ETOH/heroin/cocaine=GOOD times!! :)

Scrubby · Aug 16, 2009

Hmmm you can type the F word and get an explanation from the same dictionary, still doesn't make it a polite word to use in everyday conversation. Incidently, the f word and druggy are both considered to be slang words.

The OP used to term druggie in what I found was an offensive manner. The use of the word druggie alone by the OP may not have evoked such a harsh response from me but the OP stated that they swore at the patient, baited them by accused them of planning on selling hospital equipment for drugs etc as well. I thought it was quite a hateful thread and beyond just venting.

I also understand how difficult it can be with a person addicted to drugs. I have been exposed on a personal and professional level and I know about the manipulative behaviours, verbal abuse etc. I'm not perfect, I certainly don't have oodles of compassion, in fact I'm downright cynical and have my own issues with some areas. But I recognise these and try not to let them interfere with how I interact with patients at work.

Perhaps I was overly judgemental to the OP but if someone feels that strongly perhaps they need to self reflect on better ways to deal with patients with drug issues.

morte, LPN, LVN · Aug 16, 2009

a drunk is a drunk, and a druggie is a druggie, you can dress them up in all sorts of fancy theories and words.....doesnt change who they are......

leslie :-D · Aug 16, 2009

The OP used to term druggie in what I found was an offensive manner. The use of the word druggie alone by the OP may not have evoked such a harsh response from me but the OP stated that they swore at the patient, baited them by accused them of planning on selling hospital equipment for drugs etc as well. I thought it was quite a hateful thread and beyond just venting.

i agree w/this, scrubby.

that's why i added my disclaimer at the end of my post.

regardless of how obnoxious a pt is, we all need to uphold minimal standards of care, which do not include swearing or baiting.

i didn't see the post as "hateful", but the op clearly crossed the line...

and do believe she shouldn't be dealing w/this population if she can't control her bias.

leslie

Jules A, MSN · Aug 16, 2009

i am a nurse and a recovered drug addict.
it is rather infuriating to me the way some of these patients behave, and i remember that once upon a time, i probably behaved that way and treated my nurses that way at one point in my recovery. and no, they weren't nice to me. whatever i dished out, i got back, and i deserved it. tough love, to me, is one of the best ways to help an addict recover.
rule #1 of dealing with addicts: you cannot fix someone who wants to stay broken. period. it comes from within them. you can educate them until you are blue in the face, and yes it will make you mad, because the sense of entitlement and the feeling that it's going in one ear and out the other is probably correct.... until they come to that point where their inner core says "i can't do this anymore"...
i work on a tele unit where we are seeing more and more addicted patients now, especially since the economy has been so poor, because of lost jobs/depression, and younger and younger patients with strokes and new onset afib. it's very sad. some of them do make the turning point in their life, some don't.
our area has a huge problem with crack. i can't even tell you how many crack pipes i've taken away and how many crack rocks i've found in and on patients. these patients will spit on you and curse you to hell and most of the time return to the streets to the same horrible cycle, many infected with HIV/AIDs because they do what they have to do for drug money. it's heartbreaking to watch them deteriorate over and over, and it's even harder to take the abusive treatment from them sometimes.
we had one little lady who was a known prostitute with AIDS, who was a heavy crack abuser. so much so that she was in end stage renal disease and heart failure and was in and out of the hospital weekly. once, she left for the whole day, with her monitor on and IV in, she just disappeared. we had the police looking out for her and everything. she came back high on crack at around 11am the next day, screaming for rambo to get in the bushes, walked into her room, to tell the patient now in her bed to "get out". she came in with scabies once and chased staff around when she knew she was supposed to be isolated. she would hide honey buns in her tissue boxes and when she was NPO she knew that was the perfect time to break them out. she even had a friend bring in a cup of dirt with some watermelon seeds on top, saying it was her watermelon plant, only to find crack rocks underneath. sometimes though, she would cry.... when she thought no one was looking... and one of us would find her there, and she would be angry that we did, but she always did something in her own backwards way to let us know that she did appreciate it. she died one morning in her dialysis chair.... and instead of us being relieved that her battle was over, we were all very solemn that day. was she difficult to deal with? hell yes.. she was downright frustrating. did she want to get better? no. the hospital was a safe place for her, filled with loving and nuturing people who fed her, cared for her and made sure she was bathed and tucked in at night. we were her family, and as difficult as she was.... i think in her own way, she loved us all.

