I had to take care of druggies today, and was disgusted! - page 2

Hello everybody. I am a new nurse and I had my first patient who was a drug user yesterday. I took care of him but found it difficult to deal with having a patient like him as he was basically using... Read More

  1. by   damarystx
    I understand the frustrations and the idea's that these people could help themselves or that they did this to themselves. It can be very trying to work with addicts. But from a different perspective I am a detox/rehab nurse. I have heard stories that would absolutely blow your mind. I have seen a lot of clients come in that were introduced to drugs by their parents, little girls started on heroin by their own mothers because mom was tired of prostituting herself to support her own habit so they start their kids on it and then prostitute their children to support their own habits, clients whose entire family were addicted. Clients who have started using after having something horribly traumatic happen to them and not knowing how else to deal with it and not having any type of support system, that with a lack of knowledge about how to find support can be a bad mix especially when there is still a stigma attatched to seeing a doc about emotional stuff. Even educated people have told me that they could handle their depression, anxiety etc. by themselves even though they were obviously suffering yet they thought it was weak to seek help. There is always a story behind why/how someone started using, and yes a lot of their behaviors are manipulative and self serving it goes along with the whole lifestyle of addiction. This is why being able to set boundries is key to working with these clients. There are also some current studies showing that there is a genetic component to addiction which can make it an even harder fight to get clean. Battling addiction is a very long and hard road, it is not just detoxing or going through rehab. it is addressing all the psych issues that go with changing all of your behaviors, learning how not to be manipulative, or "run a game". Once a client gets clean it also means facing the embarrassment of what they have done, facing all of the damage that they have done to themselves and friends and family. Dealing with the pain that may have caused them to start "self medicating" in the first place. Someone really has to be ready to take on that challenge. So I guess I would say try not to judge a book by its cover, and at the same time when all is said and done do not let people manipulate you, they don't have the right to treat you as a servant, and they can only manipulate you if you let them. I do have to get very firm with clients at times and let them know that in no uncertain terms are they going to suck me in to their manipulation but it comes from a very good place in my heart that does not judge them.
  2. by   Kymmi
    I understand that very hard circumstances have brought addicts to the point in their life that they are at. I have no problem understanding that aspect but I guess what I was trying to say is the frustration comes into play when the addict or any other person with a illness does not want to help themselves in recovery. They continue to do whatever destructive behavior they have been doing and then expect us to "fix it" and then when we do they go back to whatever it is they want. Im talking about the diabetics who have numerous admissions with DKA and when we "fix it" they go right back to not taking their insulin or not following their diet or the CHF patient who continues to forget their lasix etc. I guess my biggest problem is that I accept responsibility for my actions and I want others to at least be willing to participate in their care and take responsibility for their outcomes. I have alot of empathy for the drug addicts, alcoholics, DM, CHF etc who truly attempt to control their disease but I do not have respect for those patients who expect everyone else to "heal" them when they refuse to attempt to help themselves.
  3. by   damarystx
    I guess for me , I don't look at it as "fixing" anyone. I know that I cannot "fix" an addict, I can offer them the best nursing care that I can. I provide the best care I can to those who truly want to get clean to show them support for their decisions and I give the best care that I can to those who may not be ready in a nonjudgemental manner so they know that there is a safe nonjudgemental place for them to come to when they are ready, if they ever become ready. Their recovery is totally up to them. For me to stay sane I have to acknowledge that I am truly powerless when it comes to "fixing" or trying to change others, all I can do is be caring, educate and meet their medical needs within the capacity of my job, hopefully that will make a difference in someones life, but it may not and I am o.k. with that. One of the counselors I work with uses a line with clients alot. Basically: "You can be active in your recovery and do everything we ask of you to help yourself and I will go home tonite and sleep like a baby. Or you can choose not to participate at all and not get anything out of your treatment and I will go home tonite and sleep like a baby. It's up to you, either way I am going home tonite and I will sleep like a baby." And believe me I have been in a hospital setting and seen patients and gotten that glimmer of a thought of why don't you take better care of yourself, but I always try to step back and acknowledge that I only know that one little slice of a persons entire life story, I have no idea what has happened that brought people to where they are at the moment they cross my path.
