Does anyone else feel this way?

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I'm currently a nursing student and while my passion is to help people feel better I find myself going in with mixed feeling towards certain patients. The patients I am referring to have sicknesses caused by smoking and drinking. While I will do everything in my power to help them get better or be as comfortable as possible I find myself not feeling sorry for them. I feel like they got what was coming to them and that they knew the risks involved in using these substances and so only have themselves to blame. Does anyone else feel this way?

I know some may answer that the same should apply to obese and diabetic patients and I believe it doesn't. You need to eat to live, yes moderation is the key but many things can contribute to obesity and you can't not eat; however, you don't have to smoke and you don't have to drink and so it is solely the choice of the person using these substances.

Specializes in Med/Surg, Ortho, ASC.

Never mind....

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you know i think they've taken away the ability to go back and edit a post if it's been more than a few minutes. i was looking at a post i made just an hour or so ago and i saw no option to edit.

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So, somehow the cellular biology which triggers cancer is more real than the neurobiology that predisposes a person to addiction? (because there is a neurbiological difference even before an addict is first exposed to whatever it is they become addicted to)

you know, i'm not fully convinced that any addiction is a "disease".

can follks be predisposed to certain genes (and its subsequent structures) that makes them more inclined to start a, b, or c?

sure.

IF addiction is a disease, at least it's the type that one has a choice to activate, or not.

that said, i don't care who you are, we all have our aversions, and cast judgments accordingly.

as long as we try and manage our biases, that's all we can ask of ourselves.

op, i would suggest that you ignore the naysayers...

and don't take it personally.

those who wag their fingers at you, are definitely wagging them at others.;)

is it me, or has there been lots of threads about different forms of addiction recently?

must be something in the air...:)

leslie

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you know, i'm not fully convinced that any addiction is a "disease".

can follks be predisposed to certain genes (and its subsequent structures) that makes them more inclined to start a, b, or c?

sure.

IF addiction is a disease, at least it's the type that one has a choice to activate, or not.

that said, i don't care who you are, we all have our aversions, and cast judgments accordingly.

as long as we try and manage our biases, that's all we can ask of ourselves.

op, i would suggest that you ignore the naysayers...

and don't take it personally.

those who wag their fingers at you, are definitely wagging them at others.;)

is it me, or has there been lots of threads about different forms of addiction recently?

must be something in the air...:)

leslie

Wouldn't it only be a choice if you knew you were predisposed to developing an addiction?

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In my career I have several people die just for the fact that doctors and nurses thought they were drug seeking. They were in their early twenties and had damaged spleens. This is very painful but otherwise not easy to detect. It requires emergency surgery. Would you have liked to been responsible for the death of one of these patients? There are various drug abuse laws in force and it is our job to help see they are enforced in hospitals. This does not mean we should with hold services from patients who have these problems.

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Wouldn't it only be a choice if you knew you were predisposed to developing an addiction?

yep, you're right about that, curious.:)

still, if your parents and/or siblings are addicts/alcoholics, decent chance you'll have same genetic disposition.

the reason 'dependence' transitions to 'addiction', is because of the psychological benefit one derives from it.

if the person gets a desirable feeling, then 'use' will turn to 'abuse' which results in addiction.

and if one does get addicted, s/he still has a choice to continue or not...it's just that it'll feel like it's near-impossible...but it is doable.

one needs all different types of support, and i find that addicts make all sorts of excuses why they cannot do it.

i am a cigarette addict, had been smoking for 35 yrs.

it's been sev'l months since i've had a smoke, and i had tried to quit a dozen times before the last time.

my husband is an alcoholic.

through counseling, i learned i had been enabling him for many yrs.

i learned all the different ways that enabling manifests itself, and it/i stopped...i can promise you that.

so yeah, i understand addiction.

and i too, wish smoking/drinking was both illegal.

leslie

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In my career I have several people die just for the fact that doctors and nurses thought they were drug seeking. They were in their early twenties and had damaged spleens. This is very painful but otherwise not easy to detect. It requires emergency surgery. Would you have liked to been responsible for the death of one of these patients? There are various drug abuse laws in force and it is our job to help see they are enforced in hospitals. This does not mean we should with hold services from patients who have these problems.

I'm curious, what drug abuse laws do you feel it is your job to enforce?

The way I see it, I work in the medical field...not law enforcement. It's not my job to enforce any laws, but to treat folks with medical needs. (Of course, there are mandatory reporting laws for abuse/neglect for medical professionals....but no enforcement responsibilities).

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ok, i looked up the word "disease", and the following is from medline.

disease is:

"an impairment of the normal state of the living animal or plant body or one of its parts that interrupts or modifies the performance of the vital functions, is typically manifested by distinguishing signs and symptoms, and is a response to environmwntal factors (as malnutrition, industrial hazardes, or climate), to specific infective agents (as worms, bacteria, or viruses), to inherent defects of the organism (as genetic anomalies), or to combinations of these factors."

http://www.merriam-webster.com/medlineplus/disease

so, re addiction, are 'they' saying it's a genetic anomaly?

would truly appreciate input/feedback on why it's a disease.

leslie

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I have my own family experience as well :)

If family members are recovering addicts and there's been recovery/therapy available....then yes, it's likely that folks will know they are susceptible. Having that insight before recovery....well, I think it can definitely be more challenging.

