Assessment is the first part of the nursing procedure and after conducting the process of assessment, care plan can be formulated. The essential requirement of accurate assessment is to view patients holistically so as to identify their exact needs. Thus, in such respect the present research study has been describing drug and alcohol nursing assessment for a patient called James who is 34 year old male and is admitted to A&E department. He is found with his friend Bill and both of them usually go for drinks once in a week.
At the time, Bill says that when he picked up James at his house, he and his house found messy and the bin was also overflowed with bottles which shows that James usually drinks too much. Bill also reported that when both of them were out of the car, James fell to the ground. Thus, according to the present situation of James, care plan has been formulated through which proper care will be given to James so that he can get rid of drug and alcohol consumption habits.
Therefore, accordingly discussion has been included regarding relevant points about James’s presentation. Appropriate information has also been collected from diverse sources so as to complete the drug and alcohol assessment for James. Similarly, emphasis has also been given towards important issues that might occur in James’s treatment. Lastly, researcher has formed a nursing management plan for treating James in the best possible manner.
Identify relevant points regarding James’s presentation
As per the case study, it can be said that James always drink excessively which in turn leads to unconscious state. Bill is his one of the close friends whose company drives him more to go for alcohol consumption. Both of them have been drinking since their university days and this made James addicted towards alcohol. While giving any sort of medical assistance to James, it is vital for the health care practitioner to find out the actual causes and problems that happened to James. Further, actual state of James is also required to be found out so that he can be provided suitable care and treatment.
As observed, James was not able to stand properly and he fell down after getting out of the car. Thus, it clearly shows that James is addicted towards alcohol. Further, looking towards the present situation, it can be predicted that James might be taking drugs as well along with alcoholism. This, is not only hampering his present situation; but is also leading James towards critical health situations. Thus, at early stages it is essential for James to stop this habit so that he can move towards healthy life.
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Outline further information that might be needed to complete the drug and alcohol assessment
Treatment for a drug or alcohol problem usually begins with an addiction assessment and basically this assessment is conducted so as to determine the co-existing conditions with this assessment. There must be proper interaction between patient and nurses so that the actual situation of the drug consumption can be identified. In the drug and alcohol assessment, professionals needs to be trained so that they can diagnose addictions typically through carrying out drug and alcohol abuse assessment in private settings.
Thus, in the case of James as well, nurse and care practitioner is required to conduct a private session so that hidden information about the patient and the habit can be ascertained. Further, the nurse must also ensure that they are keeping confidentiality and the information is used only for treatment procedure. In the present situation, nurses are required to focus on CAGE assessment technique which includes major categories of ascertaining the addiction of patient.
- Cutting down on drinking: During such question, the practitioner should ask James if he ever felt to cut down the practice of drinking.
- Annoyance because people criticized your drinking: Nurses are required to ask if James ever felt irritated when people criticize his drinking habits.
- Guilty feelings: It is crucial for the nurse to know that if James ever felt guilty of his drinking habit.
- Eye – openers: Herein, it is vital for the nurse to ascertain if James ever felt the need to drink immediately in the morning.
Hence, conducting this assessment is essential in this case as that will assist the nurse to ascertain all the needs of James during different time period. This is also vital in terms of identifying the needs of patients and according to that changes can also be made to James’s schedule. It is also essential for the nurses to conduct drug and assessment because the manifestation and development of alcohol and drug problems involve a complex combination of biological, psychological and social factors which are unique in each individual. At the same time, it is essential for the nurses to acquire information about James personal life regarding how well he is managing his life.
3 Differential diagnoses for James presentation
According to the present condition of James, it can be said that it is crucial for the nurse to diagnose the situation in effective manner so that proper services can be rendered accordingly. There is a direct relationship between alcohol and bipolar disorder and it also holds importance in dual diagnosis. Any individual who presents with significant mood fluctuations must be screened for an alcohol use disorder. Thus, it can be said that there are three major differential diagnoses which exist in the present case of James. Panic disorder, generalized anxiety order and bipolar disorder exist in the present situation of James. Alcohol abuse or independence might reflect self- treatment for these conditions. It can also be said that James is taking much level of alcohol and along with that, he is also taking drugs similarly in the same quantity.
This might have changed his mental status and as a result, he is developing other disorders. Thus, considering the situation, it can be said that James is having co-morbid disorder under which several problems are there. It is also analysed that depression, anxiety and antisocial personality all are more common in persons with alcoholism than in general population. Thus, the relationship among all such disorders is required to be analysed so that actual situation of James can be ascertained. Moreover, it can also be said that Bill has also confronted that James usually drinks too much and most often they go out for drinking. There might be different situations that is happening with James and because of that he got addicted for drinking.
