Addiction in Hospital Settings: The Nurse's Perspective
As a nurse working in a large medical center, I have seen firsthand the increasingly devastating effects of substance use disorders over the years. Addiction to drugs and alcohol is becoming our most pressing social issue, as it crosses all boundaries of age, sex, race, ethnicity and socioeconomic status. According to the National Center on Addiction and Substance Abuse (CASA), 1 in 7 Americans has a substance use disorder. Nowhere is this more apparent than in our nation’s hospitals. Since nurses are the largest group of healthcare providers, we struggle daily to provide care to these suffering alcoholics and addicts.
Many reasons exist for sub-standard care. People with substance use disorders can be difficult and frustrating to treat. Although the American Medical Association declared alcoholism a disease in 1956, addicted persons are persistently viewed as “morally weak” or “lacking self-control” and at fault for their addictive behavior. At times, I have fallen prey to these attitudes despite what I know both personally and professionally about addiction. Imagine seeing the homeless alcoholic sleeping off their last drunk in the emergency room only to rise and repeat the same behavior yet again, or the craving addict pacing the halls and demanding another dose of narcotics. I have had emotionally touching moments with some of these patients, while other patients have been belligerent, blaming and openly hostile. People struggling with addiction often lack family support and have complex emotional, psychosocial, physical and sometimes mental-health issues. Because addiction is still poorly understood and even misunderstood, nurses receive little to no drug and alcohol training, medical doctors struggle to appropriately manage addiction, and few organizational policies exist to assist in this care. As the front-line caregivers, these are the realities that nurses must face.
I believe we can and must do better! Addiction is a disease not a crime or personal failing. We must reject the idea that addiction is a personal choice. Negative attitudes by caregivers only perpetuate the stigma and shame of addiction and degrades the nurse-patient relationship. Nurses thrive as patient advocates, but must receive the proper training and support to effectively care for substance abusers. It takes the combined efforts of all healthcare providers to tackle this national health crisis.
We need all hands on deck to manage this issue and provide unbiased and compassionate care.
Diane Payne has been a nurse for over 20 years and resides in Charlotte, NC. She has B.S. degrees from Penn State University and Edinboro University of Pennsylvania, and a Masters in Nursing Administration from University of North Carolina at Charlotte. She is passionate about improving the quality of addiction care especially in hospital settings.