatient unit for adult detox. Two major things I've learned: in acute detox, it's all about assessments and meds. The big surprise is how short a stay detox really is...patients are barely swallowing their last doses of their detox meds as out the door they go. Therefore, we can look forward to seeing many of them again. The upside is, the crew I've been working with is phenominal, and I never, ever get bored enough to sit back and watch the clock!:chair: Of course, I'm new here. I'm also old enough to know that the part of nursing I DON'T like is as generic as a bitter pill and not likely to get sweeter any time soon no matter where I practice.

That's my take on it all now. Ask me again in six months when the honeymoon is over.

Spazzy Nurse, RN · Sep 4, 2006

Like you, I started out as an LPN and I was working in mental health. For the last year and a half I have been doing MI/CD as an RN and it's quite a bit different than straight MI in my opinion. I think to be able to stay in it for the long haul you need to have a team who works good together and a director/supervisor who is involved (in a positive way) in everything that is going on. It really wears on you some days, but it really is a facinating field.

WyndDrivenRain, BSN, RN · Nov 10, 2006

Hi,

I work in chemical dependency. I have tried other areas and I always come back to CD. I just love it. Somedays I do get frustrated with seeing the same patients over and over but overall I find the job rewarding. We deal with a variety of health issues beyond addiction too. I deal with diabetics, cardiac issues, neurological issues, wounds, concurrent mental health issues...you won't ever be bored. I think the best way to know if it is for you is to try it. I think this will be my home for the long term. I think it is one of the best kept secrets in nursing.

donmomofnine · Dec 5, 2006

I am being considered for a DON position at a detox center. I am very excited about it and hope that I am hired. So much to learn, but it's challenging to learn new things!

joe3 · Dec 10, 2006

I've been working at a detox/ rehab center for a year. It's the best job i've had in 10 years of being a RN. The staff here is great, easy to work with and the nurse manager is very nurse friendly. Sure, it gets frustrating at times--seeing the frequent flyers--but better than the ER. There is more interaction with the patients, I get to see them detox, get better as the weeks go by then they are on their own. There is more of a sense of satisfaction here than in the hospitals. The only downfall is the pay is lower than at a hospital.

Like what was said in the above posts, you really have to try it to see if it is for you.

RedheadRN1958 · Dec 15, 2006

Do any of you think that previous experience with a personal addiction makes you a better nurse in CD? Or having experienced a mental illness makes you better with MI?

joe3 · Dec 15, 2006

As a RN in CD I can't have anything on my record, CD requires a squeaky clean slate & we also take adolescents as pts. There is a page and 1/2 of disqualifying incidents that could keep a person out of CD.

To answer your question: IMHO............yes, it's a been there done that and have the experience to relate to and with. After a year in detox, I can relate well because of my experience. Personal addiction would give you a better feeling for those pts in CD. MI......I wouldn't have a clue....although we all are a little crazy :smokin:

Most of our counselers have been addicts, patients relate to them better than those that aren't ( per the pts. ) It's not the rule though, we do have one retired military counselor who has a great rapport with his patients, he is straight forward, takes no BS, and is well respected.

tddowney · Dec 23, 2006

As a RN in CD I can't have anything on my record, CD requires a squeaky clean slate & we also take adolescents as pts. There is a page and 1/2 of disqualifying incidents that could keep a person out of CD.
To answer your question: IMHO............yes, it's a been there done that and have the experience to relate to and with. After a year in detox, I can relate well because of my experience. Personal addiction would give you a better feeling for those pts in CD. MI......I wouldn't have a clue....although we all are a little crazy
Most of our counselers have been addicts, patients relate to them better than those that aren't ( per the pts. ) It's not the rule though, we do have one retired military counselor who has a great rapport with his patients, he is straight forward, takes no BS, and is well respected.

I'm also looking at this field. I'm a recovering alcoholic--sober for 14.5 years--and appreciate your comments.

Despite what I thought going in, I really liked my psych clinicals. One of my strengths, I think, is teaching, and helping dependent people work their way out of the trap they're in seems like it can be very rewarding.

I have a question about the "squeeky clean" part. I had one DUI arrest back in 1980, I think, but no problems since then (one traffic ticket, non-alochol related). I've had background checks done for volunteer positions in Seattle and Montana, and I was an EMT in Montana as well. No complaints in any of those places, and my nursing school did background for our clinicals as well.

I'm assuming the quarter-century old DUI wouldn't be a problem, but is that correct?

joe3 · Dec 23, 2006

I don't know that answer, I do know here in Florida and at this facility you would not be hired. Squeky clean.......You would need to ask where ever you are, I'm not sure if it is a state or facility mandated issue, I know several patients here have wanted all staff to be recovering, my nurse managers comment was " the law doesn't allow nurses in recovery to work here ".....corporate law or state ?? I don't know.

I do know that with your background you can and will relate very well with this type of patient. We have a tech with 20 + years of sobriety and he does very well with the patients, they really respect him.

Please let me know what you find out, I'd be curious. And after the holidays I'll ask the NM what she knows.

Merry Christmas, Joe

damarystx · Jan 3, 2007

I work in a state funded detox and rehab...28 day program. I LOVE IT! It was kind of a fluke that I found the job, never ever crossed my mind to do this kind of nursing, guess I didn't even know that it existed. A friend applied first and initially did not take the job, referred me I took it and then a couple weeks later she realized she made a mistake in her job choice and came to work at the facility, luckily we had another opening, she calls herself a lifer now b/c she loves it as much as I do. I have family members that were/are alcoholics no personal experience with substance abuse myself, I think that it is VITAL to be VERY NONjudgemental to go into this type of environment but we have good employees with and without personal experience. I don't think that at our facility they are as strict as the other posters facility sounds as far as hiring. So all you can do is give it a shot. Hope this makes sense I am kind of addressing a few different posts at once