ASSESSING PATIENTS One of Adarkwah-Yiadom's primary roles at the detox facilities is conducting nursing assessments of each client's physical condition and nursing follow-up. Conducting patient assessments is a vital skill that physicians and nurses learn through clinical experience. It's a combination of “what the client is telling you and what you see as well,” Adarkwah-Yiadom says. Depending on what symptoms are observed in the physical exam and urinalysis, the physician overseeing care may need to make adjustments in the dosages or types of medications the client is being prescribed. Some patients may have also been using other drugs, often illicit street drugs such as cocaine, marijuana or benzodiazepines, Adarkwah-Yiadom says. “Some of them are impaired when they arrive here.” Of course, some drugs still have a measurable presence in the body for some time after a person discontinues use. But the results of blood or urine analyses can show whether levels are gradually dropping, indicating that a client has discontinued use. For example, “THC (tetrahydrocannabinol) stays in the urine for some time. If the (test) numbers are coming down, I can tell that the patient is doing better, but if the numbers are going up, that might indicate they will need inpatient treatment.” The detox process is designed to manage opiate
abusers' acute intoxication and withdrawal symptoms. The detox process needs to be tailored for each client, based on his or her physical and mental condition and individual needs, Adarkwah-Yiadom notes. Medication-assisted treatment, with naltrexone or buprenorphine, is also part of the care delivered at the clinic. MAT addresses both physical dependency and addiction by reducing the severity of withdrawal symptoms and helping return normal brain function. Other “support medications” are also used to help relieve the physical effects of withdrawal. The nurses' job also includes educating clients, providing information about dealing with withdrawal, side effects and other aspects of addiction and recovery. Once they are safely detoxed, most clients go through intensive outpatient treatment, four days (or evenings) per week.
“The caring aspect of nursing is what interested me.” – Stephen Adarkwah-Yiadom | Nurse, Eva Life Giver detox center 55
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