let me start off by setting it straight that i totally agree with geena.

the money spent in forcing an unwilling alcoholic to detox, is, in my opinion a waste of money. and yes, thousands of dollars would have been spared if there is a clear protocol or policy that states that anybody in the healthcare system does not have the right to impose to a patient the decision of when or how he will battle his addiction.

i have no doubt that the suggested, and what have been done, based on the first comments on the post is a reasonable way to save a lot of money. you know, when a drunk patient comes in for let’s say a broken bone because he tripped over out of extreme drunkeness, fix the bone, give him a few bottles of beer after surgery, then send him home with the teaching that he was lucky to just have a broken bone this time, but if he does not stop opening the bottles, a time will come when he will be harder or impossible to fix. financially, this is the most logical thing to do. i absolutely agree with that statement.

i will not elaborate further on the idea because it will be redundant. what i am going to talk about is MY own feelings about the whole thing.

in the hospital where i work, we do exactly what most hospitals do with alcoholics. we fix the presenting problem, then “impose” the detox. ativan here, librium there, restraints there, prolong the hospital stay here. when i worked in the philippines, i have not encountered this issue maybe because most of the sick alcoholics are never brought to the hospital. what this fact means is that i have never given any patient an alcoholic drink.

the thought now is not that i do not agree with this idea as logical, because i already set it straight that i agree it is very logical. the question is, will i be comfortable in doing it? my problem is, logic doesn’t always synch with my personal comfort zone. if one day, a doctor tells me to give my patient a beer, will i open the bottle, and with a smile, offer it wihtout a second thought?

it didn’t surprise me that my answer to the above question is a  loud, bold, NO. just as i will do everything within my power to convince a patient not to go off the unit to smoke, i will probably go around looking for excuses not to give the alcohol.

at first, i cannot think of any reasonable explanation for this. why would i have inhbitions in doing something that i believe to be logical? i have already concluded that dealing with an addict, whether it is food, cigarette, or alcohol is a complicated situation. i have also established that no matter what kind of teaching, even “threatening” we do, (”yes sir, smoking can affect your sexual capacities”) it will never be up to us to decide what the patient wants to do with his body.

then, i realized something…

the desire to fix other people’s addcition is rooted from a childhood experience. i clearly remember the times when my siblings and i had to drag my dad or brother out of the street in fear that they will be run over or killed because they already looked worse than dead.

i have vivid memories of the pain alcoholism inflicted on me and my loved ones. there have been countless number of times when i wished i can just wave a magic wand and make all the drinks disappear. the idea that “if they don’t see it, they will never dirnk it, then, they’ll be better” have always been there. turns out, it is not just an idea, it is wishful thinking.

you know, just maybe, this patient wants me to intervene, and he just doesn’t have the courage to say it. maybe. maybe if i step up for him, and start the whole detox process even if he didn’t really ask for it, maybe he will come around and commit. maybe.

this is why i have no problems in giving the ativan. this is why i never question the supposed imposition of detox. in my head, even as i stand in front of the patients as their nurse, in my heart, i am still that little girl, terrified that alcohol will take away my dad, my brother, or my aunt. and maybe, i can save them. just maybe. just maybe.

so, i have a lot of questions. as always.

am i the only one having second thoughts in implementing such a simple but logical solution?

those who are uncomfortable in giving their alcoholic patients a drink or two in the name of logic, how do you psyche yourself to do it?

those who are comfortable in doing it, do you ever feel, even in a small way, like an enabler?

the loved ones of alcoholics who are in the hospital for other health issues, what do you think about all this?

those patients who have experienced the “forced” detox protocol, how do you feel about it afterwards?

those patients who were left alone, given a drink to prevent withdrawal, was there ever a time you “wished” the doctors “forced” you to detox?

i’d like to hear your thoughts. any thought. please?
THANKS.

and thanks to geena for bringing this up.
pondering on a saturday morning is always a good thing.

________________________

blogosphere buzz is explained here.