Substance abusers disillusion me...

Nurses General Nursing

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Had another ETOH withdrawal patient yesterday, he was also a mental health patient in real life, chronically unemployed, and had been readmitted after being discharged post knee-replacement surgery (thank you U.S. taxpayer!), meth positive and in full blown ETOH withdrawal.

High-dose protocol, IV Ativan q 1/2 hour, 1:1 sitter in room + wrist restraints. Any time the patient awoke he launched into loud abusive profanity and tried to grab the crotch of the sitter.

I guess one positive in all this is job security for healthcare professionals, including myself. :rolleyes: But, I must admit, this type of patient disillusions me...:no:

I ask you, how does a person such as this afford a 1/5 of whiskey a day, plus methamphetimine???:confused:

Specializes in LTC.

What person isn't judgemental. I'll admit I have a lot of issues with addicts due to personal history. I try to treat patients that are addicts with respect, but sometimes it's really hard for me not to judge.

Addiction is a disease, but so is CAD. What do we think of the man who comes in having his third heart attack who's 200lbs over weight and has a Supersized BigMac Value Meal for lunch every day? Who can't help but think that this person brought this on themselves.

Or what about the COPDer who smokes a pack a day?

Whatever it is there were some choices made in a person past that put them down the road they are on.

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Specializes in Med/Surg.
after detox, you don't have to struggle with the physical withdrawal, your mind is clearer and are able to truly make decisions.

no longer powerless, no longer a victim...

as long as they stay clean.

but i think many will overlap the powerlessness when actively using, versus the control one does have when clean.

am i making any sense?:chuckle

i've always thought that 2nd step warranted further clarification.

leslie

I guess I need further clarification because I'm not understanding?

Thanks

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Specializes in Med/Surg.
What person isn't judgemental. I'll admit I have a lot of issues with addicts due to personal history. I try to treat patients that are addicts with respect, but sometimes it's really hard for me not to judge.

Addiction is a disease, but so is CAD. What do we think of the man who comes in having his third heart attack who's 200lbs over weight and has a Supersized BigMac Value Meal for lunch every day? Who can't help but think that this person brought this on themselves.

Or what about the COPDer who smokes a pack a day?

Whatever it is there were some choices made in a person past that put them down the road they are on.

Good point. I am not judgemental against those who have recovered from drug addiction but I am judgemental against those who have COPD and take their 02 off so they can smoke.

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I guess I need further clarification because I'm not understanding?

Thanks

before one gets help for their addiction, i do believe they are powerless.

that, they will breech all ethical, moral and legal boundaries in order to get their drug/drink if pushed far enough.

but-

once they are given the time to withdraw/detoxify, the physical addiction is no longer an issue.

they are no longer under the influence and can make reasonable decisions about themselves and their lives.

they have control again.

now, once they are provided with education about their addiction, they are fueled with the resources to make healthy, committed decisions.

even if they relapse again, thinking "i thought i could do this w/o getting addicted", then they now know that they can't.

so before they detox, they are truly victims of their disease.

but after detox and education, they are in a position to take control of themselves, one day at a time.

yes, it's a disease that requires lifelong mgmt and hypervigilance.

but it's doable and clearly, a choice to surrender to your will or His.

it's not easy to maintain sobriety.

but, one is no longer powerless over their disease.

and that makes all the difference.

leslie

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In regards to the original post ... I wonder how much control someone has over their behavior towards others when they are in the middle of being detox'd. Perhaps it's unreasonable to expect people to be on their best behavior when going through detox? And perhaps this individual patient wouldn't be verbally abusive towards nurses if he/she wasn't going through detox.

I've noticed that nurses (myself included) get very frustrated by bad behavior from patients ... and I've started to think that maybe *we* are the unreasonable ones to expect best behavior from people at their physical and psychological worst.

I've been trying to think about this more in my own practice. I work in pediatrics, and it's helped me have more patience with parents who push the call light every five minutes for stupid things or parents who won't change diapers themselves or parents who are rude to me or kids who throw temper tantrums ... stuff like that.

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Specializes in Med/Surg.

it's not easy to maintain sobriety.

but, one is no longer powerless over their disease.

and that makes all the difference.

leslie

:yeah: Congratulations on your sobriety and wisdom learned from it :bow:

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:yeah: Congratulations on your sobriety and wisdom learned from it :bow:

aw thank you, binkie.

not my sobriety though.

my husband's.

i'm merely sharing my many yrs of insights and observations.

and he finally agrees!!:chuckle:up:

leslie

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Specializes in ER, LTC, MDS, Hospice.
I have very little sympathy for drug users who blame the world on their problem. Maybe I am judgemental but about ten years ago my partner completely wrecked his life because of crystal meth, heroin, anything he could get his hands on and inject himself with and he nearly took me down with him. I tried my hardest to help him but he wasn't willing to go to rehab and I wasn't willing to stay with someone who was leaving needles all over the place and stealing my stuff and selling it for more drugs. I don't know if he's even alive now, probably not I think. His friends were all pretty bad as well and they all had one thing in common. It's never THEIR fault that they ended up addicted, always someone else's fault. This sort of attitude really angers me. I've had BAD problems in my life, was unemployed for some time and I used to drink heavily everyday just to forget about past events. But I woke up to myself and went back to school and eventually became a nurse and moved on.