  4. by   Kymmi
    Damarstyx---I understand what you are saying and I can appreciate where you are coming from. I admit that I have no experience with the psychological issues that go along with drug/alcohol addiction. I see the patients when they are in the acute phase in the ICU. Please dont misunderstand that I dont have empathy for those that are truly in need and are seeking help....I realize everyone has issues in their life and some people havent developed or been taught good coping mechanisms. When I say "fix" I am referring to those patients with medical problems whether it be a chronic disease related to drugs/alcohol or any other medical condition. I see alot of people that want no responsibility for their well being but they expect the medical profession to make things better and that is why I put the word "fix" in quotations. I have had family members and patients come right out and tell me that they know we can fix the B/P or Blood sugar or whatever seems to be ailing that person and then get upset when the problem is corrected and they go home only to return a week or two later because the problem returned because the patient didnt take their medicine or whatever the case may be and they blame the medical profession ie doctor or hospital for not being treated right the first time around but they fail to understand their responsibility in the disease process management.
    I completely understand drug/alcohol addiction is a disease process....My ex-husband had a alcohol/drug problem and I have attended many AA meetings and therapy sessions attempting to help him thru but he wasnt able to accept his responsibility in the situation and whenever he didnt like what the therapist had to say he quit going because he felt the therapist didnt like him and was taking my side. I guess this is a touchy subject for me because I hold resentment towards him for always placing the blame on others and never accepting his responsibilities to me, his kids or himself.
  5. by   TheCommuter
    When dealing with a patient whose values (and habits) vastly clash with your own values, it is so very difficult to remain nonjudgmental.
  6. by   Patti 2nd gen RN
    Any patient who refuses to take responsibility for their own health issues, and lies and manipulates staff, is of course frustrating. And there's nothing wrong with professional venting--so long as we are not malicious--just asking for someone to understand and validate us. This is one of the ways we need to take care of each other as a professsion. With any substance abuse issues, we need to be specially inserviced so that we have the tools we need to- a-assess the right things the right ways, b-how to set appropriate boundaries the right way,--c-how to deal with the issues involving all the significant others, d-how to document to protect ourselves,and d- what to do when we need help dealing with any difficult patient. Choose your mentors!!!--and I agree w/ DAMARYSTYX on not letting them run your life. Leave it at the door as much as you can.
  7. by   goldengirl25
    Not disgusted, but saddened! People come into the hospital for treatment. If you have a drug addiction, there is treatment for it! I had a patient last semester that was on vent for three months - caused by a heroin overdose. When they finally plugged the tracheostomy and took him off the vent, I was left in the room to monitor his vitals. After 3 months of not being able to speak, this guy looked at me and said "I don't know how I got here - I stopped doing drugs ten years ago. He is not only denying his addiction, but playing with his life. The next time he might not wake up! This guy has four little kids.
    Last edit by goldengirl25 on Dec 30, '06
  8. by   jesa
    have to chime in here again. personally, I am a recovering alcoholic/addict. I have almost 6 years sober. I think what people don't understand is the nature of this disease. no other disease tells the sufferer that they do not have a disease. this disease does. no other disease affects the mind, body, and soul like addiction does. treating addiction doesn't work with a simple treatment method like taking medication. the truth is, just like any other disease, you cannot judge someone about their treatment or lack thereof until you have HAD the illness. to say that they have help and why don't they just get it is the common mistake people who have no understanding of this disease make. it makes my heart break to watch people with addiction not be able to stay sober. I would suggest everyone get a copy of the big book (AA's main book) and read it to understand more. go to a couple open AA meetings and listen to these people. they are human and working against a disease that is working on a daily basis to KILL them.
    I understand the OP's frustration and commend the OP's ability to be honest and look at her feelings about working with people who have addiction, the thing that bothered me about this post was the title "I had to take care of DRUGGIES today", those words immediately show a lack of knowledge and a blatent stereotype and disregard for the patient's disease.
