I’m employed by a large hospital system, and instruct clinical for an undergraduate nursing program at another. These are both magnet hospitals. I’m also currently in my last year of working on my Psychiatric Mental Health NP. So imagine my intrigue when one of my students asks me if she was allowed to give her patient his scheduled 5 beers at 11am. “What kills alcoholics? Seizures do.” I was so surprised. I am so proud to say, in the hospital I currently work, we have an Addiction Medicine team. They can be consulted for a variety of addictions and start the detox process EARLY. A vital component in treating our ETOH patients, even if their original reason for admittance was not to be detoxed. At this hospital, if you claim to drink 10 shots of whiskey daily that is exactly what you get. It comes up from pharmacy and you can find a bottle of Wild Turkey right next to the intravenous antibiotics in the fridge. Is under reporting even being considered here? What if they’re really drinking 15 shots and only claim 10? Delirium tremors are treated at this facility by using a CIWA scale and Ativan IVP or PO. Have any of you seen anything quite like this in practice? What kind of screening assessments or scales do you use? What medications do you prescribe/ have seen prescribed? Benzodiazepines, barbiturates, anticonvulsants? A combination? Is there a different kind of protocol at your facility? I really would like to share this information with my students for it has really started an ethical debate amongst them. Thank you in advance for sharing!
I thought I’d share this link which features some of the more popular tools used to assess for dangerous or risky drinking behaviors.
http://pubs.niaaa.nih.gov/publications/AssessingAlcohol/index.htm.)
References
Perry, E. C. (2014). Inpatient management of acute alcohol withdrawal syndrome. CNS Drugs, 28(5), 401-410. doi:10.1007/s40263-014-0163-5