This one is a liability! What should I do?

[Dr.Nurse2b]

I've got a mess on my hands and to be quite honest I don't have the time or the patience to deal with this. Help!

I have a classmate that is struggling...we will call him Bob.

Bob started having trouble last year. Seems there are problems with his spouse and home in general. I've provided moral support and general counsel and Bob is coming along.

I've always suspected that Bob had some other issues and last week my suspicions were confirmed. Each time Bob has a crisis he calls me from the local bar to report what terrible things have been happening to him. I figured these were just remote instances. Recently I've been picking up a hint of alchol on Bob's breath...fruity, acetone breath...It's frequent now.

Long story short...Bob's got a chemical dependancy and is at risk for flunking out this semester. The professors are looking to me to provide support but they are unaware of his condition.

I personally think Bob is a liability. I've offered help but he seems to have an answer for everything...and "everyone else" seems to be the problem according to Bob.

I hate to sound selfish but I don't have the time or the resources to care for someone who is out the ruin their life. I don't think Bob should be caring for small animals let alone people.

I am one for being straight forward and have thought about just telling him to quit...he's bringing a lot of people down...constant negativity, self absorbed. I mean here I am reaching out to find help for him and Bob is still recovering from a two day binder that he's been on. Animals smother the ones they think won't make it...right? Is this an option?

Help!

[Dr.Nurse2b]

You are in as much need of help as Bob. You are protecting him and are going to continue to protect him because there is obviously a strong bond between the two of you. As long as you continue to protect Bob you are enabling his behavior. Until you develop some insight as to why you continue to do this and begin to understand your own behavior and how it is affecting your power to act there is nothing more you can do. You are as stuck in this same rut as Bob is. I would suggest that you start by attending local Al-Anon meetings where you can get some help for yourself first.

I don't think I care enough to attend classes. I'm the class rep...I got involved because I was asked to provide support to students that were falling behind. It seems to me this one has fallen far behind. I'm still involved because Bob won't go away...not because I have bleeding heart syndrome and can't let go.

I don't think my behavior could be considered "enabling". The guy is having a hard time with nursing school and so I encourage him and provide some supportive advice ... you know the kind of person I'm talking about here..."I'll never make it" ... "This is so hard" ... "The instructors are so unfair" ... "I'm leaving my wife, she doesn't understand" ...

I guess this was an invitation to call me whenever Bob decides the have a pitty party and have one too many at the bar.

I'm in healthcare, and I have compasion but I am an "Emergency" kinda guy... If you have a big hole that needs to be plugged or your heart stops then I'm your guy... If you're sad and depressed I suggest calling your mom... Not a chance I'm considering Al-Anon.

What I am looking for here is for someone to exhonerate me from the situatuon. I turn to Allnurses when I have problems like this...makes it easier to deal with difficult situations.

[Dr.Nurse2b]

This sounds horrible, but unless you smell alcohol on his breath when he is at clinicals, I would probably keep quiet.

The alcohol is doing what it's supposed to...make you not function.

If Bob can't function and flunks out, I fail to see how that is a tragedy.

Just let nature take it's course.

PS: I can give you another explanation for fruity/acetone breath. People that use a recreational drug called "poppers" or "locker room" will the same breath. I am also a person that you can smell alcohol on my breath the next day, even if I have only one glass of wine.

Just be careful about assuming he has a dependency...just b/c someone drinks alot doesn't equal a dependency.

Thanks for the advice...I guess I'm not being clear here.

Bob has called me from the bar on multiple occasions and stated "I am drunk" ... "I've been drinking since this morning" ... OR ... "I went the bar Thurday, drank 'till I coundn't stand, went home and slept 'till Sunday."

I think I can safely call ETOH when I smell acetone breath on Monday morning.

[Dr.Nurse2b]

Why are the professors looking to you to support Bob?

I am the poster child for this operation and the class representative. Everyone looks to me for support. I am supposed to be a role model and the one with all the answers.

I was asked to provide support...I've done it in the past successfully but this is out of my realm.

[justme1972]

Thanks for the advice...I guess I'm not being clear here.

Bob has called me from the bar on multiple occasions and stated "I am drunk" ... "I've been drinking since this morning" ... OR ... "I went the bar Thurday, drank 'till I coundn't stand, went home and slept 'till Sunday."

I think I can safely call ETOH when I smell acetone breath on Monday morning.

