Nursing Voices

Tuesday, August 28, 2007

All the Things I Wish I Could Say to My Patients Who Need a Kick in the Pants.

I had another challenging weekend at work. I am ordinarily a patient person with a long fuse, it takes a lot to set me off, but even I have my limits. There is a segment of the population that I have a hard time working with on a daily basis. These people are drug addicts who believe that the world owes them whatever they want whenever they want it. They typically are demanding, blame everyone else for their problems, and refuse to take responsibility for their actions. I am sure that the young lady in the picture is telling her boyfriend that it’s his fault that she is a junkie. After all, she wouldn’t be forced into using illegal substances if he were only a better person. How dare he interfere with her right to do whatever she wants to do! These patients are a walking nightmare. They don't respond well to unit rules or, God forbid, limits on their inapproperate behavior.

It’s really hard not to tell entitled drug addicts to go jump in the lake, but since I can't afford to leave Hospital X right now, I’ve learned to keep my thoughts to myself. Here are the things I’d like to tell people who abuse drugs and overwhelm our health care system.

Now Hear This…….

Shut up and stop griping. You are a screw-up and your own worst enemy, so stop blaming everyone else for your problems. Your family members, friends, or significant other didn’t hold you down and make you shoot-up, smoke, snort, or ingest harmful substances. Grow up and start taking responsibility for your actions.

You're right, life isn’t fair, but that doesn't give you the right to be a jerk. Stop demanding that people enable you. The world is a tough place, so grow some balls and start acting like an adult.

Stop making excuses for your actions. Maybe your brain is different than a normal brain, and that you crave substances because you are hardwired differently than everyone else. So what! Maybe you haven't heard this, but you have free will. You can choose to change you life. Granted, it’s not always easy to do, but it’s the first step to staying clean and sober.

And for God’s sake, don’t tell me that I have to jump through hoops to make you happy because you are paying my wages. My tax dollars are paying your hospital bill so shut the heck up.

Here is some advice for nurses who work with drug addicts. Bring in lots of Little Debbie snack cakes the next time your unit is overrun by drug addicts. Place the snack cakes in a basket and put them in the patients' lounge. The sugar in the snack cakes will temporally sooth your patients’ craving for drugs, and it will keep them away from the nurses station for a few precious moments while you get some of your charting done.


Anonymous Caroline said...


10:21 PM  
Anonymous Hospice RN said...

You're right--the entitled ones are the hardest to handle and drive me insane, too. I love to watch the program "Intervention" on A&E because I am fascinated at the awful behavior of the addicts and the endless enabling of the family. The designation of addiction as a disease has not helped.

8:14 AM  
Blogger jbwritergirl said...

Your advice sounds like a conversation I've had with a certain someone in my family.

9:32 AM  
Blogger MonkeyGirl said...

You called it, MJ.

Maybe you could hire yourself out as an independent contractor that goes around to all of our hospitals and says the things that the nurses can't say.

I'd pay you.

10:31 AM  
Blogger Mother Jones RN said...


I'm still looking for a new job. This is a great idea! How much do you think I can make per year?


11:13 AM  
Blogger The Curmudgeon said...

Third time I've tried to come up with something clever here.

I give up.

Great speech.

And I should be heeding your advice and getting my work done rather than trying to think of something clever to say.

3:28 PM  
Anonymous Audri said...

Very offensive tirade. I am an RN who is also an alcoholic; a drug and nicotine addict with many years of contented, happy sobriety, a joy filled life clean from smoke, and all other drugs. Recovery was hard. if I had been your patient, I would have felt your nasty attitude and it would have made me feel even worse than the way I already felt about myself . I was at rock bottom, full of remorse, shame, guilt and I was suicidal. maybe another client would have gone over the edge from your style of nursing. People other than nurses read nursing blogs. Student nurses, families and spouses of them and kids aspiring to become a nurse. The behavior of addicts is sometimes rotten. Bad behavior should not be condoned but your attitude toward the disease itself is telling. I feel sorry for you and sorrier for your patients. I know you won't post this but I needed to tell you how your remarks affected me.

11:25 PM  
Blogger Mother Jones RN said...

No, Audri, I'm not going to delete your comment.
Congrats on being clean and sober. I'm sorry that you are offended by my comments, but I'm not sorry for stating the facts. You didn't get clean and sober by having people enable your behavior. You grabbed the devil by the horns and took control of your life. My patients come in time after time and expect me to fix their problems. They scream that they are victims while they victimize everyone else around them. Go ahead and feel sorry for my patients because I'm their nurse. I suspect that someone gave you the same lecture sometime in your life, otherwise you wouldn't have turned your life around.

