Tugging at my heartstrings


Hi AN community.

"This RN" (haha: throwback from recent post) has noticed a recent uptick in ETOH withdrawal pts and hospitalizations r/t heroin. One, in particular, is really tugging at my heartstrings. To be clear, I am very good at compartmentalization so it's not the patients who are the challenge. I care for them quite clinically and without judgment. That's one of my nursing gifts, as we all have our different ones.

For me, it's the families of these people. We all know the likelihood of reoccurrence is like, WAY UP THERE. How do you like that scientific stat? But I digress... So between SW, and my gentle nudging for the families to take care of themselves too during this time I end up just feeling powerless, which is precisely what the families are...POWERLESS. No amount of daily McDonald's runs for the pt newly downgraded from ICU is going to change the fact that when that person gets discharged they are more than likely going right back to their dealer. And we will see that same family again. Only this time the pt won't be as lucky, because as we know the clinical manifestations tend to get worse every time.

I guess I'm just venting, but what experiences have you all had (good or bad) that have helped you get through cases like this? For reference, I'm a new nurse but have been in pt care for quite a while so I'm not new to family dynamics or hospitals. Thanks. Oh, and just to show I'm not a total softie cause you know those ETOHs be trying to drink their own pee on the regular. ?


canoehead, BSN, RN

6,837 Posts

Specializes in ER. Has 30 years experience.

I'm a mean old cuss, so when I see McDonalds runs for the OD patient, I see them rewarding bad behavior. OF COURSE the addict will go back to their drug, and will OD again, because what are the consequences? McDonalds and sympathy vrs rehab, rules, and withdrawals?

Point out to the family what they are rewarding, vrs what they should be rewarding, refer them to family support, and let them make their choices. Above all, remember, it's their crisis, not yours. You need to maintain your own mental health.


79 Posts

Thank you! You are absolutely right! I will remember that for next time.


79 Posts

A couple of days ago I came back across this reply. I had almost forgot I’d written about this experience. Well guess what? The pt showed back up ... dead. Idk if it’s because I had just read this again or whatever but I was fortunate enough to have the support of a fellow nurse (when I had a minor breakdown) who assured me I’m in the wrong job if I don’t let some things get to me. Then later I had a charge who encouraged my chin up and carry on process. Mind you, my work wasn’t affected. But dam! Sometimes you just know! Jails, institutions, and death are a well known phrase for a reason. I went in the room and said good bye to her before start of shift and said a prayer for her, and all the addicts still out there suffering. That’s all I can do.


Nurse SMS, MSN, RN

2 Articles; 6,837 Posts

Specializes in Critical Care; Cardiac; Professional Development. Has 12 years experience.

I am sorry for the death of your patient and send you thoughts of comfort for your tender heart. The patient is very fortunate to have had you. Many have shut down their minds and hearts to addicts. You saw her as a person with potential and for that you grieve.