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.
I like this answer. Rarely do I deviate from the letter of the law, but the honest truth is it makes sense to dump it out. I don't care about their property rights with alcohol in a hospital. I just don't.
I'm sure there are some people who don't care about they things that you care about, and thus would have no compunction in violating your rights in those matters.
Confiscating people's property is bad enough, but doing it when they're unable to do or say anything about it is even more troubling.
I'm sure there are some people who don't care about they things that you care about, and thus would have no compunction in violating your rights in those matters.
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!
I would def leave it. Alcohol withdrawal can kill the alcoholic. If he/she was in for rehab/detox it would be a different story.
By your criteria, you'd toss out the Beaujolais nouveau, but keep the '82 Bordeaux? If I fell down on my way out of the wine store an was taken to the ER with my bottles, I would not be happy if you poured out my wine. .
The OP specifically asks about a scenario involving an alcoholic coming into the ED. That's how I answered the question.
You assume so much about me from one post! As teenagers in my day would have said, "Take a chill pill." And keep the discussion civil, per AN ToS. Thank you.
Several posters have suggested that alcohol should not be allowed in the hospital. UNLESS the person is admitted to the hospital for treatment of alcoholism -- and that's whether it is voluntary or court ordered -- the hospital has no right to force a patient to be detoxified from their alcohol addiction. The alcohol detox protocol should be offered and encouraged, but if the person is adamant, the hospital -- with an appropriate prescription -- should provide, as a medication, enough of some sort of alcohol to prevent acute alcohol withdrawal. In the ER, hopefully the person will not go into acute withdrawal; but if the person is in impending DTs, some form of medication, either alcohol or a benzodiazapine or whatever, to prevent DTs (which can be lethal), is mandatory. Generally, a person admitted to the hospital will not be allowed to bring alcohol with him/her, but I have seen physician orders that allow visitors to bring the alcoholic beverage of the patient's choice to the patient for the patient to consume ad lib. I've also seen an ethanol containing IV being infused for a patient unable to consume alcohol by mouth.
If we want to encourage a person with an alcohol addiction to become sober we don't want to first convince them that we consider them as stupid, incompetent, weak willed persons. Rather, we want them to perceive us as caring professionals who have help to offer and respect for the dignity of a person who would seek help. For centuries we tried to punish people out of wanting to drink -- but it never really worked. Lets try to attract the alcoholics to treatment -- invite them to feel better and to take control of their lives. Many of them we'll never reach -- but we'll reach more "with honey than with vinegar" as the old saying goes.
So, the ethics require the bottle to be returned to the patient with any other personal belongings. Ethics and other parts of good nursing care, require adding verbal and printed information about sources of treatment available in the area where the person lives.
If they're over 21 and it's in a sealed bottle/can, we have to return it. If they're under 21, we can confiscate it. If the bottle/can is open, then we can dump it under the premise of "we have no idea what is really in there."
Do I like this policy? Not really. But legally it is their property: refusing to return it would be the same as theft.
Also, while the patient is in the facility they are not allowed access to it period--it is kept locked up until discharge.
The OP specifically asks about a scenario involving an alcoholic coming into the ED. That's how I answered the question.
You assume so much about me from one post! As teenagers in my day would have said, "Take a chill pill." And keep the discussion civil, per AN ToS. Thank you.
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This is the OP's scenario:
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.
It's neither detailed nor complex. Would you like to elaborate on why in this scenario you think it's OK to confiscate the patient's property and dispose of it? You've said what you would do. I assume your ethical compass functions on more than just gut feelings.
Hancock330 nailed it-he really did. I suggest you read his post if you haven't already.
It is part of the client's belongings.. period. Quick example from co-worker's past experience: The client is a smoker, you smell smoke in the room, but they refuse to surrender their cigarettes. The nurse took them when the patient was asleep and the client complained that she took them without permission. This is similar to if you take their bottle of alcohol and dump it out!!!! My friend lost her job The moral of this story is simply that we have no right to take or dispose of anyone's belongings. It puts our own morals on the line. What else would you take if you could take that? Are you capable of throwing away my other stuff because you think I shouldn't have it? Since we are not the moral police, we have to stay objective and always put ourselves in their shoes or put our family member in their shoes. If we keep this perspective, then morality is rarely an issue. Hold yourself to the highest standards.
To take the cigarette issue one step further....I had a pt who had recently completed chemo for lung cancer with mets. She also had severe COPD and was in the ER with another exacerbation. Let's suppose while packing up her belongings an unopened carton of cigarettes fell out (not inconceivable considering she asked if she could step outside for some 'fresh air'...which is interesting considering that she could probably not make it one or two steps given her poor oxygenation status). In that case should I have thrown the cigarettes out with the logic "I know what is best for you and you don't need to smoke?" My answer to that is 'of course not.' Even though I think it is really really foolish to continue smoking for her given her circumstances, I have no place saying what is or is not good for her, and I have no right to take her belongings using my ethics as justification.
Now people will argue that etOH is different that cigarettes. The cigarette does not physically harm someone else, but the alcoholic could leave with his etOH, drink it all immediately and kill someone in a drunk driving accident. On the other hand, we have a patient that regularly comes in drunk. Drinks too much, passes out in public, someone calls 911, he comes in for a banana bag, sobers up, and leaves to repeat the incident later in the day, week, month... I don't think we have ever seen him with a container of alcohol (if you don't count his blood stream as the container) and I don't know of a circumstance where he has hurt someone (usually he just falls off a park bench and passes out). Obviously if we took any alcohol he came in with, he would just get some more. Taking it would not prevent further episodes. Taking it is not going to someone improve public safety. Taking it would not end his drinking--much like taking one's cigarettes is not going to stop a COPD pt from smoking.
Now, I'm not saying that we should do nothing. I'm not saying we just let the drunk drink himself to death. I am saying that we are not doing anything to help the situation by confiscating the alcohol...if we think we are helping, we are just fooling ourselves. While it may make us feel better to take the alcohol, there is no legal or ethical justification to do so. I say give it back.
The moral of this story is simply that we have no right to take or dispose of anyone's belongings. It puts our own morals on the line. What else would you take if you could take that? Are you capable of throwing away my other stuff because you think I shouldn't have it? Since we are not the moral police, we have to stay objective and always put ourselves in their shoes or put our family member in their shoes. If we keep this perspective, then morality is rarely an issue. Hold yourself to the highest standards.
Wet Noodle
56 Posts
I'm sure there are some people who don't care about they things that you care about, and thus would have no compunction in violating your rights in those matters.
Confiscating people's property is bad enough, but doing it when they're unable to do or say anything about it is even more troubling.