  9. by   caliotter3
    I, too, have found myself getting impatient, and yes, even judgmental. The patient....an elderly LTC facility resident, who obviously did not have pain issues but exhibited these very same manipulative, offensive, and "I am the center of the universe" attitudes when she called every night for her vicodin right at shift change. It took me a long time to figure out, on my own, how to best deal with her. I think it was the stubborn, defiant look on her face as she refused to verbalize pain symptoms so I could justify giving her the med per MD orders. I think I developed the same negative feelings toward her as I would have toward an especially annoying "druggie". And I know I am supposed to be knowledgable and empathetic and show the same professionalism toward everyone. One thing I remember though, is that I usually come on this site to ventilate frustrations and despair; I do not consider myself looking for validation from others for my feelings, attitudes, or behaviors. I hope the OP has the ability to not be so disturbed by future encounters with patients w/this particular disease.
  10. by   caliotter3
    Oh , and BTW, one of my former DONs was stealing psychotropics. What a hellhole she was running. She needed psychotropics, but did not feel that she needed the services of an American MD to properly prescribe for her so that she could take what she needed legally. Every time I think about her I have mixed emotions.
  11. by   RN 4 U
    Quote from jesa
    instead of frustration maybe you should educate yourself on addiction. drug addiction is a disease, your patient is in the hospital. feel thankful you are not plagued with addiction and treat every patient with the same respect, regardless of their disease
    I justed wanted to reply to your post because this was not helpful to me at all. "Be glad you are not plagqued with an addiction" You could have kept this little comment to yourself.
  12. by   jesa
    if that was offensive to you it wasn't meant to be. personally, I am thankful not to be plagued with diseases I don't have.
  13. by   RN 4 U
    Quote from Kymmi
    I didnt find this posting offensive at all either. I completely understand where the OP is coming from. I realize that addiction is a disease. We see so many people with many forms of illness but I do find it much more difficult to care for someone who could have control over the disease if they'd accept responsiblity for their actions. There is a difference between a drug addiction and a 40 year old woman dying of breast cancer. They both cause illness however how many times have you taken care of someone that is struck with a life changing illness and would do anything possible to overcome that illness and cherish life but they cant. It is very frustrating to see people that can make a difference in their outcomes but chose not to and those are the same people that manipulate and expect us to "fix it" for them. I have much more empathy for those people that want to help themselves compared to people who expect everyone else to take care of them when they refuse to do for themselves.
    I know people are going to say that my view is not a good view but I think we as nurses are so focused on helping everyone that we neglect to see that some people could help themselves. What other profession will take over and "fix" whatever is broken? In all other walks of life we are expected to help ourselves as much as possible.
    If I choose not to do something that I should do no one else comes in and just does it for me because they have empathy for me. I am responsibile for me and I accept that....if I choose not to pay my bills or put gas in my car then it was me neglecting my responsibilities and no one comes along and says let me do it.
    I totally agree with everything your post said. Just the fact of taking care of someone like this was very frustrating. The care i gave this man was no less than the care i gave to my other pts. I realized he is a sick man and that his addicitive behavior is what brought him here. But to munipulate someone into giving you drugs and demand that you bring his pain medication on time, everytime, as scheduled is a bit much. If you are getting pain medication strong ones at that how do you have no relief. I am a nurse, not anyone maid and I just wanted to voice my frustrations about this as i was really frustrated. I am educated, i graduated from nursing, i know all about addiction but in the real world which i am in now, it was a totally new experience for me. People have to take responsibility for their destructive behaviors even addictive ones. Just because you have addiction does get you off the hook. If the police catches some one who is addicted to drugs with drugs they don't say, "you have disease and you can't help it i'll let you off the hook this time" I'm sorry that just does not happen. I would have more respect for someone who acknowledges the fact that they have a problem and are actively seeking help that the one who does not think they have a problem and continue to munipulate others into getting what they want.