Something I found horrifying when I started nursing school, was that many nurses end up having substance abuse problems. As a new nursing student they teach you all the harm smoking, drinking, and other drugs can cause to a body. Good heavens, it seems like smoking is a risk factor for damn near every cancer, disease, and ailment known to man. Likewise, alcohol and street drugs (including marijuana, though that is debatably "street" depending on which state you're in...) are also risk factors for so many ailments that the three things cannot even be a test question because the answer would be "all of the above" or you'd have to select all options on a "select all that apply" question.
Learning these, and then hearing that nurses become dependent and/or abuse alcohol, tobacco, and other drugs (street and prescription) was absolutely shaking to my foundation. Keep in mind that I was under the legal drinking age and had not ever been drunk or had a drink for the first year and a half of nursing school and the whole year I spent on prereqs. That's about 2.5 years of college without drinking while those around me drank whether of age or underage.
I was also in a glorious little bubble where the hymns at church speaking of suffering meant that I suffered at the hands of friends ignoring me for a couple of days because they didn't like what I was wearing, or they happened to be PMS-ing that day and had it in them to focus all of their evil menstrual rage in my direction. This happens for males and females alike, don't worry.
As I went through more and more college, and became old enough to be "legal," it became acceptable for me to responsibly consume ethanol (drinking alcohol). You learn pretty quick that it calms down your mind, dancing is more fun (or actually possible with someone as uptight as I am), and life slows down and relaxes for a moment. Is this healthy? I think it is okay in moderation. The danger zone comes into effect when it is your daily routine, you have to drink in order to "wake up" in the morning, or you begin to use alcohol to get through anything you may be going through in life. These are excessive. Quite frankly, there is a very fine line between okay and absolutely not okay. It is even easier to cross over said line and take it to an unhealthy level.
It is frowned upon for anyone to smoke, let alone doctors/nurses/other healthcare professionals. However, if you talk to those who smoke, nicotine provides and instant period of relaxation. They can be having a mental breakdown or they could have experienced a hugely traumatic event and smoke a cigarette and then they can breathe and calm down for awhile. Do cigarettes have carcinogens, increase you risk of having a stroke, and cause powerful addiction talons to dig themselves into your life and drain the money and life right out of you? Yes, they probably do. However, keep in mind why people begin smoking in the first place. You don't know what life struggles they face and what kind of things have happened in their life collectively to bring them to the place they are now. This is difficult to remember when the 30 year smoker is demanding another nicotine patch after an hour of putting on the first one while they are also asking you (the nurse or health professional) for a cigarette.
Prescription drugs and "street drugs" can be seen similarly. They can provide a high and an escape from reality.
The thing with all of these substances is that they are very dangerous and problematic for those that use the substance. It doesn't matter if it is alcohol, tobacco, prescription drugs, street drugs, or any other type of mind altering substance. These things can be very dangerous and addicting. However, before you judge someone for smoking, drinking, or using, remember you don't know their story.
I have at least a triple threat of alcoholism and substance abuse because: 1) I am the daughter of an alcoholic and have a long, extensive family history of alcoholism, 2) I am going into nursing which is a terribly difficult career and lifestyle choice, and 3) I have been raped, sexually assaulted, and severely abused (mental, physical, sexual, and psychological [pretty much all of them]) for a year with boys and longer with others in my life that I will left unmentioned. I am also the daughter of a smoker with a long, extensive family history of smoking and other substance abuse.
I have the deck stacked against me. My mind never shuts off. Maybe some of you know what this is like, but I pray none of you do know this pain and the daily struggle of fighting through the constant noise in your head to just get out of bed and possibly get food or water each day. Don't even go into needing to be a sister, solid daughter that helps, a student, and the other various roles I've had to fill. I will admit to having the occasional margarita with friends after class, during happy hour. We are stressed, we are looking for opportunities to hang out and decrease some of our tension. This is enough to want to take some time and quiet our brains. Add in anything else (being a parent, having family/friend drama, trauma, abuse, and anything else) and you have exponentially increased the desire to have a drink and calm down.
It can be easy for anyone on this earth to feel stressed enough, at one point or another, to desire a way of release. Each person has a way they find that tension relief. All I ask is that you don't judge when people are under your care that have smoked, have a history of alcohol use, or a problem with using. Yes, these things are self-inflicted and they cause so many of the problems we see in hospitals. It is easy to blame a behavior instead of understanding the reasoning behind a person's behavior. Having been through what I've lived through, I have had my mind opened to being so much more understanding to those who use or have a history of using substances. Hell, some nights, the only thing that will shut my brain up for a solid 5 minutes is having a drink and appetizers with friends that I trust.
Don't get me wrong. I do not condone drinking and driving, smoking, using drugs, or getting prescriptions to fulfill a person's desire for prescription drugs. I am not supporting abusing substances in any way. I'm just saying, you don't know why someone started using. Chances are, they understand how bad their substance is for them, but you don't know what is going on in their life or what is happening in their head. My head is a constant "war zone" of sorts. I can't explain exactly what happens, but I have constant flashbacks of the guys that have hurt me, my friend committing suicide, the voice telling me I am unwanted/unlovable/worthy of death or lifelong solitude, and a myriad of other terrible experiences. In the world, you can use music or physically move to change your surroundings. When the bad things that happened to you are constantly replaying in your mind and dreams, you have no way of controlling the thoughts that bombard you whether you are awake or asleep.
You don't know the abuses, the pain, or the circumstances anyone has had to live you. You don't know. There is no way to actually be able to completely convey what a person has lived through.
My point: Please, just don't judge anyone.
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