David Childs was a self-taught IV expert. He'd had enough practice, shooting drugs into his veins for more than 40 years. It wasn't an adjunct to his life; it was his life. Using was his work, his play, his mission. He lost his wife in the bargain, but no matter. His soul belonged to a mistress called heroin.
Now 65, Childs is clean - has been for 13 years. Chalk it up to another woman, an RN in the addiction unit at Penn-Presbyterian Medical Center (PPMC), Philadelphia.
"I'd been suffering with drug-related abscesses on my legs," recalled Childs of a period in 1996. "After medical treatment and a detox period, I was referred to PPMC for rehab treatment.
THE CLEAN TEAM: Nurses in the addiction unit at Penn-Presbyterian Medical Center, Philadelphia, work with patients who are addicted to drugs or alcohol. Addiction nurses need to understand addiction is a disease, says Marjorie H. Lehigh, MHA, MHEd, BSN, RN, CHES, nurse manager of this unit.
"Was I resistant? Absolutely! I didn't want treatment!" admitted Childs. "I had 'attitude.' I was selfish, arrogant, 'entitled.' I wanted special treatment yet I was indifferent to the help I was getting.
"Then one of the nurses stepped up in my face and said to me, 'David, if you don't want to be here, you can just leave.' It still stops me in my tracks to think about it. Her attitude was monumental. I knew then I could leave, go back to using and just die. Or I could stay and get help.
"I stayed. And look at me. I'm still here."
Indeed, David is on the addiction unit team as an alumni volunteer, conducting a twice-a-month group meeting to help other addicts turn their lives around.
And that RN who helped David tame his addiction?
She is replicated throughout the Penn-Presbyterian addiction unit.
"I have a remarkable team, completely dedicated," said Marjorie H. Lehigh, MHA, MHEd, BSN, RN, CHES, nurse manager. With 390 admissions a year often keeping her 18-bed unit filled to capacity, Lehigh has staffed her unit carefully.
"An addiction nurse has to be here for the right reasons," she explained. "It can't be personal - for example a sibling may have an addiction and a nurse wants to learn how to deal with it. And it can't be because she thinks it's less physical. less lifting. Those people don't get hired. This is not an 'easy' job, and there are 'physical' moments. I look for people with field experience, combined with compassion and a deep understanding that addiction is a disease. It takes a certain type of personality."
'You Can't Be Wimpy'
Miriam P. Yorkman, BSN, RN, CARN, knows what it takes to work in this field; she has been an addiction nurse at PPMC for 13 years. "You can't be wimpy in this specialty," she offered. "You can't allow others to manipulate you, and you can't be thin-skinned. Addiction nursing has its own set of skills, a whole different language. I've been in addiction nursing for years, and if I ever leave here to go out on a med floor, maybe I'd just be too flippant. I have to be confrontational with my patients. I let them know they can't get one over on me. I let them know that yes, I want them to get well, but no, they cannot break rules."
Addiction patients require nursing patience. "They create their own demons and put themselves into a bad light in society and the medical community," said Yorkman. "They can make themselves nuisances when they come to the ED, acting out. They can really be very ill, but how would an ED nurse know they aren't med seeking? Our clients are so hard to handle sometimes; it can be so frustrating. And yet, when I get up in the morning, I know this is what I love to do, and what I must do. Talk to the other nurses on the unit. they all feel the same way."