Crisis of Care

In 1966, I stood in a linen closet crying because I was just too scared to do a bed bath…..on a man….kind of old - probably about 40. That was the crisis I had to deal with. 

Telling my dad that I was quitting nursing was the alternative. Just over twenty years later, there was another critical point in my nursing career. Yes, I continued in nursing. That crisis was on a medical unit in Regina. I wanted to know how, with nursing process, to care for patients in alcohol withdrawal. So I moved to Texas. There was no nursing education specific to alcoholism, however I did get experience in a treatment center. Nurses were in treatment centers, not hospitals. And yet, alcoholics and those with drug addiction frequently require medical care for the medical effects of alcoholism and/or drug addiction.

Today, there is another crisis in the world of nursing. In the world of health care workers at any level.  On the streets, in the ambulances, in emergency rooms. Fentanyl, prescription opiate and illicit opiate abuse. I’m not sensationalizing when I say the people are dying out there. Withdrawal management, better known as detox, is alive and well whether in hospitals or detox facilities. I have told many patients over these last many years that I will take care of them as many times as is needed. I have told them that relapse is not a shame but part of the process of addiction. This brings me to the next crisis in the world of active addiction. It has become so much bigger than that first bed bath. And it really is not my crisis.

We, within health care, have the knowledge, tools and abilities to treat the medical effects of this dreadful condition that spirals into so many other medical conditions. We are saving lives…..over and over again. For those that still have loving families, employment and community support systems there is some hope. Hope that a new life, a good life, is a possibility. And then there are those whose bridges have all been burned or are at least severely damaged. Those that are homeless, jobless, with no family. And yet we save lives.

I am reminded of Ebenezer Scrooge when he relegates them to ‘work houses and prisons’ and ‘if they would rather die then let them’. Is that where we are now? And yet we still ‘save lives’. And where do these lives go? The ones that are homeless, jobless, and with no family. Has society even thought about the personal addiction treatment that is needed alongside valuable medical management? In five decades, my limited view of how we have progressed past the stigma, to identify the chronicity of this condition, is that we are still blinded by the brilliance of controlling substances. We seem to have completely forgotten the individuals, the families that have been devastated by the conditions of alcoholism and addiction. 

To begin to mend this crisis, treatment centers, outpatient clinics and more importantly affordable homes are required. Housing and funding. For those that have housing, their ability to maintain clean and sober time increases, the quality of recovery is improved. Is this an easy task? No. It will require a complete restructuring of our attitudes and our ways of thinking in our increasingly complex system of health care.

“Sometimes you need a little crisis to get your adrenaline 

flowing and help you realize your potential.”

~ Jeannette Walls, The Glass Castle