Chemical Dependency Nursing

SoxfanRN · Mar 20, 2007

It depends what kind of substance abuse (SA) treatment you'd be doing. If you're doing detox, a strong med-surg background would help. If you're doing counseling or groups, a strong psych background is key.

I also found that doing visiting nurse helped with my groups and counseling: I knew the areas the SA folks hung out at, I knew the street lingo, I saw first hand how miserable their lives were. When you can recall experiences of what you've seen with the group, it gives you some "street-cred." Once you have that, they'll listen to you. Some of them, especially if they're in the pre-contemplative or contemplative phase of change, will not listen to anyone who "hasn't been out there." This can be extremely frustrating when you're trying to help. Knowing the street terms and difficulties they have, you can cut down on them challenging you. Obviously, if you have your own experiences to call on, you can do that without necessarily letting them know how you have those experiences.

Really, the best way to learn is to let them teach you. You learn all the tricks, scams, terms, areas, and happening you'd ever want to know (or not).

purplekath · Mar 29, 2007

I've worked in both areas as well as in forensics. IMO, these three disciplines go hand in hand and the more you can learn about them all, the better you will be. One thing I do know is that no course I ever did was as valuable as actually working in these areas (if your area is anything like mine, they are crying out for nurses in psych) and learning all you can by experience.

Any acute psych unit will have a LOT of chemically dependent patients. If you are able to go right into a chemical dependency unit, any of these will have a LOT of psych patients. Either of these will have a good intake of forensic patients too.

As for skills, one thing that would be useful would be a sound ability to quickly assess a patient physically...such as the stuff you do on med/surg. Particularly in psych it is easy to dismiss physical/withdrawal symptoms as psych/behavioural issues. In any given week I'll come across several patients whose behaviours actually stem from chemical dependency. Eg: I had a young girl who was known to be coming down from ice, is a major management problem behaviourally anyway, and who was sweaty, sneezy, yawny etc (typical opiate withdrawal symptoms). She adamantly denied using opiates, but was happy to admit she had been on ice. As it turned out, a UDS tested positive and she was very shocked. Turns out her dealer was lacing the ice with heroin to make it even MORE addictive and to keep her coming back to him. So, we were able to get her onto an OWP that alleviated these additional symptoms. This relief in turn helped her behaviours and ultimately her willingness to accept treatment for her mental illness.

Good luck!

jpRN84, BSN, RN · Apr 14, 2007

hello,

i currently work in a chemical dependecy detox unit at a drug and alcohol treament center. we have a 28 bed unit and monitor clients withdrawing from alcohol, opiates, benzos, sedative-hypnotics or any other drug that needs close monitoring from withdrawal. the patients that come to us do have to be pretty much medically stable though to be there. i currently work on 11p-7a and on that shift we mostly take care of admissions that are left over from the 3p-11p shift and monitor the patients. some nights there's barely anything to do and some nights its busy. the job is wonderful, and the people i work with are great. i started there about 10 months after i graduated nursing school, from an asn program, and my previous experience before that was in a nursing home. hope this helps you out.