Have detox interview-no experience-advice?

Published

I'm a new nurse practitioner and I've been invited to interview with an outpatient detox group that uses Suboxone and other meds to detox pts. This would be my first full time NP job. I have grown up with drug addicts and have sibilings and relatives currently addicted. (I myself have never had that problem-except maybe to fudge cake :p). I feel comfortable dealing with the addict and comfortable treating them (once I was trained that is).

What types of things make a nurse successful in this type of environment? I can tell it must be chaotic as the office manager I spoke with seemed so stressed in general, you could just hear it in her voice...

Any advice on what to say in the interview to get the job? Like what skill set are they looking for? What's the work like if anyone can share thier experience. I've heard burn out can be great in this field? Are the pts violent?

Last but not least how is the pay? This is a cash only office and they are opening a new location in a couple weeks. Their ad says they pay up to $120/hr (and will provide training), but I find that impossible to believe and think it must be a typo. Although it sure would be a nice thought..

Up Vote Up Vote ×
Specializes in Addictions, Acute Psychiatry.

1. Go to 12 step meetings and learn everything you can. You must be able to associate with how they're feeling in order to be effective. Read and watch videos, including relapse prevention. Most places about half the staff are in recovery but the other half has taken it upon themselves to understand addiction. I'd say most likely those interviewing you will be in recovery (if I were a gambler).

These units will be chaotic and staff will be off kilter so you need to appear as the stabilizing force. If you've got issues, they will be exposed by patients and staff over time. But it's all good! One happy dysfunctional family!

I wouldn't worry about what to say or do to get the job; either you're a good fit for them or you're not. Just relax and be you! Rarely have I met an addictions NP who didn't walk on water.

Oh..the pay; they're likely not playing around with that! It pays well because addictions NP's are highly sought. Pretend the pay doesn't excite you at all if it's that high (don't squash a blessing in the making).

Finally- Pt's are rarely violent; more often they run out for a drink or a hit or something (unless you have something to do with their life...reporting to a PO, jail, etc). Go with your gut; it's like any other psych NP job or rotation you've had. Basically they're adults stripped down to babies because what helped them function is gone and their skin is super sensitive to anything you do or say. Pretend they've all got PMS x100 and that will make sense.

Again, you're at a huge disadvantage if you don't know about the 12 steps and can redirect them to do xyz when they act out, worry, obsess, etc. That's the most powerful tool I've found. When they stress, act, react, I say stuff like "Stress is worrying about what might or might not happen...so what's happening at this moment?" "We're talking in the hallway; that's what's happening right now...one day at a time, one minute at a time and let tomorrow worry about itself, you worry about your recovery and everything will fall in place as it's meant to be...come on, you know that already, why are you listening to me?"

Sounds silly but it works every time. "First things first" "One day at a time" "When in doubt, do nothing" "The therapeutic value of one addict helping another is without parallel" "Insanity=repeating the same thing expecting different outcomes" "Addiction=continuing the same behavior despite increasingly negative consequences" (tell them to get and call their sponsor)...blah blah blah!

Little sayings will trigger hours of discussion, education or memories and you save yourself a lot of time!

That's just me, though! Turn it over; Pray and let the rest go! you'll get the job if it's meant for you. If you turn it over and don't let go, you're upside down!

Up Vote Up Vote ×

Thank you for that awesome response! Unfortunately on my way to the interview they called me to reschedule it, said they'd call back to reschedule but never did. I called today and left a message. I hope it's just that they are a chaotic mess and not that they hired someone else.

I have been to a few AA meetings with various family members but would certainly need to become more familiar with that. I deal with my brother who is an addict and I know what you mean about how fragile they are and are like immature children with no adult thought process. I think I would be good in a role like this because my life is 110% solid, I'm very grounded I could provide support and direction, be the stable one. I've done that all my life for a family of addicts (my mom, aunt and brother).

Sure hope they call me back. Sounds like a challenging job...

Up Vote Up Vote ×
Specializes in Addictions, Acute Psychiatry.

Then you're familiar with addictions! Kudos! The challenge you'd likely face (I'd say) are of codependence, then. Many families are challenged with that. Don't let it skew your judgement and you'll be just fine. We've got lots of staff who love addicts because of being family and they've come around to making healthy decisions. Same goes for those in recovery; setting limitations, etc are key.