1:00 AM  
Anonymous ali said...

amen sister!!! i have worked on a medical floor for three years and medical=crazy, addicted or step-down. my theory is they stop maturing when they started using and have no idea how to cope...and why is this my problem again? oh yeah i'm the nurse!

11:26 AM  
Anonymous Anonymous said...

Whoa... hold up. I, like audri am a recovering addict and alcoholic. I happen to be 18 years sober. The month I had my last drink+drug was the same month I entered nursing school.

Can you tell me if any of your patients that had diarrhea could just stop because they wanted to? Can COPD'ers manage their O2 sats on will power alone? Can folks w/ Alzheimer's "just snap out of it"? Maybe schizophrenics are jerks too that just need to grow up?

Chemical Dependency is not a choice and having finally understood that after years of constantly screwing up I and many nurses that I know (and non nurses alike) have been able to come to grips with something that almost killed us. Luckily, I didn't kill anybody or drive my car into a school bus full of kids but if you watch the news - well, I can see how close I was so many many times to having done something aweful like that...

I understand your rant, as I've spent 15 years working in ER's and have taken care of many "entitled" folks - some addicts some not but your's and others lack of compassion is somewhat disheartening...

In 2001, the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine jointly issued "Definitions Related to the Use of Opioids for the Treatment of Pain," which defined the following terms:

Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

1:41 AM  
Blogger Mother Jones RN said...

Here's my beef, Anonymous:

I'm getting threatened by people every freakin' time I go into work who are drooling out the side of the mouth as they DEMAND their Ativan and Oxycontin. They rage when the social workers can't get them into public housing, and I've been physically threatened when the doctor won't give these people what they want. Yeah, I know it's not politically correct to hold people to standards of civil behavior, I get it, but when will it start being politically incorrect for people to act like the world owes them whatever they want? I give good care to my patients when they are physically ill from withdrawl, but that doesn't mean that I have to like the people who spit on me, or call me an fucking bitch everytime they don't get their way. I disagree with you, there is an element of choice when you are hooked on drugs. You are an example of someone who made the choice to stay clean and sober.

6:10 AM  
Anonymous Anonymous said...

Mother Jones,

I make a choice everyday to stay sober - in that sense you and I appear to agree. However, I am no longer hooked on drugs and as a result it is much easier than before for me to make that choice.

Quite simply, when I was hooked I did not have a choice. That's why they call it addiction. If you read the definition provided: "...impaired control over drug use, compulsive use, continued use despite harm, and craving...." you might be able to see the root problem with addiction. Certainly, if someone has those problems - there's a pretty good chance they'll be disrespectful, greedy, and have a grandiose sense of entitlement or in a nut shells - jerks.

Now I'd like to think that when I was using that I was a polite and caring doper and that I was respectful but when I was admitted to my first detox and rehab at the age of 15 I left thinking that all those nurses and doctors and therapists were axxholes and when I turned 18 I would sue them all for malpractice... When I turned 18 I was back in the saddle of getting high and drunk everyday. Living on the street, in abandoned cars and on basement floors, I had a 16 year old girlfriend who was pregnant and I was on my way to experiencing the worst and most rapid decline in my life due to the addiction that had already started to ruin my life and the lives of those around me and those yet to enter the world.

Am I proud of what I've done? No. Am I proud of the recovery I've made? Yes. Luckily, I've managed to retain enough brain cells to observe that you seem really really upset about a much broader group of people than mere drug addicts and alcoholics.

I too have been spit on, bitten threatened and assaulted while working in several emergency rooms by people who I suspect had chemical dependency issues and those without that problem. The sad sad truth of the matter is that never did I see any of those people - like some addicts/alcoholics that you describe receive treatment for what their main problem was which was their substance abuse. Usually, these folks receive treatment for their tertiary problems - not the root cause of why they are in the hospital to begin with.

It was all consuming. It was all I knew. It was my hobby, it was my life and it was who I was.

Thank God there were some caring, patient and objective people in my life that could see something positive in me despite the fact that I was a "fucking asshole - piece of shit" as described by many others who knew me.

Had I listened to the later group of folks I don't think I'd be typing this reply to you.

Mother Jones we all have a choice. Sometimes the choices are easier to make than others. I hope you can make the best choices possible in your life - despite your situation.

2:14 PM  
Blogger Mother Jones RN said...

Dear Anonymous:

Keep making good choices, and I'll do the same.


6:47 PM  

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