Day 6 - A client self-discharged after 3 days. We talked to her and tried to convince her to stay but she kept saying "I can't do it", and "I feel like I'm going crazy". Because she had already bonded with the other clients, we had a meeting with them after she left so they could talk about how they felt about her leaving.
Day 7 - A new client was admitted and he was clearly high on heroin but denied that he had just had some. It's not unusual for them to have one last hit before to ease their anxiety. Some tell you straight out that that's what they did, while others are ashamed or think they'll be judged negatively for doing that. Actually the reason the nursing staff need to know is because we need to monitor their withdrawal symptoms and planning their medication accordingly. He had no withdrawal symptoms, speech very slurred, very flat affect, about a 5 second delay when you ask him a question and pupils were not reacting to light (we shine a torch in their eyes). When someone has had narcotics, whether it's heroin, morphine or general anaesthesia, their pupils are very small and do not reacted to light. When we did his bag search (I get to live my border security fantasy or being a customs officer by doing bag searches when the clients come in), we found two used syringes in his backpack. It was a difficult and awkward admission, he seemed very negative and not sure about being in detox, and had no plans for when he got out.
Day 8 - slept through my alarm and was two hours late today . . . oops! luckily they said it was no problem. I offered to stay back to make up the hours but they said not to worry about it.
Day 9 - Led an afternoon discussion group on "mindfullness" - being mindful of your thoughts, words, behaviour and the effects they have on those around you, especially in this environment right now. The client who was admitted two days previously who was high on heroin when he came in, is now coming out of his shell, we are seeing more of his personality, sense of humour and other good qualities he has. He says he feels "straight" and really good, and that he is really enjoying being here . . what a turnaround! Actually it is very heartwarming to see that by the end of their stay, most clients don't want to leave because they are so happy with where they are at, in a safe, supportive, happy, healthy, drug free environment. However, they have to move on and start rebuilding their life. Most go to assited living/rehab facilities with a plan to stay for three months or more. The places they go to have activities to keep them busy, regular/daily AA and NA meetings, meditation, housework and other life skills they have to do, and counselling. They are allowed to leave, but they get random urine testing and if they have been drinking or using drugs they're out.
Day 10 - watched a documentary about recovering heroin addicts on the methadone program. After watching this I am totally for this program. Not everyone realises this but being on the methadone (or suboxone) program means these addicts have to go to the same pharmacy every day for their dose, and it does not make them feel 'high' or like they have had 'free heroin'. The drug does affect the same opiate receptors but it just makes them feel 'normal' or 'straight' and not craving heroin. Some addicts do use heroin on top of their methadone because psychologically they want the 'rush', however physically they do not need it. Being on methadone is expensive, about $150 per month, and it is not covered by PBS. However, it is a lot cheaper than having a daily heroin addiction which can cost up to $100 a day for long-term users, and most of them would have to commit crimes such as burglary or prostitution to find this kind of money.
Also took a couple of clients clothes shopping at the Salvation Army store. Some clients are homeless or come to detox with just the clothes they are wearing. If they have no money they can get a voucher.
The last thing that happened today is I am going to be a Salvation Army volunteer! I will be doing a one hour meditation and relaxation techniques instruction and discussion group every week in the next month's activities program. I will most probably doing it on a week night. How exciting! I am really happy about this.
Friday, October 22, 2010
Monday, October 18, 2010
Detox Diary continued . . .
Day 4 - admitted two new clients, a 24 year old girl, and a 29 year old guy. Asked them about their intake for the last two weeks and what their goals are after detox. For most clients it seems their goal is to work, because they've lost their jobs due to their drinking/drug use. The guy was really struggling with withdrawal and wasn't sure if spending a week in detox was really what he wanted. The next day I he was already gone, decided he couldn't handle it. I offered the group a meditation session before bed, seeing as they seemed to like it. I advertised it as "Hardcore Relaxation", hahaha. It was a heart chakra meditation about unconditional love, followed by a discussion.
Day 5 - Found out that the guy who was admitted yesterday self-discharged, couldn't handle it, wanted to drink. Spent about an hour comforting the girl who admitted yesterday who was upset about her domestic situation (family were being evicted) and desperately wanted to leave so she could help them and also so she could drink away the worries. We convinced her the best thing she could do for her situation is stay right where she is and thankfully she did. The clients requested another guided meditation before bed, so this time I did "Detoxifying Meditation".
Weekend - spent all weekend researching and writing my final assignment for this year. It's for my Community Nursing subject and is about Secondary School Nursing. I chose that topic because I felt it was something I can relate to and write about. The essay was 1200 and I wrote it in one day. I thought I would be able to submit it electronically, but I found out late last night that it had to be handed in hard copy at uni. So today after finishing at 3:30 I came home, proof read it one more time, printed it and drove to uni just in time to hand it in at 4:55pm (due 5pm). Phew!