It takes time. If you've gone to meetings and you "get" the winning by losing concept and letting things go, you've got most of it. I find I can apply any part of the 12 steps to any part of my life including work. I stress about staff who got fired, staff writing each other up but as a whole it's not MY problem and I'm just doing the next right thing and I need to be reminded "when in doubt, do nothing." I guess that doesn't count for prescribing, though (hahaha)! When in doubt, call your doc :o)

Communication and preventing staff splitting seem to be the major challenges (and those in recovery who are insane and not working their program for healthy decisions).

Imagine your family members affected when you're treating. They're human and they've been robbed of their coping skills. One point; you can't disgnose in the middle of PAWS since some will present with schiz and bipolar when it's judt acute decompensation with someone who's got no skin and no coping substances. Crutches like trazodone, etc help depending on how long your program lasts...that's my 2 cents! I love the field and the chaos...staff are sick in every place I've been to but acceptance is key...stick on their side and they won't forget it. Betrayal or thoughts of betrayal to staff working in addictions can cause lots of dysfunction. blah blah blah :o)

Up Vote Up Vote ×
Specializes in Addictions, Acute Psychiatry.

One point; I've gotten many jobs because I asked for the interview; ask to get in there and interview and acknowledge they may have already had a decision or a preference. Many have better offers or no shows and they just might like you better in person than on paper. Tell them you're recovery friendly and how you get along with others. Most are full of dysfunction so accenting your stabilizing factors is good. I can count several staff on board who also asked just for a quickie interview and are working there. You never know what's meant to be till you do the footwork and see. I'd ask to talk to the manager (your would be boss) cause they have clout over HR. It can't hurt; costs nothing to see if this is the one for you :o)

Up Vote Up Vote ×
Specializes in OB/GYN, Peds, School Nurse, DD.

Can I just say this: CAstlegates, you are DA BOMB! :yeah: I am not an addictions nurse, but I have been through rehab for suicidal depression. I went through a recovering professionals program with a LOT of addicts and I can attest to everything you say. It is amazing how much alike addicts and depressed people are. I came out of an 8 week program with a whole new outlook on what it means to be addicted. You guys rock~

Up Vote Up Vote ×
Specializes in ER, ARNP, MSN, FNP-BC.
Thank you for that awesome response! Unfortunately on my way to the interview they called me to reschedule it, said they'd call back to reschedule but never did. I called today and left a message. I hope it's just that they are a chaotic mess and not that they hired someone else.

I have been to a few AA meetings with various family members but would certainly need to become more familiar with that. I deal with my brother who is an addict and I know what you mean about how fragile they are and are like immature children with no adult thought process. I think I would be good in a role like this because my life is 110% solid, I'm very grounded I could provide support and direction, be the stable one. I've done that all my life for a family of addicts (my mom, aunt and brother).

Sure hope they call me back. Sounds like a challenging job...

I was a substance abuse nurse for a lot of years working detox, rehab, outpatient, and admissions counselor. The one piece of "advice" (I hate that word lol) would be to keep your codependence issues in check. You said that you are the "stable one", the one that has to "deal" with family members in addictions. Yes, they are fragile, yes,, they may be immature with no adult thought process. However, it is their journey with your guidance. They are responsible for their OWN recovery. There is a fine line between guidance and control. I would recommend you read Co-dependent No more, Women Who Love Too Much.... they are two great books that will help you make sure that if you do have codependence issues, you identify and work on them. The only thing more damaging to an addict than drugs/alcohol can be an enabler :) Not saying you are, just prudent to find your weaknesses if they exist . Good Luck!!

Up Vote Up Vote ×

I agree with the other post. I have been on both sides of the fence and can tell you from experience, pt's will respond and respect you if they feel that you have a little knowledge under your belt. The co-dependants books (Beattie) are great, but don't forget to grab a Big Book while you are at it. You may be looking at NP medical stuff while you are working, but there are many opportunities to encourage the addict. I am still amazed at how many of those who work in addictions don't know who Bill W. is, nor anything about the 12 steps. If you do look at these (and i highly recommend it) play close attention to step 4. It saves many lives. Good luck.

Up Vote Up Vote ×
+ Join the Discussion