Rapport with pts

I work in a detox.  We have already established when I started, that we don't give our personal info to patients on the unit.  Some techs we have are in recovery, and I don't know what they do.  they may see former clients at meetings, but we as nurses should keep professional boundaries.  I don't know about driving him anywhere.   I'd rather drive someone than see them get a DWI or hurt someone.  An uber or other solution could be reasonable.  If I saw a former client out drinking, I would personally try to not get involved.  

I don't know the whole story, but that's my opinion

On 6/23/2021 at 6:31 PM, GS ED RN said:

Hello all - 

I am sorry if this is not the right platform - but I figured this was how I could reach the most experts. I fiercely admire the patience/dedication it takes to work with patients with addiction as a disease. My friend was in rehab for alcohol addiction. Sounds like he may have established an inappropriate relationship with one rehab nurse and the other was a tech.... he had their phone numbers...they texted ...he was swinging by the rehab to pick up sober event tickets and he got one of them a coffee- like I am sorry but WHAT???? 

it gets better....my friend relapsed less than 5 days after discharge - he relapsed HARD... he went to a casino/bar where this staff was hanging out, they proceeded to drive him to a hotel-(he wouldnt provide them with his home address so they could take them there) so he wouldnt drink and drive. Couldnt they have called the facility to ask for his address/emergency contact--- shouldn't they have called an ambulance or IDK.... Rehab nurses please tell me what you would do if you saw your pt intoxicated/relapsing? I need your perspective. 

Hi, I have mental health, dual dx, rehab and detox experience. We have a very challenging, and sometimes dangerous setting. There have been cases of stalking and assaults of nurses. Our patients can be amongst the most manipulative. One speck of personal information passed amongst the patients can be added to until too much as is known. Like I had one ask if the jeep was my car. He was fishing in the dark, trying to find out which car is mine. Some of them are or are affiliated with gang members. Bottom line, give no personal information whatsoever. Most likely your facility prohibits this type of conduct. And it is important to have firm boundaries. If I coincidently saw a patient in an outside setting, I would keep it short and professional. If I believed they had too much to drink I would discuss with the bartender, the responsibility here is with the server. He/she should call a cab. I doubt the facility would release the information under HIPPA laws.  I cannot comment on a social worker or peer support person. If I were attending a support group, I would also minimize my contact with the person, respect their anonymity, and hope they respected mine.

There are different philosophies on boundaries when it comes to recovery. I used to work in a community program for people with mental illness and addiction (not inpatient). I would never ask anyone to bring me a coffee, and if they asked I would say no. If they brought me something small like a coffee without asking (rare) I would probably not refuse it. Picking up tickets for a sober event seems like a perfectly acceptable thing, and at my program, that kind of thing would happen as a matter of course. As far as what I would do if I saw a former patient intoxicated outside of my work hours/ work setting, it depends on the specifics. But I would not call the facility to get their address if they were refusing transport home. That is inappropriate. I would call an ambulance if I assessed the need for emergency care and/or if the patient wanted an ambulance. Given the situation, I don't think anyone did anything wrong by driving the patient to a hotel, and it may have been my action as well. It rather seems like going above and beyond and your friend is lucky to have former staff who care about him. 

In all honestly I don't think focusing on the actions of the staff members is the best way to help your friend in this particular situation.

The bottom line is you friend is an addict. Your friend had a relapse after leaving treatment. They need to work on their sobriety which includes owning their actions and doing their best to make the best possible choices they can going forward. You shifting blame onto others is unlikely to help that.