Thank you for sharing this story. I think it is bump worthy.

regularRN · Aug 16, 2009

I think a psychiatric trained RN working with addicts in a behavioral health environment one on one, is a different kettle of fish than an RN assigned several patients on a very busy med/surg floor. The latter is not conducive to drug or alcohol rehab and it is extremely frustrating dealing with such people. Especially when they are not ready to enter recovery. :redbeathe

sissiesmama, ASN, RN · Aug 16, 2009

I think a psychiatric trained RN working with addicts in a behavioral health environment one on one, is a different kettle of fish than an RN assigned several patients on a very busy med/surg floor. The latter is not conducive to drug or alcohol rehab and it is extremely frustrating dealing with such people. Especially when they are not ready to enter recovery. :redbeathe

Lotte - Good point. That is one thing that was really great about the mix of nsg staff that worked on our med-surg unit at one of the first facilities I worked at after passing boards. The hospital disbanded the CD unit and the nurses were distributed on remaining units. We initially had a ratio of 6 or 7 to 1, but before I left the unit the staffing had drastically changed to 11 to 1. This is staffing that can just drain you, and the chance for error, like anywhere else in health care, keps you on your toes.

We were officially the DTC floor and did most all the insulin pumps on patients in our area. These patients were usually some of the easier ones, and we did a lot of pt and familt education and accu cks very frequently. GI bleeds were some of our main frequenters, also diabetic wounds, and a lot of COPDers, asthmatics, ect. (Just a big mix of everything).

Even with the more comfortable ratio of 7 to 1 can go from being "tolerable" to a nightmare if you have 2 addicts in there two. Even some of the patients quite a but of the time present with one dx and have psych components. Throw in 1 or 2 addicts in there, with the manipulative or destructive behaviors and it's bad enough. If one of the CDers turns violent toward staff or themselves, and it's not somewhere I feel very comfortable.

I hope I don't come across as sounding like they are all "horrible", or that the other patients are more deserving of compassion. I am an addict 10 yrs in recovery and I know how I was to some of the staff members when I entered rehab. I was not a very pleasant patient - at all.

Anne

diane227, LPN, RN · Aug 18, 2009

I grew up in a family of alcoholics. The substance abusers used to bug me to no end until I went out and got myself some therapy for MY co dependency issues. Now I can deal with most anyone most of the time. I will have to say however, that when I have a drunk on the floor who is visiting, demanding and cursing at the staff I get a bit punchy and I revert to my former pre therapy self. My logical self tells me that you cannot argue with a drunk and that "how do you know an addict is lying...their lips are moving" theory is applicable here but it just somehow pushes all the old buttons. So I have to stand up and put out my thick Texas accent and attempt to put them in their place. As for the addicts on the floor, the patients, I just give them what ever they have ordered in terms of pain meds etc and I never argue about it. I don't work on a rehab unit and I am not trying to rehab these people. That is for someone else to do. I treat them nice just like I treat every other patient and hope that God will bless them with the wisdom to clean up before the drugs kill them. That's about all I can do.

southernbeegirl, BSN, RN · Aug 18, 2009

I'm a drug addict/alcoholic and have been in recovery over 5 years. the OP didn't offend me. I hope she really didnt use that exact language with him for professionalism sake (lol, is that even a word?). she's venting just like we all do occasionally.

I look back on how i treated the nurses and doctors that have taken care of me and absolutely cringe from shame at times at how i acted when i was in active addiction. it's true! the sense of entitlement during active addiction rivals no other!

everything is about "me". all i cared about was "me" and how bad i hated myself and how i felt nobody knew how bad it was. your classic "victim/martyr". i can't imagine what it was like to try to take care of me professionally. i should probably send all my past therapists some flowers or something for putting up with my crap when i wouldnt admit my problem was drugs and blamed everyone else.

call us druggies, addicts, PIAs...whatever works for you. doesnt bother me because it's all true.

and it's so true that if an addicts lips are moving they are lying!

*ac* · Aug 18, 2009

I have not read the whole thread but the first few pages make me really want to jump in.

I totally get that this is a disease and we are supposed to rely on our therapeutic communication skills...

but when addicts go out of their way to make your day miserable, for example doing things that cause you to have to write incident reports, with your own name on them, and then needle you with that passive-aggressive manipulative, "you don't like me..." crap, I can easily end up as done as this OP.

This is a vent post. Let her vent.

PS, I'll take the non-compliant diabetic any day, as well. At least they are only hurting themselves, and not trying to take the nurse down, too.

Diaper, RN · Aug 18, 2009

Well, in my unit, most patients came in with ETOH/DT. I was taking care of a young man for almost a month. At first, he was confused, pooped all over the floor, trying to get out of bed and cussing to all the nurses.

His mom visited him almost every day and she had some chronic illnesses. When he was more awake, alert and oriented, I told him how much his mother loved him and how much she wanted him to live and stop drinking. Although he kept telling me to stop and it's just 'Between my mom and I". Judging by the look of his eyes, I could tell that my patient really cared about her but he didn't know how to express his affections and gratitudes.

At night, when he couldn't sleep, I briefly gave him a back rub and conversed with him about video games and guitar. Suprisingly, he said 'thank you' twice !

