Give pt 1 can of beer w/each meal

Nurses General Nursing

Published

A couple of years ago, there was a doctor new to our facility who ordered for a ETOH dependent pt to receive 1 can of beer TID w/each meal. The nursing staff got a good laugh about it, but another nurse told us that some facilities give their patients beer to prevent withdrawal symptoms. Is this common in other hospitals? Or used to be common, but resorted to ativan instead? Some nurses say we might as well give them beer since when they leave the hospital, they'll be drinking anyway. But others think that it's going to make it worse for the pt since most alcohol dependent individuals drink more than 3 beers a day and it would cause more agitation by "teasing" them. I'm just very curious as to know how other hospitals handle their ETOH dependent patients.

Specializes in Acute Care Cardiac, Education, Prof Practice.

***DISCLAIMER*** Soap box perspective.

I prefer to treat a patient effectively and with appropriate alcohol withdrawl protocols.

I believe everyone deserves a chance for a fresh start, no matter how many times it has happened before.

I have never given a person a "beer" or had the order for it. Even in a small 40 bed rural hospital with plenty of frequent fliers (including our surgical tech!).

My grandfather was an alcoholic of over 50 years and died of esophageal cancer and liver cirrhosis. It makes me sick to think that when he went to the hospital there was the chance that they gave him alcohol to keep him from DT's instead of helping him get better. It is a shame on the nursing profession to not help someone attempt to become the healthiest they can be, despite their history.

I do not feed my CHF patients jugs of water because "I know they will do the same when they get home". I will prevent suffocation and fluid volume overload.

I do not feed my CABG/Heart Cath patients fried chicken because "I know they will do the same when they get home". I will prevent further coronary artery damage.

I do not give my diabetic patients candy and carbohydrates because "I know they will do the same when they get home". I will prevent hyperglycemia and all of the myriad of associated diseases.

Yes I understand that detoxing from alcohol is the ONLY detox that can kill you. I understand that the program is difficult, and I have held the hand of a 42 y/o man as he seized because of UNDERmanagement of his DT's. But he came IN with seizures, and we later found out it was because he was trying to go dry at home, on his own.

I have watched a 19 year old refuse IVF because she thought she was going to get "fat" from them, and then later hear she passed out in a snowbank attempting to get to the grocery store across the street for more vodka, the $10 her parents gave her clutched in her fist.

I have held the shoulders of a 60+ man as they gave him Q30 minute Ativan and IM Haldol, only being able to calm him with talk of his favorite tequila, whiskey and scotch.

I am not a optimist, I am not an idealist, I am a pragmatist who believes everyone deserves a change to change.

Tait

Up Vote Up Vote ×

I've seen it prescribed often. Just reinforces my idea that many people choose not to change and its not my place to force them to.

Up Vote Up Vote ×
Specializes in IMCU.
***DISCLAIMER*** Soap box perspective.

I prefer to treat a patient effectively and with appropriate alcohol withdrawl protocols.

I believe everyone deserves a chance for a fresh start, no matter how many times it has happened before.

I have never given a person a "beer" or had the order for it. Even in a small 40 bed rural hospital with plenty of frequent fliers (including our surgical tech!).

My grandfather was an alcoholic of over 50 years and died of esophageal cancer and liver cirrhosis. It makes me sick to think that when he went to the hospital there was the chance that they gave him alcohol to keep him from DT's instead of helping him get better. It is a shame on the nursing profession to not help someone attempt to become the healthiest they can be, despite their history.

I do not feed my CHF patients jugs of water because "I know they will do the same when they get home". I will prevent suffocation and fluid volume overload.

I do not feed my CABG/Heart Cath patients fried chicken because "I know they will do the same when they get home". I will prevent further coronary artery damage.

I do not give my diabetic patients candy and carbohydrates because "I know they will do the same when they get home". I will prevent hyperglycemia and all of the myriad of associated diseases.

Yes I understand that detoxing from alcohol is the ONLY detox that can kill you. I understand that the program is difficult, and I have held the hand of a 42 y/o man as he seized because of UNDERmanagement of his DT's. But he came IN with seizures, and we later found out it was because he was trying to go dry at home, on his own.

I have watched a 19 year old refuse IVF because she thought she was going to get "fat" from them, and then later hear she passed out in a snowbank attempting to get to the grocery store across the street for more vodka, the $10 her parents gave her clutched in her fist.

I have held the shoulders of a 60+ man as they gave him Q30 minute Ativan and IM Haldol, only being able to calm him with talk of his favorite tequila, whiskey and scotch.

I am not a optimist, I am not an idealist, I am a pragmatist who believes everyone deserves a change to change.

Tait

I couldn't have said it better myself...probably because I am not a nurse yet!

