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.