Thus, according to the present situation, it is vital for the nurse to analyse the exact problems that is prevailing with James. Nurses must also consider that in order to deliver prominent treatment to James, it is crucial to develop suitable interaction so that all the aspects can be analysed suitably. However, nurse should also realize that issues and challenges may also arise at the time of delivering services to James as he is drug and alcohol addicted patient. At the same time, nurse must set out suitable nursing intervention for James so that accurate and suitable care can be provided. While developing nursing care plan, it is crucial for the nurse to ascertain that dealing with alcohol problems is not easy as it requires lot of encouragement and motivation. The nurse must have to develop convincing skills so that to assist James to quit alcohol and drug consequently.
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Analyse important issues in James’s treatment and create a possible nursing management plan
Since, James has admitted to A&E department; therefore it is clear that his condition is quiet critical. Thus, looking towards the condition, nurse should prominently address how the habit of alcohol can be resolved in the case. Thus, at the time when nurses are dealing with James, they have to consider the fact that a person who is drug addicted will take time to quit it. Thus, several issues may arise consequently. While dealing with James, it is possible that James may not respond properly in the situation due to lack of interest. Thus, his in-activeness can bring certain issues in the case. Further, unavailability of information can also be one of the challenges in the case. Nurses are required to acquire all sort of information about James regarding his past and present situation as then only, the actual reason for alcoholism can be identified.
Similarly, nurses can also experience problems if James will not adopt the routine that is being given to him. For instance- if the nurse has asked to present on the counselling session; then it becomes mandatory for James to consider the same. However, failure of such thing can bring several issues in the nursing procedure. At the same time, nurses can also face problems because due to improper scheduling. It is also possible that within the scheduled time period, other nurses and counsellors are not present. Thus, it may hamper the entire procedure of nursing and as a result it may also lead to failure of addressing nursing problems.
Reflect on how your own attitude, values and personal experience might influence the practice when caring for a client with drug and alcohol problems
While working on this case, I can say that it is highly difficult for the nurse to treat with a patient who consumed alcohol excessively. While working on this case, I came to know that alcoholism is one of the most important issues that needs to be prominently addressed as that hampers the health aspects in the most affecting ways. At the same time, I can also say that the patients who are alcoholics needs to focus more on keeping themselves busy so that they can get rid of the habit of smoking and alcoholism. In this context, I can also say that I have analysed different methods through which the habit of alcoholism can be improved.
However, while speaking to James, I also came to know that a person when start consuming alcohol, it takes less time to become addicted. Similarly, I also realized that it takes much time to encourage the person so that he can quit alcohol and drugs. Therefore, while working on such case I realized that I must be a motivating personality so that I can deal with drug addicted patient. This will also assist me to guide others as well to quit smoking. Moreover, I need to focus on delivering information about ill impacts of drug and alcohol consumption so that people can realize that whatever they are doing is dangerous for their health.
Further, in this context I also realized that the person who drinks excessively should get assistance from physical activities and therapies. This is also essential for the purpose of distracting the patient from drinking and drug consumption. However, I can also say that in such a case, it is essential for the care practitioner to conduct a thorough analysis so that the actual situation of the patient can be analysed. In such cases, I will be analysing the past situation of the patient so that accordingly nursing practices can be carried out. Moreover, in this aspect I can suggest that proper relationship should be developed with the patient so as to deliver optimum care. The most important thing that I would like to state is that people should never get to alcoholism when they are depressed or distressed.
Possible strategies that can be employed to overcome such attitudes and values
In general, the issue of drug and alcohol is difficult to treat; hence several problems will be coming in this situation while dealing with James. However, there are possible strategies that can be adopted for the purpose of dealing with such aspects. In the below mentioned section, discussion about a few strategies are being discussed:
- Appropriate involvement in physical activities: It is essential for the nurses to involve the patient in physical activities as sports activity can distract people from alcoholism and drug consumption. At the same time, this can also bring numerous health benefits to James respectively. Interesting as well as suitable exercises can be employed in the present case of James as well so that he can try to engage himself in other practices.
- Proper communication with alcoholic patients: It is also vital for the nurses to develop proper communication with alcoholic patients so that the relevant information about the case can be adopted. Thus, accordingly in the present case as well nurse must communicate suitably with James so that he can specify all such health problems which are prevailing in James.
- Scheduling timely counselling sessions: It is vital for the nurse to schedule timely counselling session so that improvements in the activities and habits of James can be identified. Similarly, this is also useful for the purpose of identifying suitability of nursing intervention.
Concluding the entire research work, it can be said that prior delivering any medication or care services to the patient, it is essential for the nurse to collect past and previous history of the patient. This is highly useful for reducing the health problems prevailing in patients regarding alcohol and drug consumption.
- 8 Substance Dependence and Abuse Nursing Care Plans. 2014.
- Alcoholism Differential Diagnoses. 2016.
- DRUG ADDICTION ASSESSMENT. 2017.
- Evans, E.A., Grella, C.E., Washington, D.L. and Upchurch, D.M., 2017.