If you find yourself in the hospital and the admitting nurse
asks how frequently you use alcohol – tell the truth. If the same nurse asks
you if you take anything for anxiety – like benzodiazepines – and you take more
than your allotted daily dose, fess up. The nurse or doc isn’t there to judge
you. They want to keep you safe while you are in the hospital. They have
probably seen and heard it all. But, be honest because if you end up being
admitted to the hospital and you normally drink or take more medication than
you said to make yourself look better, this may happen to you:
You may have a fairly uneventful first day and even second
day – a series of tests, lab work, standard stuff…and then your night nurse
arrives. You seem a little anxious but are pleasant. Then your family leaves
and you start getting more restless. You tell your nurse you are feeling short
of breath and finding it hard to get enough oxygen. You start to get a little
agitated. The nurse thinks your lungs sound pretty good but puts some oxygen on
you and calls a respiratory therapist to come see you. The respiratory
therapist concludes that your lungs sound good and you just appear to be very
anxious. The night progresses.
You beg your night nurse to help you because, although
everything appears ok – vital signs stable, labs decent – you are sure you are
dying. This concerns the nurse and she starts looking through all the notes a
bit more carefully. There is a vague mention of the possibility that you use
more anxiety medication than you have been prescribed. There is another fuzzy
mention that you might experience withdrawal while in the hospital. The possibility
seems a bit remote so the doc doesn’t put any ativan (common for anxiety) on
your medication list so you can taper off. Withdrawal isn’t pretty or always
safe so, typically, it is a slow weaning process. Not in this case. There is
nothing to taper so the nurse tries to reassure you that you are okay and maybe
you could take some deep breaths and get a little sleep? No such luck because you used the ativan to sleep and now you don’t have any. Pretty soon you are
constantly on your call light. You want the nurse to sit with you and are
appalled that she has four other patients who want some attention.
Pretty soon you are calling 911 and asking to get admitted
to the ER. What you don’t realize is that when 911 gets calls from patients already
in the hospital, they alert the hospital. So, the nurse is made aware that you
are calling 911. She goes in to ask you what you are hoping for from 911 and
you tell her you want to go to the ER and she should take you – right now. You
insist. You don’t care when she tries to explain that you are already in the
hospital. You are getting help and being followed by the doctors in your
current location. You are no longer rational. You strip off your clothes and
run into the hallway naked. Why not? Then you realize you can’t leave the hospital
naked so you put on your nylons and heels…quite a fashion statement with the hospital
gown. You insist you are leaving. The nurse tells you it isn’t safe to walk out
on the streets at 3 in the morning with no family here to take you home.
The
nurse realizes that you are delirious and the doctor needs to be notified. The possibility
that you are withdrawing now seems to be very real. The doc is roused and the situation
explained. An order for ativan is secured as well as some labs. The
problem seems temporarily solved EXCEPT you are too agitated to agree to take
the ativan. Much to your nurse’s dismay, you refuse. You insist that you must
talk to your family and you are sure they want to hear from you at 3 a.m. So,
you call. Your family, bless them, calms you down and reassures you that the
nurse is there to help you, not harm you. You decide to take the ativan. You
settle down and get a few hours of sleep. Meanwhile, you have given the night nurse gray hair that she did not need. Now, wouldn’t this have been much
easier if, in admitting, you had just disclosed to the use of a little extra
medication to help with anxiety?
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