Day 5 - Found out that the guy who was admitted yesterday self-discharged, couldn't handle it, wanted to drink. Spent about an hour comforting the girl who admitted yesterday who was upset about her domestic situation (family were being evicted) and desperately wanted to leave so she could help them and also so she could drink away the worries. We convinced her the best thing she could do for her situation is stay right where she is and thankfully she did. The clients requested another guided meditation before bed, so this time I did "Detoxifying Meditation".
Weekend - spent all weekend researching and writing my final assignment for this year. It's for my Community Nursing subject and is about Secondary School Nursing. I chose that topic because I felt it was something I can relate to and write about. The essay was 1200 and I wrote it in one day. I thought I would be able to submit it electronically, but I found out late last night that it had to be handed in hard copy at uni. So today after finishing at 3:30 I came home, proof read it one more time, printed it and drove to uni just in time to hand it in at 4:55pm (due 5pm). Phew!
Tuesday, October 12, 2010
Detox Diary
Day 1: Arrived at detox centre and met the Registered nurse on duty and the Drug and Alcohol support worker. Nursing handover then I had a tour of the facility. It's two levels, boys upstairs and girls downstairs, there's a living room with a TV and library, fitness room, kitchen, ping pong table and outdoor area mainly used for smoking. It's located just near Australia's largest brewery, but luckily the clients aren't allowed to leave by themselves.
Each day they have activities to participate in including daily trip to the local pool to swim, sit in the spa or have a sauna. In the afternoon there are meetings with social workers, AA or NA meetings and housework chores to do (there's a roster). The patients get everything for free - food, accommodation, medicine - but they have to stick to the rules, participate in the activities and be respectful, otherwise they're out.
The patients have to prepare the dinners for everyone. It's good food and staff can eat it too so I've been getting free meals too. Most of them are really malnourished and need a good feed. I've been getting to know about them as much as I can and most of them are friendly and talkative.
In the evening everyone watched a short DVD about the science of relapse (how the brain works when someone is an addict) followed by a discussion.
Day 2: I started taking on more of the role of the RN. I did all the daily OBS and gave out evening and night medications. I also gave my first intra-muscular injection (a Vitamin B injection in the bum cheek). Also started assessing the patient's withdrawal symptoms. Attended my first AA meeting.
There are only about 12 patients and most of them are withdrawing from alcohol. It can actually be really dangerous (as well as very difficult) if they try to do it on their own, they can have a seizure and die, so it needs to be done under medical supervision so they can use diazepam (Valium) to manage their symptoms and also get 24 hour emotional support and reassurance when they're feeling frustrated. I've seen a few very frustrated patients already.
There are also a few who are withdrawing from opioids such as heroin and painkillers. They take a different drug that helps ease their withdrawal symptoms and reduce psychological cravings.
Most of the patients have a bed in rehab to go to after detox, but some just go back home. The patients are a mix - aged about 25 - 50 on average, a few of them are aboriginal, some of them have been in and out of detox centres, rehabs, jail and boarding houses their whole lives, and others have had more 'normal' lives that have recently fallen apart due to their drinking/drug use. One (a middle aged woman) recently relapsed "because St Kilda lost the grand final".
Day 3: Today I did two new admissions. I had to read through all the rules and get them to agree and sign a contract. Then I did an assessment of their drug and alcohol use in the last two weeks, their medical, psychological and social situation, and what their goals are. Each new patient gets a bum injection of vitamin B for the first 3 days after they arrive. I also made some calls for a patient who has Hep C, who needs to find treatment and support services in his area. In the evening there was a relaxation/meditation session which I took part in. Everyone was really enthusiastic about it and thought it was "awesome". They obviously don't do enough of that.
So far I'm really enjoying this placement. I'm the only student and there are only two staff members so I already feel like part of the team and the patients all know me by name. I don't even have to wear my uniform, it's very casual.
Each day they have activities to participate in including daily trip to the local pool to swim, sit in the spa or have a sauna. In the afternoon there are meetings with social workers, AA or NA meetings and housework chores to do (there's a roster). The patients get everything for free - food, accommodation, medicine - but they have to stick to the rules, participate in the activities and be respectful, otherwise they're out.
The patients have to prepare the dinners for everyone. It's good food and staff can eat it too so I've been getting free meals too. Most of them are really malnourished and need a good feed. I've been getting to know about them as much as I can and most of them are friendly and talkative.
In the evening everyone watched a short DVD about the science of relapse (how the brain works when someone is an addict) followed by a discussion.
Day 2: I started taking on more of the role of the RN. I did all the daily OBS and gave out evening and night medications. I also gave my first intra-muscular injection (a Vitamin B injection in the bum cheek). Also started assessing the patient's withdrawal symptoms. Attended my first AA meeting.
There are only about 12 patients and most of them are withdrawing from alcohol. It can actually be really dangerous (as well as very difficult) if they try to do it on their own, they can have a seizure and die, so it needs to be done under medical supervision so they can use diazepam (Valium) to manage their symptoms and also get 24 hour emotional support and reassurance when they're feeling frustrated. I've seen a few very frustrated patients already.
There are also a few who are withdrawing from opioids such as heroin and painkillers. They take a different drug that helps ease their withdrawal symptoms and reduce psychological cravings.
