RN interested in job in detox

mentalhealthRN · Jan 29, 2011

Well being that I was the RN who did the interviewing and hiring recommendations for a detox center I will tell you what I looked for......

Psych experience. There is a huge relationship between CD and psych. Dual Diagnosis is big. Being able to deal with people as they detox can be trying and having psych experience is good. So many people with psych issues self medicate with street drugs......for depression, for anxiety, to "make the voices go away", as a form of self harm for those with personality disorders, etc. So to be a really good CD nurse you need to understand psych and the connection. I would say 75% of the people we had at any given time had some psych dx or symptoms and not yet dx'd. So psych experience is golden in my opinion. Another thing is some medical experience--ER is always good. If you came to me and had ER experience and psych I would so be interested in hiring you. If you live somewhere where they have a psych ER I would say try to get in there. You will need psych inpatient experience first though so you can get that them move to the psych ER. If you don't trying to get into either ER or psych would be good. If you are able to work part time on both units.....that would be great. When in the ER try to pick up the cases of pts brought in for intoxication that will be getting treatment like fluids, Bananna bag, ativan, etc. or other drugs. They are often monitored until their levels come down to a certain level before being moved to another unit. Some serious drug ODs will go to ICU. In psych ER you will also get those who will be monitored for withdrawal-- using the CIWA for ETOH w/d monitoring and COWs for opiate withdrawal. Learn about methadone, suboxone, benzo use for w/d--usually Ativan or Valium. Learn about DTs--what they are and what to watch for to know they are starting. Hopefully this was helpful and good luck to you!

Tom RN, NRC · Jan 30, 2011

First of all I agree with MentahealthRN that experience in the areas that she mentioned would help, but I think your next question would be how do you transition to them with little to no acute experience? A bit of a catch-22. So instead of focussing on that lets look at it differently. Geriatrics is an amazing area of nursing, but is often undervalued for the complexity of nursing that it involves. The reality is that as a LTC RN you probably have more transferable skills than an ER nurse when it comes to working in a detox, but unfortunately that is not the perception most people have. In my mind the transition for you is about 15% skills, 20% education, and 65% marketing.

Since I just had my coffee and feel a little frisky I’m going to draw you a little map that I think would be the shortest distance between where you are and where you want to be. To do this I am going to assume that you are a great LTC RN who is leaving because she feels like she needs a change in her career, not an old crotchety burnt out bag who’s fed up with the BS back at the home. LOL.

15% Skills

Strengths-

Relational practice (finding the join, coming alongside, meeting people where they are at, maintaining a therapeutic relationship, and counselling), psychosocial assessment and care, organization, multi tasking, maintaining continuity of care, careplanning, multidisciplinary approach to care, ect...

Weakness-

Acute medical assessments and care, dealing with manipulative clients (you may think you have but just wait), acute mental health issues (as mentioned, co-occurring disorders are the norm now not the exception), and others

Suggestion-

A medical unit might be the best bet as your geriatric experience would be seen as a strength. At the same time would get you feet wet and refresh your skills. In a perfect world you would be in a hospital with a psych unit or detox for education part of the plan.

20% Education-

10%- It is my belief that it would worthwhile for every nurse to take a generalized course on addiction. I believe that addiction is pertinent to all areas of nursing yet is one of the gaping holes in our knowledgebase.

10%- As mentioned co-occurring disorders are now the norm in addictions, so if addictions is your area of nurse I believe it is negligent to practice without some understanding of them. The University of Southern Florida offers a free online self-paced course which you can for a small fee provide CE’s. Bang for your buck it is probably the best out there, but the content is starting to get a little dated and it is minus a practice component that would get your foot in the door of a detox.

65% Packaging

When you apply to work on a detox your resume should be specific to the work (i.e. emphasize your strengths in relational planning, working with families, counselling, leadership, teamwork, careplanning, critical thinking.) You would be surprised how much of a difference this alone makes. If you struggle with resumes then get a professional resume writer to help you. It is money well spent. Don’t ever use the words only or just in describing what you do. You are a nurse which means you are one of the most sought after professional on the planet. You have an enormously transferable skill set and the ability to learn just about anything you put your mind to. If you added a bit of medical experience and the education I mentioned to your resume I think you'd be quite marketable.

If you have a passion for addictions we’d be lucky to have you. Well the coffee has worn off and this seems to be getting a bit wordy. Good-luck and I can’t wait to read the rest of the posts.

Tom T RN, NRC

dekagirlsRN · Jan 31, 2011

Thanks for the great responses. Tom, I guess I should have been a little more clearer where I am working right now. True, I have LTC experience, but that's not my present job. Right now I am working at a long-term residential treatment facility for women addicted to drugs and alcohol. I have learned a great deal as far as clients with co-occurring disorders (and still learning). But I am looking to make a transition into a more acute setting. In the meantime, I am taking CADC classes and reading as much as I can about addiction.

Tom RN, NRC · Jan 31, 2011

That was completely my bad. I missed a key word. Oh well no harm done other than my ego, and it has seen worse. Other than the rhetoric about LTC I think my answer is about the same. I really think that some time on a medical unit would be both accessible and useful in reaching your goal. You might still look at the co-occurring disorders course I mentioned as well. It is quite significant in content, counts for up to 27 CE hours, and as I mentioned is free (they ding you $25 for the CE's, but ifyou wait till the end you only pay the 25 once). Thanks for not raking me over the coals on my blunder.

Tom T, :uhoh21:

dekagirlsRN · Feb 1, 2011

So, Tom, do you think working on a med/surg floor is a better direction towards a detox unit, than what I'm doing now? Thanks for your input.

Tom RN, NRC · Feb 1, 2011

In all honesty I think the ideal would be if you could split your time between the two. I think psychosocially speaking you are building on many of the same skills needed to work in a detox, and I think your experience there will serve you and your patients well. What you are likely lacking in both the psychosocial and medical part of detox nursing is acute experience and skills.

You might try getting on casual on a med floor. Ask for a good chunk of orientation and take advatage of all the free training they offer. Good hospitals have in-services and refresher every other week or so. I hope that helps.

Tom T. RN, NRC