How to Care for Patients Who Abuse Alcohol
Terri Polick | NursingLink
Nurses often find themselves playing detective when caring for patients. You thought your patient was being straightforward with you when they shared their health history, but when unexpected physical and psychological symptoms cropped up, you wondered if they were telling you the whole truth.
Keeping secrets with their medical history is an unfortunate reality, making it tough on the patient to get the care they need, and challenging for you to get all the pertinent information. Especially when you’re dealing with someone who is hiding an addiction. Unfortunately, many patients are reluctant to tell medical professionals about their alcohol use, which can lead to serious consequences. Patients who are addicted to alcohol are at high risk for withdrawal during their hospital stay and may have grave medical issues related to their drinking.
According to the National Institute of Health, nearly 27% of the American population between the ages of 18 and 64 meet the criteria for alcohol dependency, making it the most prevalent addictive disease in the United States. It’s estimated that 17.6 million adults in the U.S. are alcoholics or have alcohol-related problems, and that up to 25% of hospitalized patients are alcohol-dependent.
Additionally, when patients enter the hospital for alcohol-related illnesses, the sudden drop of alcohol in their system puts them at risk for developing alcohol withdrawal syndrome (AWS). Nurses must be able to pick up subtle clinical symptoms of alcohol withdrawal as they develop at the bedside in order to prevent life-threatening complications related to the condition.
Accurately screening patients during the admission process is the first step to identifying patients with an alcohol problem, who are also at risk for developing AWS. Ben Cahna, RN, MSN, an author, and psychiatric nursing instructor at the University of Maryland, is a nursing expert in the field of addiction. He said that nurses sometimes rely too heavily on patient self-reporting when doing their initial assessment of the patient. Of course, it doesn’t help that patients may try to intentionally cover up their dependency issues, or they may be in denial about their drinking problem.
“Patients may not realize the extent of their drinking problem," said Cahna. "They might view an alcoholic as a skid row bum and they aren’t. They see themselves as functional. They have a job and they aren’t begging for change to buy a bottle of wine.”