Most of the patients have a bed in rehab to go to after detox, but some just go back home. The patients are a mix - aged about 25 - 50 on average, a few of them are aboriginal, some of them have been in and out of detox centres, rehabs, jail and boarding houses their whole lives, and others have had more 'normal' lives that have recently fallen apart due to their drinking/drug use. One (a middle aged woman) recently relapsed "because St Kilda lost the grand final".
Day 3: Today I did two new admissions. I had to read through all the rules and get them to agree and sign a contract. Then I did an assessment of their drug and alcohol use in the last two weeks, their medical, psychological and social situation, and what their goals are. Each new patient gets a bum injection of vitamin B for the first 3 days after they arrive. I also made some calls for a patient who has Hep C, who needs to find treatment and support services in his area. In the evening there was a relaxation/meditation session which I took part in. Everyone was really enthusiastic about it and thought it was "awesome". They obviously don't do enough of that.
So far I'm really enjoying this placement. I'm the only student and there are only two staff members so I already feel like part of the team and the patients all know me by name. I don't even have to wear my uniform, it's very casual.
Sunday, October 3, 2010
Placement finished, two more to go
My hospital placement is over now. The last two days I looked after a patient who had a flesh eating bug that gave her massive sores on her legs that looked a lot like pressure wounds. I got to do the dressings each day for her which involved washing out the wound using sterile technique then packing it with gauze again and re-dressing it. It took about 45 minutes each time. The wounds looked a lot like this and each one was about twice the size of a tennis ball and quite deep. There was a lot of yucky yellow stuff in it as well.
Because the bug was resistant to all antibiotics and contagious she was in an isolated room and I had to wear a disposable gown every time I went in. The other patient I had had TB and anyone who went into his room had to wear a mask. He was also a drug addict and was very rude and abusive. He always asked for more morphine and said his pain was 10 out of 10 even though 5 minutes before he was walking around and going downstairs for a cigarette. He even wanted "lots of morphine to take home" when he was discharged. In those cases, I just got the doctor to speak to him about it because he was just bossing me around. It didn't bother me though. You can't take these things personally, and it's good preparation for my next placement - drug and alcohol detox.
On the last day my buddy wanted to switch roles with me, so I played the role of the RN and he was my buddy. I had to make a plan for the whole shift for 4 patients, delegate tasks to my "buddy" and decide what to do when something unexpected happened. Nothing too exciting happened but it was a good exercise to gain confidence and I had the chance to liaise directly with the allied health staff (doctors/social workers etc) to plan patient care. We all had to bring something as a gift for the staff on our ward to say thankyou. I brought strawberries and a bag of lemons (from my garden) and they were a big hit. We got to leave a bit early and our whole group went out for dinner and drinks at one of the nearby pubs on Brunswick St.
Yesterday I went over to my nan's house again to watch the football grand final (again, because it was a draw last week). Collingwood won so a few drinks were had and I stayed for dinner. Today I've just been cleaning my house and doing my assignment which is due tomorrow and I've just finished. It was about patient care following a blood transfusion allergic reaction.
This week I have off but I have quite a bit planned: Monday - yoga, return library books, massage; Tuesday - hairdresser, take manny to vet for vaccinations; Wednesday - Le Bop dance class; Thursday - teaching; Friday - teaching.
Because the bug was resistant to all antibiotics and contagious she was in an isolated room and I had to wear a disposable gown every time I went in. The other patient I had had TB and anyone who went into his room had to wear a mask. He was also a drug addict and was very rude and abusive. He always asked for more morphine and said his pain was 10 out of 10 even though 5 minutes before he was walking around and going downstairs for a cigarette. He even wanted "lots of morphine to take home" when he was discharged. In those cases, I just got the doctor to speak to him about it because he was just bossing me around. It didn't bother me though. You can't take these things personally, and it's good preparation for my next placement - drug and alcohol detox.
On the last day my buddy wanted to switch roles with me, so I played the role of the RN and he was my buddy. I had to make a plan for the whole shift for 4 patients, delegate tasks to my "buddy" and decide what to do when something unexpected happened. Nothing too exciting happened but it was a good exercise to gain confidence and I had the chance to liaise directly with the allied health staff (doctors/social workers etc) to plan patient care. We all had to bring something as a gift for the staff on our ward to say thankyou. I brought strawberries and a bag of lemons (from my garden) and they were a big hit. We got to leave a bit early and our whole group went out for dinner and drinks at one of the nearby pubs on Brunswick St.
Yesterday I went over to my nan's house again to watch the football grand final (again, because it was a draw last week). Collingwood won so a few drinks were had and I stayed for dinner. Today I've just been cleaning my house and doing my assignment which is due tomorrow and I've just finished. It was about patient care following a blood transfusion allergic reaction.
This week I have off but I have quite a bit planned: Monday - yoga, return library books, massage; Tuesday - hairdresser, take manny to vet for vaccinations; Wednesday - Le Bop dance class; Thursday - teaching; Friday - teaching.
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