Detox against their will.....

  1. This just kills me and maybe someone can bring some light to this.

    Why do we, as healthcare workers, force people to detox when they don't want to? I see so many repeat offenders (aka frequent fliers) in our unit that keep coming in for the same thing, ETOH abuse that obviously don't want to detox.

    Why do we waste our tax money on these people forcing them to do something they don't want to do?

    Why can't we just give them a beer in the ER and send them along their merry little way and stop holding up our rooms for people who legitimately need them?
  2. Visit aerorunner80 profile page

    About aerorunner80, ADN, BSN

    Joined: Dec '06; Posts: 581; Likes: 197
    NICU nurse turned FNP student class of 2019; from US
    Specialty: 8 year(s) of experience in NICU

    35 Comments

  3. by   AirforceRN
    I don't think that giving out what will, in the end, most likely be a "free drink" for the patient will end up decreasing the number of emerg visits. Sure its a cheap treatment but there is still the time spent with the triage nurse, the emerg nurse and the doc before a beer can be prescribed.
  4. by   Bluehair
    Quote from aerorunner80
    This just kills me and maybe someone can bring some light to this.

    Why do we, as healthcare workers, force people to detox when they don't want to? I see so many repeat offenders (aka frequent fliers) in our unit that keep coming in for the same thing, ETOH abuse that obviously don't want to detox.

    Why do we waste our tax money on these people forcing them to do something they don't want to do?

    Why can't we just give them a beer in the ER and send them along their merry little way and stop holding up our rooms for people who legitimately need them?
    I'm with you! I have worked with Doc's who were the same way - treat whatever they came to the hospital for, and get them back to their self-medication of choice before they detox (assuming they had absolutely no interest in detoxing, were frequent flyer detox'ers, etc.). Other MD's seem to have the view that it was their personal responsibility to make sure they dried out every warm body they had the privelage to write orders on.

    Maybe I'm wrong here, but I thought things like AA, etc. had already shown you can't help an alcoholic who doesn't want help/doesn't want to stop drinking. You just put them at more risk for complications from the detox process, as well as waste everyone's resources. Even theirs. I'm certain they get a bill for all that, even if they can't pay. Sometimes we can't avoid it when someone presents to the ED (or wherever) with a condition that requires just enough hospital time that detox is inevitable. You can't exactly send someone with a ruptured bowel home for a cold one before surgery. But it does seem like there are more times than not when we (i.e. the medical profession in general) force some people to detox who are not remotely interested in it.

    Just my .
  5. by   SuesquatchRN
    My grnadfather was killed by being detoxed.

    He was in his 60's and went in for an infected ingrown toenail - in the days when health care was about care, people went in for things like that. Well, the doc decided he needed to come off booze. He said to my mother, "If you don't get me a drink, I'll die." She answered, "Don't be silly, Dad. You won't die."

    Guess what? Took a stroke in the hospital and later died.

    We are such a bunch of Puritans. Who cares who is using what. Make it legal and let people use what they want without becoming criminals.
  6. by   leslie :-D
    after contemplating the op's question, i'm not really convinced we (healthcare agents) are trying to detox these folks.
    obviously they are being admitted for a medical condition that warrants immediate interventions.
    in the meantime, we are addressing their symptoms of inadvertent withdrawal.
    we're not trying to purposely make them detox.
    but we have a choice of administering etoh or anti-hypertensives, sedatives et al.
    and i'm not convinced the meds we give them, cost a whole bunch of money, so it's not a financial issue.
    but can we ethically and responsibly continue in infusing etoh while inpt?
    i honestly don't think i could.
    but, i certainly wouldn't be opposed to them drinking a couple of nips if it wasn't contraindicated.

    it's so true...
    that an addict/alcoholic has to be ready before attempting sobriety.