It's not that I don't care because I hate to think of the lives that they lead and inflict on their children. I've seen it and it's not something I'd wish on my worst enemy. But it's the failure to take personal responsibility on their actions and do something about their problem instead of whinging about how bad the world is,and it's never their fault which makes me give up on them. I do consider them to be victims but I agree that they have made themselves victims. No one forced them onto that path they did it to themselves. I know my partner and his mates all had drug education in schools, they knew the risks they were taking.

As patients I do not treat them any different because I'm there to be their nurse not to judge them. But I won't tolerate abuse from anyone, and I'm not there to be blamed for their substance abuse problems.

Unless substance abusers are willing to take responsibility for their actions and see the damage they have caused, as a nurse there is not a lot you can do for them.

Scrubby, you are describing an "active" addict/alcoholic. They/we are usually in the realm of "self absorption at the time and do have a tendency to blame others for our/my problems. That is where the 12 steps come in. With myself and anyone truly working the steps, we come to look at our own part in things (step 4)---taking a fearless and moral inventory of ourselves. Those are the ones who are the winners, who follow the program and stick with the winners who have come before us.

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Specializes in ER,ICU,L+D,OR.
What person isn't judgemental. I'll admit I have a lot of issues with addicts due to personal history. I try to treat patients that are addicts with respect, but sometimes it's really hard for me not to judge.

Addiction is a disease, but so is CAD. What do we think of the man who comes in having his third heart attack who's 200lbs over weight and has a Supersized BigMac Value Meal for lunch every day? Who can't help but think that this person brought this on themselves.

Or what about the COPDer who smokes a pack a day?

Whatever it is there were some choices made in a person past that put them down the road they are on.

I tend to be nonjudgmental in a professional setting

I tend to be respectful in a professional setting

I tend to be polite in a professional setting.

Im always very good at what I do in the professional setting.

But the other night a patients was both yelling and whining at me that I have to care for what is happening to him because he is an addict and in withdrawal. I faced him in a very polite, nonjudgemental, respectful, manner with a sweet smile on my face and said " I will take excellent care of you in every way that counts, but no where is it written that I have to care for you on a personal and emotional manner."

then I looked at him and said " PEACE"

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I will take excellent care of you in every way that counts, but no where is it written that I have to care for you on a personal and emotional manner."

then I looked at him and said " PEACE"

I thought nurses were supposed to take care of the WHOLE person???

:) Just teasing you. I haven't had the pleasure of taking care of a full blown addict but I have had the pleasure of disowning my addict brother. No judgments here. :up:

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Specializes in Acute/ICU/LTC/Advocate/Hospice/HH/.

Just a little tid bit from an objective nurse. I never used a drug until I was given a drug. Drank some in HS. Brother and sister were users and drinkers, but I was not aware until nearly 15 years later. Saw it, inhaled once or twice. Made the choice that seemed right at the time. Got my nursing degree. Exposed to all sorts of pills and shots, but never thought twice about using. Have kids now, 10 years married. Survived all sorts of stressfull events in my life and never looked to the bottle or syringe to change my reality. Then, had tonsillectomy, needed loads of Vic's. Then had the lap chole, lots more Vic's. All of the sudden, I am finding a reason for the RX. So, with a strong genetic predisposition, I am looking for the "moment I chose the drug." Just like those with CAD, HTN, IDDM, CHF, ESRD. Can they pinpoint the "moment". Probably not. Was I born an addict or was the problem overlooked by an inept MD or RN who agreed to refill my initial RX nearly a month post-op. I am too smart to be that stupid. But I can empathize with those who were blind-sided by the disease of addiction.

I can teach you to give a pill. But I can't teach you to CARE if it works.

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Specializes in ER, LTC, MDS, Hospice.
In regards to the original post ... I wonder how much control someone has over their behavior towards others when they are in the middle of being detox'd. Perhaps it's unreasonable to expect people to be on their best behavior when going through detox? And perhaps this individual patient wouldn't be verbally abusive towards nurses if he/she wasn't going through detox.

I've noticed that nurses (myself included) get very frustrated by bad behavior from patients ... and I've started to think that maybe *we* are the unreasonable ones to expect best behavior from people at their physical and psychological worst.

I've been trying to think about this more in my own practice. I work in pediatrics, and it's helped me have more patience with parents who push the call light every five minutes for stupid things or parents who won't change diapers themselves or parents who are rude to me or kids who throw temper tantrums ... stuff like that.

I can speak from personal experience that I was NOT myself when I was detoxing. I was soooooooo totally miserable thru it all, even though they had me on Methadone at the time. Also, in February, I was VERY sick...abd pain, vomiting green bile, etc. I was clean for 7 years in January, but in Feb. my daughter took me to ER. I don't remember that night real well, just know what my daughter told me.....I threw a thermometer at the nurse as she was trying to get it in my mouth while I was vomiting.....was in a lot of pain and screamed at them to give me something for pain, etc. Like I said....I really don't remember it. This is what my daughter told me happened. I was in no condition to tell them, "NO NARC'S" and my daughter said she didn't think about telling them at the time and she just wanted them to do something for me. Well, they loaded me up with IV Dilaudid. Next day saw a surgeon and the following day had a cholecystectomy. Much better then....but the addiction had me again....after 7 years!!!! After that...I take full responsibility for my wrong choices. Yes, I was powerless when the hospital first gave it to me in ER and throughout my hospital stay. After that, it was totally my fault and used again. I tried to quit on my own but the detox'ing kept me going back for a "little more" so I wouldn't get so sick. But after detox....I was back to my sweet self.

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