Few days ago, he was screaming in agony and we thought he's just being a pain and the butt and he refused having any procedures or treatments...

Last night, my coworker told me that he passed away yesterday due to acute respiratory failure. Nobody could see it coming. Although he was not my favorite patient, I felt emotionally connected to him in some ways. I just wished that he could have lived longer... at least for another year!

flightnurse2b, LPN · Aug 18, 2009

Well, in my unit, most patients came in with ETOH/DT. I was taking care of a young man for almost a month. At first, he was confused, pooped all over the floor, trying to get out of bed and cussing to all the nurses.
His mom visited him almost every day and she had some chronic illnesses. When he was more awake, alert and oriented, I told him how much his mother loved him and how much she wanted him to live and stop drinking. Although he kept telling me to stop and it's just 'Between my mom and I". Judging by the look of his eyes, I could tell that my patient really cared about her but he didn't know how to express his affections and gratitudes.
At night, when he couldn't sleep, I briefly gave him a back rub and conversed with him about video games and guitar. Suprisingly, he said 'thank you' twice !
Few days ago, he was screaming in agony and we thought he's just being a pain and the butt and he refused having any procedures or treatments...
Last night, my coworker told me that he passed away yesterday due to acute respiratory failure. Nobody could see it coming. Although he was not my favorite patient, I felt emotionally connected to him in some ways. I just wished that he could have lived longer... at least for another year!

god bless him.

underneath that person that you see, is the person that was once there before. if you were to look at photos of me from say 8 years ago, i was a shell of what i am now. i never woke up one day and said "i want to do drugs, make my family miserable, lose my college scholarship and spend a few months in rehab, that sounds like a blast".

i know for me it was more of an escape to numb emotions. i didn't know how to deal with them. first it was the eating disorder, and when i was stripped of that control and forced to eat, i didn't have the coping skills to deal with life without being somewhat distructive.

so although i do lose my patience with these patients, i think i am better able to relate to them. sometimes i will sit down next to the bed in a chair and say "i'm going to talk, i just want you to listen..." and alot of the times once they find out i'm not so different from them, they stop the i hate you and i'm so tough front. i know for me, i still to this day hate crying in front of people and it's hard for me to truly express my feelings on something to someone i don't think will understand what i'm trying to convey. i think JB and i were together for two years, living together, before he ever saw me cry... and it was one of those moments where i tried to tell him i had something in both my eyes, i was so embarassed.

see, the thing about drug addicts is that the commericial back from the early 90's is true. nobody ever says "i wanna be a junkie" when i grow up.

sissiesmama, ASN, RN · Aug 19, 2009

I'm a drug addict/alcoholic and have been in recovery over 5 years. the OP didn't offend me. I hope she really didnt use that exact language with him for professionalism sake (lol, is that even a word?). she's venting just like we all do occasionally.
I look back on how i treated the nurses and doctors that have taken care of me and absolutely cringe from shame at times at how i acted when i was in active addiction. it's true! the sense of entitlement during active addiction rivals no other!
everything is about "me". all i cared about was "me" and how bad i hated myself and how i felt nobody knew how bad it was. your classic "victim/martyr". i can't imagine what it was like to try to take care of me professionally. i should probably send all my past therapists some flowers or something for putting up with my crap when i wouldnt admit my problem was drugs and blamed everyone else.
call us druggies, addicts, PIAs...whatever works for you. doesnt bother me because it's all true.
and it's so true that if an addicts lips are moving they are lying!

Oh, yeah!! I was such an ____ went I went in, I worked everyone's nerves. I had the "halfway pleasant" attitude, if that makes any sense in that I was the model pt IF I was getting what I wanted, when I wanted it the way I wanted it. If I didn't, watch out. And I am still embarrassed to admit that - but that's the truth.

One time I had arrived at the ER (not where I was working) to see what I could get for pain, c/o back pain. I had "fallen off a roof" actually JUMPED off a 20 ft. roof with the intention of getting whatever narcs I could. Dodn't worry about that I could have ended up a para or quad, JUST what would I get - Demerol, Dilaudid, ect. I wasn't picky.

Anyway, the doc came in and did his thing, and went out to write some orders. It's been at least 11 yrs and I can still hear the words echoing in my ears. One of the ER techs said, (very loudly) "Let me guess. She just wants to get some f ing drugs. True, but still... Then, 2 or 3 other staff members chimed in with, "Man, drug seekers suck. I wish they would all die. Or we can put them all on a boat out to sea and they can kill each other out there." I got dressed and was gone before the ink on the order sheet had time to dry.

So, 10 yrs later, I apologized to the ER doc. He is good friends with my dh, who is also an RN and also an addict.

But, southernbee, you're right. Nothing else mattered. It's like the Toby Keith song, "... me, me, me, I just want to talk about me." And it really is, nothing else really matters.

Anne, RNC