I'm not saying that calling addiction what it is, a disease, is a "get out of responsibility free card." But how does someone get treatment for something that isn't a disease. To say it's not a disease, is akin to saying stopping is just a matter of willpower, instead of a disease that they need to be treated for. I just don't think that's a fair statement.

yep, you're right about that, curious.:)

still, if your parents and/or siblings are addicts/alcoholics, decent chance you'll have same genetic disposition.

the reason 'dependence' transitions to 'addiction', is because of the psychological benefit one derives from it.

if the person gets a desirable feeling, then 'use' will turn to 'abuse' which results in addiction.

and if one does get addicted, s/he still has a choice to continue or not...it's just that it'll feel like it's near-impossible...but it is doable.

one needs all different types of support, and i find that addicts make all sorts of excuses why they cannot do it.

i am a cigarette addict, had been smoking for 35 yrs.

it's been sev'l months since i've had a smoke, and i had tried to quit a dozen times before the last time.

my husband is an alcoholic.

through counseling, i learned i had been enabling him for many yrs.

i learned all the different ways that enabling manifests itself, and it/i stopped...i can promise you that.

so yeah, i understand addiction.

and i too, wish smoking/drinking was both illegal.

leslie

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Specializes in BSc, ASN- RN, MBA.

There are many reasons why people smoke, abuse drugs, over eat, drink etc. For many, their illness came long before they ever did any of those things. Often time the desire to look cool, peer pressure might get a person started smoking. Their addiction and the stress relief they feel keep them smoking. Their illness could be said to be a lack of self-confidence among their peers. Perhaps they grew up in a family of smokers and grandpa lived to be 95. Some people think that those illnesses will never happen to them, that they are invincable.

Some people are in so much pain psychologically, that drug use gives them a break - they can stop feeling guilt, shame, depression, etc. I am overweight because I work night shift, am a now single-parent to three active teenagers and between work, running them to activities, and trying to get 5 hours of sleep - I often am not sure when I will have an opportunity to eat again, so I overeat when food is available. I often stop at mcdonalds between locations to make sure kids get something. I don't want to be fat, but unless you have been in my shoes and do what I do everyday, you really cannot judge me or how I look. I was thin until I had kids.

My point is, if you can't feel compassion for the cause of someone's disease, feel compassion for what caused the cause in the first place, If that makes sense. We all have "baggage" and we all deal with our baggage in some way - some in more healthier ways than others. You may see them as weak, selfish people. Not everyone can be as grounded and strong as you.

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Specializes in Community, OB, Nursery.

OP - as a nursing student in my first semester, I was where you are. My first clinical rotation was at a teaching hospital and there was a lady up there (very long-term) who was in a persistent vegetative state due to a MVC. She was also the mother of a toddler and pregnant with #2 when she was in the MVC. She wasn't much older than us students and taking care of her left us all in a funk every clinical day.

One day I got assigned to take care of a man who'd also been in a MVC and sustained a bad CHI. He'd been trying to evade the cops and crashed his vehicle, which happened to contain a stash of illicit substances. The man was also badly inebriated. I was reading through his history and upon finding all this stuff out, I wondered to myself if it wasn't bastards like this who were responsible for the aforementioned woman's car accident and subsequent tragic circumstances. I really felt no pity for this man's situation, I didn't care that he was lying in the bed hurting, and felt like he deserved to lie there and suffer for the pain he had no doubt caused others. I'm not sure I can adequately convey my feelings toward this man in words, but it was about as close as I've come to hating someone I don't know. I completely lost it emotionally - I remember saying loudly and through tear-blurred eyes, "I hate nursing, I hate nursing school, I will never be able to take care of someone like this, and I don't think nursing is for me." My instructor (for whom I'm eternally grateful) sent me home to do some self-reflection, not on whether nursing school is for me, but on what had caused such a visceral reaction in the first place. And she promised me that when I got to clinical the next day, I would be assigned to that man again. (Aside - I had to make up the clinical day, for those who wonder. No free passes. LOL)

I went back, took care of the man, and though I didn't feel any warm-fuzzy feelings toward him, I did it. He got safe, appropriate (though limited, as I was still a newbie nursing student) care from me, and I realized I was able to do it. (Now I look back and realize that my reaction to this man wasn't based on any sort of logic, only emotion. I had no idea what had caused the lady's MVC and was in part projecting my grief about her circumstances on to him.)

Fast forward twelve years to now. I have taken care of pedophiles, murderers, homeless alcoholics dying from hepatic encephalopathy, women who've birthed children they later abused severely....all manner of people who might have caused the same visceral reaction that man did when I was a 20-yo nursing student. I don't know exactly how, but I've managed to figure out a way to shove my judgement off to the side for the 12 hours it takes to finish my shift. And sometimes I've managed to learn a thing or two from these patients I'd least expect to be my teachers.

OP - your journey won't look like mine, but you'll get there. Do be aware of your feelings and figure out how to deal with them in a healthy way so you can give good care to your patients. (Sorry this got a bit long-winded...) :)

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The morbidly obese patient who cries when no one will move her (100 lb) leg 1 inch to the left because she's too lazy to do it herself.
Had it occured to you that it isn't laziness that keeps her from bing able to move her leg an inch to the left? Strap 100 pounds to one of your legs, now move it.
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