Interview

What type of agency did you select and with whom did you speak?

     I had the opportunity to speak with Steve, a Registered Nurse who works in the mental health unit of Lancaster General Health (inpatient hospital).

What types of services are provided to individuals who may be struggling with an addiction?

     Services include medications, support groups, and therapies. Since this is an inpatient hospital, nurses provide all medications to their patients, which is related to their condition and addiction symptoms. Some individuals that are addicted to nicotine receive gum, patches, and/or an inhaler. The inhaler provides them with the enough nicotine to satisfy the cigarette craving. It also is comforting because you hold it like a cigarette and it has a similar appearance. There are specific AA meetings held at night for those individuals who wish to attend. Therapy sessions are also offered by social workers, psych techs, and nurses to work on recovering to eventually be discharged out of the facility.

What is the agency’s framework for providing services?   

     They provide a 12-step AA program, but the main focus is recovery based. They focus on intervention, prevention, education, assessment, and referral. The groups throughout the day usually focus on two or three of the topics previously mentioned. The first step is to stop using the drug. Some individuals need medicines to manage their withdrawal. Then, they focus on staying drug-free, and this is aided with therapy and group counseling along with other medicines if needed. The next step includes changing his/her life so that they can recover. This involves changing their environment, who they are with, and what they are doing. (They do provide direct services such as counseling and medication because they are an inpatient hospital, which indicates 24-hour care.)

How many clients does the agency serve on an annual basis?

     Steve was unsure of the number annually; however the agency serves about 32 individuals a day with a length of stay being about one week. Some individuals are there for a shorter period of time, others are there for a much longer time period; it depends on the person, illness, and determination.

What are the legal and ethical guidelines that impact the work they do with clients struggling with addiction?

     Legal guidelines include if they need isolation or restraints. If they do require any form of isolation or restraints then there is legal paper work that needs to be filled out. The paperwork is seen in court by a judge and will indicate a mandatory longer stay in the hospital. Ethically, some of the individuals are pending criminal charges on a day to day basis and helping professionals should not judge them and try their best to help them. For example, one man is a registered sex offender, drug user, and just recently had a failed suicide attempt. Regardless of his past, as a helping professional, they are still required to give them the best quality of care. 

How long have you worked at Lancaster General?

     Steve said that this was his first job out of college (Penn State), and he liked it so much that he has been here ever since (32 years).

Do most of your patients have Co-occuring conditions?

     Steve said that the primary reason the individuals get admitted to the hospital is because of a mental health reason; however, the majority of the individuals have an addiction to drugs and/or alcohol.

How do the majority of your patients come in?

     The majority of the patients come through the emergency room, whether they enroll themselves or are brought by a family member or police.

Where do the majority of your patients get discharged?

     The majority of the patients get discharged back to his/her home.

How does your experience connect to information you have learned through assigned readings and in-class discussions?

     My experience connected directly to in-class discussions and assigned readings. We read about treating the individual as well as the family and therapy (at the hospital) addresses both, as they are a big part of the recovery process. Also, as we discussed in class, co-occuring disorders are difficult to helping professionals. This was a common theme at the hospital as well. Steve mentioned that differentiating between signs and symptoms of the mental illness or the addiction are difficult at times, and that majority of the people do have both an addiction and a mental condition. Steve also mentioned that many of the therapies are based around coping and managing triggers and cravings, which is something we spoke in class about. He said that because we are discharging these individuals, it is important to teach them life skills that will help them stay healthy. (He used the metaphor, of if you give a boy a fish he will eat for a day, but teaching the boy to fish will allow him to feed himself for life.)