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Looking for insight into what to expect in my clinical at medical detox

by jmrphy jmrphy (New) New Student

Specializes in CNA/Nursing student.

Hi, I was just looking for some info on what to expect from my last ADN clinical at a medical detox. If anyone can please share their day to day experiences and what skills I may be performing I would greatly appreciate it. I am lucky enough to get back into a clinical site for my last semester and have a 12wk preceptorship that will cover my leadership and mental heath requirements. I do have previous experience in direct residential care working with folks with mental health and substance abuse issues so the population is not new to me, but dealing with someone with acute withdrawal is. I was just wondering more about the level of care being given looks like. Any advice is welcome, thank you in advance.

I think the most useful skills working in detox are the abilities to de-escalate and to show empathy.  
Be prepared for charming manipulation alternating with challenging behaviors. Lying is to be expected. Still treat the patients the same as you would treat patients with any other disease; with respect, compassion and firm boundaries. 
You may want to familiarize yourself with COWS, CIWA, CINA scales. Same with common detox meds. Most places have standing orders for protocols but the protocols vary from place to place. Methadone, Suboxone, Subutex for opioids. Librium, Ativan, Klonopin, or Valium for alcohol/benzos. Some places use phenobarbital. Some offer ‘comfort meds’ for opiates such as clonidine, bentyl, vistaril. Others also offer muscle relaxants or meds to help with restless legs. Most give something for sleep.  
Depending where you live, you may also see meth, synthetics like K2 or spice, gabapentin or Wellbutrin abuse. 
You’re likely to encounter abscesses from IVDU. Seizures happen. So do overdoses. Know about Narcan.  
HCV is common, HIV less so.  Sometimes nurses run groups on these topics. 12 step programs are often encouraged. Your facility may also offer Vivitrol or MAT after detox. 
Good luck!