Clinical placements

Observing other nurses helped improve my understanding of alcohol dependency

Caring for a patient with alcohol withdrawal syndrome prompted nursing student Ellise Jaques to learn more about alcohol dependency and improve her practice

Caring for a patient with alcohol withdrawal syndrome prompted nursing student Ellise Jaques to learn more about alcohol dependency and improve her practice.

My first placement in my first year of nursing training was on a gastrointestinal/hepatology ward.

Understanding alcohol addiction
Understanding alcohol addictions. Photo: iStock

Alongside my mentor, I was caring for a patient who had been withdrawing from alcohol since admission to hospital the previous evening. 

The patient, who I will call Steve, was 30 years old and had been alcohol-dependent for about 8 years. He had post-traumatic stress disorder triggered by his time in Afghanistan working in the military, and had started drinking as a coping mechanism. 

Steve, who also had suspected liver disease, was experiencing delirium tremens and refusing to take medication to control his symptoms.

He was hallucinating and being aggressive towards staff and other patients and sometimes grabbed the drugs trolley trying to find alcohol.

Unerving situation

The other patients in the bay were frightened by his behaviour, and I was unsure what to do. My lack of understanding of what patients go through when experiencing alcohol withdrawal, coupled with little nursing experience, made me feel intimidated by Steve and I was unnerved by the situation. 

Steve’s family were upset to see him in such a confused and uncontrollable state, and didn’t understand how it had happened.

His wife was completely unaware of his addiction, and we later discovered that he had been disguising alcohol in Lucozade bottles hidden around the house. 

Steve was not allowed to leave the ward because he was considered a danger to himself and others, and was under deprivation of liberty safeguards.

Security staff trying to physically restrain him exacerbated his aggressive behaviour, and the use of touch by the nurses to calm Steve also worsened his aggression. 

Calming environment

But when a mental health nurse came to see him, he started to calm down. The nurse used verbal de-escalation techniques and discussed the importance of taking his medication.

Steve was also moved to a side room to provide him with a calmer environment, and from this point he agreed to take his medication regularly to control the withdrawal symptoms.

On reflection, I felt I hadn’t delivered the best level of care to Steve. But after observing how the other nurses cared for him and his family, I learned some successful approaches. 

Following this experience, I also attended an alcohol awareness study day where I talked to patients about what it is like to detox in hospital. Understanding the patient experience, both physically and psychologically, helped me strive to deliver optimal care for this patient group. 

Second chance

I was able to put my learning into practice when I experienced a similar situation in my third year of training.

As I could understand the condition better, I communicated effectively with the patient, referred him to the alcohol liaison team for the best advice, and ensured a prescription for a chlordiazepoxide regime was in place.

As a qualified nurse, I aim to screen my patients for alcohol intake where possible so that withdrawal symptoms can be controlled in a timely way and patients can be treated with dignity and respect. 

About the author

Ellise Jaques
Ellise Jaques qualified as an adult nurse from the University of Southampton in September 2016. She starts her first job in October on a head and neck/plastics ward in Kent

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