A binge drinker doesn't equal alcoholic. I'm just saying that before you label someone has having a chemical dependency., you still don't have enough to go by.

Do you really think that Bob went home on Thursday and didn't wake up until Sunday? Seriously....do you REALLY believe that he just layed there, didn't eat, didn't drink, urinated in his bed, etc and slept for 72 hours? Do you really and truly think that happened or is Bob looking for a little attention?

If it were me, I wouldn't be taking his phone calls...period. He's calling you because he knows you probably over-react to the situation. Most people would call a family member or a friend from the bar...not the student representative from nursing school...there is a REASON for that.

If that is the case then every other college student needs to be in rehab if that equals alcoholism.

Also, I NEVER stated that you didn't smell alcohol on the breath. Smelling alcohol and smelling "fruity, acetone" breath are two different medical descriptions. To me, one sure as heck doesn't smell like the other.

You are not directly responsible for Bob. I think you are forgetting that.

Being elected student representative doesn't equal babysitter and I would make it clear to the faculty that, "I suspect that Bob has more issues that is affecting his academics, I would prefer to keep my opinions to myself."

That is ALL you have to say.

[justme1972]

I am the poster child for this operation and the class representative. Everyone looks to me for support. I am supposed to be a role model and the one with all the answers.

I was asked to provide support...I've done it in the past successfully but this is out of my realm.

I'll be honest...you might be taking the job just a little bit too seriously.

[LovingNurse, BSN, RN]

Dr. Nurse2B -

It is difficult to watch someone throw their life away, but you don't need the monkey on your back that this guy is trying to put there. :monkeydance:

Maybe you can obtain some resource info for him and hand it to him. Let him know you don't want him to call you anymore because he needs help that you cannot provide... "but here's the number of a place that you CAN call who might help. "

Sitting in lecture with fruity breath is very different than being at clinical with fruity breath. If Bob is under the influence at any time during patient care it is your obligation to turn him in. There is no gray area here. None whatsoever.

Good luck.

[justme1972]

Sitting in lecture with fruity breath is very different than being at clinical with fruity breath. If Bob is under the influence at any time during patient care it is your obligation to turn him in. There is no gray area here. None whatsoever.

:yeah::yeah:

[Jules A, MSN]

so calling from the bar several times a week bleeding drunk is not classified as a chemical dependency? :)

this guy is drunko the clown...i don't know how he gets up in the morning.

thank you!

i hear ya and don't doubt for a second that he has issues but as others have said binge drinking doesn't necessarily equal chemical dependency and no matter what his problem is it doesn't mean you are qualified to diagnose him. even when you get your rn that won't be in your scope of practice. fwiw i've also smelled diabetic breath that could have been confused with alcohol.

you don't need us to exonerate you and it sounds to me like you just want some sympathy and possibly a pat on the back for being so important to your class, which is fine just own it.

[Daytonite, BSN, RN]

it's interesting that you ask "what should i do?" and then you criticize or find a reason for why every suggestion you are given isn't going to work. you need as much help as bob, believe me. you are just not ready to listen. you have the option of telling the people who asked for your help of saying you don't wish to participate.

[crazyframes]

I would simply tell Bob that his issues are too big for you to provide him any sort of assistance and that he needs to seek professional help with his problems. I would also let him know that you will be telling the faculty that you cannot provide any more assistance to him so they know not to look to you when Bob is having problems.

I would tell the faculty advisor of whatever program this is that requires you to provide assistance to students falling behind that Bob has problems that reach far beyond the bounds of the help you're able to provide. I'm sure there are some sort of guidelines as to what sort of help this program provides to students. Personal counseling and diagnosing any sort of chemical issues is probably far beyond the scope of practice!

And, if there aren't any guidelines in place as to the scope of practice for this guidance program, it sounds like there should be!

Finally, regardless of whether binge drinking is a form of chemical dependency or not, Bob obviously has some ineffective coping skills and needs professional (not peer) help.

Best of luck to you, and Bob.

[SuesquatchRN, BSN, RN]

I'd squeal in a heartbeat. He's a danger if he is studying impaired, let alone practicing.

I had a classmates snicking syringes out of lab. I ratted him out in a heartbeat.

A lot of nursing school discipline is nonsense. But being a danger to patients and classmates? Nail him.

[SuesquatchRN, BSN, RN]

Of course there is. But how hung over can a person be without causing harm? And how much responsibility should the staff be putting on the shoulders of another student?