I am an RN who's also a recovering(ed) alcoholic. I've found the judgmental attitudes of colleagues taking care of addicted patients disturbing. The purpose of this article is to, perhaps, get nurses to realize how powerful attitude can be when taking care of an addicted patient.
My name is Susan, and I'm an alcoholic. I'm also a registered nurse, hold a bachelor's degree in Human Services, and a Masters in Human Service Administration. I have diabetes, a cirrhotic liver, and haven't had a drink in fourteen years. And, in spite of my continued sobriety, accomplishments, and dedication to working in the helping professions, I am still considered a social pariah by many. I continually ask myself why the judgment cast on those with addictions by those who have dodged that genetic bullet is so harsh as to be venomous. I still can't seem to come up with an answer.
I'm not one to be shy about sharing the fact of my alcoholic history. I was a very functional alcoholic, never lost a job, got a DUI, had a marriage break up or any of the hundreds of things that one typically thinks of as "normal" for someone who drinks as much as I did. My consequence was ruptured esophageal verices, a condition that very nearly ended my life. I haven't had a drink since -- that was enough of a wake-up call for me. But, had it not been for one very talented, non-judgmental and supportive GI physician, I may well have gone back on the road to self-destruction. He put it to me simply, stating that if I drank again I would certainly die, perhaps not immediately, but before too long. His demeanor and non-judgmental attitude (which was not matched by his colleagues) made me think that perhaps I wasn't such a bad person after all. Maybe there was a reason for me to work on staying sober and continuing on with my work with severely mentally ill people. He didn't just save my life in the medical sense, he also helped me to see that my addiction didn't define me. It's a characteristic, not the essence of who I am. Without that support, it would have been much more difficult to move forward.
Those who have never lived with the shame, guilt and self-loathing of addiction cannot possibly understand how the words and attitudes of others, especially professionals, impact the potential for recovery. If an alcoholic or addict is being told, verbally or otherwise, that their addiction makes them less human than the patient in the next bed, it's a fair bet that message will only reinforce what the addicted patient already believes about him or herself: "I am worthless, so why even bother to attempt sobriety? I don't deserve anything more than the hell I'm already putting myself through."
In my nursing career, I've seen this on a daily basis - some of my colleagues don't even attempt to hide disgust when taking care of someone with alcohol and/or drug addiction. Granted, we who have visited that personal hell largely created our own problems. And, as such, the recovering among us (who number more than the average person may think) own that fact and keep it in the forefront of consciousness. After all, anyone who's escaped that madness intact and spent any extended amount of time living sober typically has no desire to go back. It happens, to be sure, but I can only guess that the push has to be enormous for anyone to consider revisiting the twisted existence that is addiction. The bigger issue, however, is the jaundiced (pun intended) view of the caregiver. There seems to be no shortage of self-righteousness among those charged with assisting the addicted person on a path to wellness.
I've heard my colleagues refer to alcoholic patients as "scum," "piece of crap," "waste of human flesh." I've heard pronouncements like "She did it to herself, I don't feel sorry for her." Often these words are uttered shortly before the person casting the judgment goes off the unit for his or her smoke break, an irony I would find amusing if it wasn't so hypocritical and the person so mean-spirited. Yet, this is a daily occurrence, and I don't see it changing anytime soon.
How, then, do healthcare professionals find a way to drop the judgmental attitude and start caring for a person at the core of their being, rather than seeing only the surface of the addict? I firmly believe that education is key - most healthcare professionals only get a smattering of addiction medicine in school, which is ludicrous given the number of addicted patients a nurse or doctor will see in a given year. Learning about the root causes of addiction: genetic, environmental, psychiatric and behavioral may serve to assist professionals in seeing addicted patients more as human beings with medical or psychiatric disorders as opposed to self-indulgent, lazy people who don't deserve the same care and consideration as do people with less "annoying" illnesses.
If one sits down and has a conversation with an addicted person regarding the problem I think there would be one universal truth communicated. That is, no one sets out to become addicted to anything. It's not a goal one strives for. It's an insidious problem that wraps itself around the brain, and before the affected person can think twice, it's there. The fact is, people with addictions to substances don't possess an "off" switch. If we did, we could drink like "normal" people do - a glass of wine with dinner, a cocktail before bed - but we can't. And an enormous piece of recovering is regaining a sense of self-worth, a feeling that maybe the hard work ahead will be worth it. Finding people to support this process isn't easy. But each and every healthcare professional who cares for an addicted person can make a start. By treating the alcoholic or addict with the same respect and kindness shown to someone with a more "conventional" medical problem, there's a chance the message "you're worth my time, so you're worth making the effort to overcome this" may be conveyed. I know that message came through loud and clear to me. Without it, I wouldn't be here.