Up Vote Up Vote ×
Specializes in ortho, hospice volunteer, psych,.

when i was in college, a very very dear family friend was admitted after a dx of breast ca. edna was in her 80's, a spinster (a self-proclaimed unclaimed treasure), who had been a legal secretary for several decades. she was very active in her church, a hospital volunteer, worked with brownies and girl scouts and was loved by many. when she went out to dinner, she drank tea only. no one bothered to ask about her alcohol use. this was edna, afterall. post-op, she was making an uneventful recovery, when unexpectedly she went into severe dt's and was dead shortly thereafter. later, as her estate was being settled and her little house being prepared for sale, her friends discovered a mighty stash of booze. if only someone had known.

many years after edna's demise, my elderly aunt was admitted for hernia repair surgery. when asked about her drinking habits, she answered, "just a single drink before dinner." but what she never realized, was that she frequently "freshened" her one drink which often meant another 2-4 ounces a night. i quietly tipped off her surgeon who was a neighbor and friend. as a result, she received "her beverage" but without freshening up while in the hospital.

would i give a patient their usual drink if it meant staving off the dt's? you bet i would.

sharpeimom:paw::paw:

Up Vote Up Vote ×

In LTC, the doctors know what meds they are on, when they are scheduled, and when the hs drinks are. Face it, at home they (if they are so inclined) take their meds when they want and wash them down with whatever comes to hand.

I don't think it is up to us to tell a senior how to spend their last years. At this stage of the game, if the family is alienated due to the etoh, a few months of sobriety towards the end isn't going to fix the damage.

Up Vote Up Vote ×

Well sort of topic related. I was glad to have a family member of a patient finally tell me that my very sick, new ICU patient drank A LOT of wine on a regular basis. The patient was fighting sedation, (vented, the whole works). I think that a lot of people don't even know that consistent moderate drinking means trouble when you get a serious illness. That you don't have to be a sloppy drunk either. We kept asking, and he eventually told us. Sad, I remember the stunned look on his face when we explained why things were so much more serious for his family member because of the alcohol.

Up Vote Up Vote ×

two different topics here.....the elder in ltc and the acute patient.......inre the acute patient, were are all the anti addict folk here? or are they also willing to give the opiate addicts all the opiates needed to keep them out of withdrawl, because after all, they will go back to it when they get home?

Up Vote Up Vote ×
Specializes in EMS, ER, GI, PCU/Telemetry.

our docs can write orders for beer or cocktails with meals.

they definately do it to help prevent DT's and withdrawl.... especially in very long term ETOH-ers.

since we have alot of traumas, esp on our neuro unit, sometimes if the pt was a heavy ETOH-er and has a head trauma they will order a drink with each meal tray to prevent DT's, IICP and possible seizures.

they also do it alot for the palliative care patients.

doesn't bother me much....

Up Vote Up Vote ×
Specializes in Critical Care, Orthopedics, Hospitalists.

Sorry for the double post earlier, silly blackberry...

Anyway, I agree that everyone deserves a second chance and the opportunity to change. I don't agree, however, that we should force this change upon them by withholding alcohol just because they were in a car accident. In a patient who is planned to discharge within a week, it doesn't make sense to keep them there longer than needed to "detox" them or put them through the stressors of DTs when they are already compromised by illness or injury.

Up Vote Up Vote ×
Specializes in Community, OB, Nursery.

Christen hit on what is the key for me. I'm more than willing to help them through a detox w/ meds and all that if they're wanting to quit drinking. But if they're not, it's a waste of everyone's time (IMO) to withhold that alcohol.

At my first nursing job, we had as a frequent flyer a 96yo man who drank a ridiculous amount of Jack Daniels at bedtime, and had done so for about 65 years. His 75yo son brought him his flask every night, and do you think we stopped him? Nope.

Fortunately, in mother/baby, this is not a situation we see very often.

Up Vote Up Vote ×
Specializes in CT ICU, OR, Orthopedic.
I had an instructor who discussed this with us. I have to say I that I wouldn't be thrilled about having to give this.

My question to you all is what happens when they are on meds and alcohol is contraindicated? Doesn't that leave the doc, RN and facility open to some kind of lawsuit or worse?

Or if they are addicted to an illegal substance? Should I be shooting heroine in my pts PICC?

Up Vote Up Vote ×
Or if they are addicted to an illegal substance? Should I be shooting heroine in my pts PICC?

thank you, i mentioned this already and no one appears to want to "touch that with a ten foot pole"...frankly i think any and every addict should be accomadated (sp) in the acute care setting. it is not the time to treat the addiction.....but let everyone be treated equally!

Up Vote Up Vote ×
+ Add a Comment