    leslie
  7. by   RN1982
    I had a daughter of a patient call and say "I heard you were giving my mom pain medicine. She has a problem with pain meds and she always says her pain is a ten when it really isn't." I had to tell her that we are taught that pain is what the patient says it is, that I cannot withhold narcotics if the patient is in pain and the meds are due and lastly I am not there to detox your mom.
  8. by   HappyPediRN
    I worked in a community hospital ER that was overriden by drunks who didn't want anything but a turkey sandwich and a warm blanket. Sorry, but if you're going to repeatedly tie up EMS services by drinking Listerine and taking a nap on the curb, then you should be forced to detox in an attempt to make you a productive member of society. They're holding the beds up either way, and if you let them go back on the street they just come back hours later, drunker and nastier than ever. We had one frequent flier who was infected with Hepatitis C and AIDS, and would constantly bite his lip and try to spit blood in our eyes. Most of our drunks were combative and abusive. The hospital won't refuse to take these patients so we need to do SOMETHING with them, and all we have the authority to do is send them to detox then that's where they're going. At least it's a nice break until they next time they show up. If it were up to me they would all get two 18 gauge needles and a battery of painful tests every time they roll in with EMS. But no, a warm blanket and a turkey sandwich it is.
  9. by   bossynurse101
    Quote from OctoberBride
    I worked in a community hospital ER that was overriden by drunks . . . . If it were up to me they would all get two 18 gauge needles and a battery of painful tests every time they roll in with EMS. .

    Wow. You sound pretty "burnt". Hopefully your sentiments dont shine through in your bedside manner. If it did, I'd probably spit at you too.
  10. by   HappyPediRN
    Quote from bossynurse101
    Wow. You sound pretty "burnt". Hopefully your sentiments dont shine through in your bedside manner. If it did, I'd probably spit at you too.
    When your ER deals with so many frequent flying drunks that they have to assign one whole section (4 beds) just for them then maybe you'd understand how it feels. To know that four beds have to be given up to them when there are patients who actually need them gets really old. Patients have to wait if those are the only beds because they're all in the same room, unless it's a life-threatening emergency. To see the same patients come in 3-4 x per day (and sometimes more before they're pinked and held as a danger to themselves) and go through the same song and dance of nastiness and abuse? Hell yes they're going to detox...even if it's more for our sanity than their actual want to become sober and that's the truth. Thirty days is a long time to regroup before having to go through it all over again. The people who come through our doors don't want to change but they don't want to stop abusing the system or the staff either.
    Last edit by HappyPediRN on Sep 14, '08
  11. by   RN1982
    Quote from bossynurse101
    Wow. You sound pretty "burnt". Hopefully your sentiments dont shine through in your bedside manner. If it did, I'd probably spit at you too.
    Your response was rude, non-productive and quite immature. I can't believe this "sentiment" is coming from another nurse, almost ashamed of it. ..Had a 22yo male come in last night with mental status changes because he took his psych meds along with some meth/marijuana. Now is my bedside manner suppose to be all smiles when the guy is saying "Call the f------ doctor, you fat B----"
    Last edit by RN1982 on Sep 14, '08
  12. by   HappyPediRN
    Quote from aerorunner80
    Why do we waste our tax money on these people forcing them to do something they don't want to do?
    By the way, they're usually they're already wasting our tax money the second they roll through the door, starting with the $700 ambulance ride.
  13. by   RNperdiem
    I have had a couple of post op patients who due to some complication during surgery had to go to ICU and prolong their stay.
    These patients were not entirely honest about how much they drink in their pre-op assessment, and would start going into withdrawl. Nobody tried to detox them against their will on purpose.
  14. by   lpnflorida
    At the former hospital I worked at Level 1 trauma, we were very fortunate to have the detox unit be across the street from the emergency room. Our patients were fortunate that when they came to Emor the docs would call up stairs to the Psych unit and one of our nurses would go down stairs to assess.

    While we understood the time they took up in Emor, Yes, they often times were frequent flyers, dirty and smelly.Those patients under the influence were not any nicer to us either. We would clean them as best we could, sometimes for safety's sake we would have to wait.

    The truth remains, the same number of patients die today during detoxification in a hospital setting as they do with out. It really is a medical emergency of sorts.

    It is the active disease process you are seeing. I hate the disease of alcoholism and the addiction, I try never to hate the person. Have they made me mad, yup, have I had moments I did not want to be around them , yup.

    One does not have to like a person who is drunk/under the influence spewing nasty stuff out of their mouth. I did not either. The person who sobered up was often quite different.

    We held no illusions that we had alot of power over someone"s quitting. 33% are successful after 5 years. Not high numbers at all. The one thing I did know while drunk/under the influence there was no chance at all.

    Perhaps other emergency rooms can develop some sort of plan in dealing with them efficiently and with care. I truly believe there are nurses in er who can work with them, and there are those for what ever reason can not. I do not blame them, nor judge them.

    It is not just our job to educate our patients, we educate each other. There are patient's you all can work with that I cannot. Don't have the stomach for some stuff, but I admire those who can.

close