Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) – Part 1
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Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) – Part 1


The following program is presented by the
Injury Prevention Institute of the Emergency Nurses Association “SBIRT” stands for screening. How often you drink on a weekly basis Brief Intervention When you do drink, how many days? And referral to treatment. How many drinks you have at that time, how
many days a week you drink. I’d like to think that even someone asking
more of those questions would have made me look and say “what am I doing?” We do it without knowing we drink to the excessiveness
where we get stupid or we just don’t care I believe. And that’s not even to say that what that
particular behavior is, is wrong or right. They had to bring it to my attention. A lot of patients don’t know how to help themselves,
or how to even make a beginning. And that’s what we give them, hope. Hope is something to look forward to. It’s
for patients to say that “I understand this is bad right now.” The nurse came across with a good attitude,
like he seemed like he cared. As a healthcare provider, I can help them
understand they’re not alone and that this can get better. You would ask the questions, they’re either
going to tell you the truth or they’re not. It’s the encounter with the message. Time
and time again it gives people the opportunity to change. Not every person is going to make a change,
but the one that does, you could have just saved someone’s life. We can help them help themselves. Regardless of how terrible the decision may
be, there’s a chance to bring life to it. There’s a chance to renew it, and there’s
a chance to make something good come out of it. I was at work, actually, and I got really
sick so I ended up going to the hospital that evening. They took me right away because I
had an asthma attack. You want to see that someone has some type of interest in you when
you get there. Sometimes you get it, sometimes you don’t. The counselor came in and he was
going to do a survey on alcoholism and how much it affects us and did I know how I harm
myself. If you can get them in a teachable moment,
a lot of times right after an injury you have a short time where you might catch something
that they’ve never realized before is a problem that you can identify as a problem and it
puts a new light on things. He wanted to hear what I had to say. So I
sat down, he started giving me these questions. One in particular he asked me, in a span of
8 to 10 hours, how long have you been drinking? I told him well 10 hours, you know? He goes
“well you drink a little too excessively.” I blacked out twice. I still can’t believe
that. Most of those patients are shocked, but they’re
also more apt to listen further, accept the brief advice, accept the educational material. I felt that I was able to talk to him so I
was glad he was there. Most people think about alcohol abuse affecting
their liver, or how it affects their health, but it also since it puts you at such risk
for injury, it’s also a health choice. Was the drinking behaviors that I were involved
with something that I considered to be a risk? I really didn’t think so. The real problem
was I didn’t know how much too intoxicated was. Those are the kind of facts that emergency
room nurses know; that the average person isn’t aware of. So while I didn’t think that
the things that I were doing were terribly risky, the reality was that they were and
I needed somebody to tell me and explain to those in a real clear way what was going on. If you provide that information to a patient,
so they decide not to make a change today but you’ve planted that seed so maybe the
next time somebody talks to them, or maybe the next time they go to pick up a drink,
they’ll identify that they might need to make a change in their life. Time management, task orientation, those things
make it very difficult to sometimes spend five minutes or 10 minutes at a bedside. My
first thought was “I don’t have time.” I can’t make this happen on top of all the others
things that I’m doing during my day. And then I realized that I’m not working at 100% all
day long every day. When I look back on my own experience of being
in the emergency room that evening, remembered so clearly the vulnerability, the openness
to hear things that I might not otherwise have been willing to listen to. Right now
I am a seminarian. I never would have imagined that I would have been capable of something
like this. Not the profile of somebody who you think would have too much to drink and
then get behind the wheel of a car. Myself and several other friends from the seminary
had gone out to a restaurant, and when it came time for us to leave, the person who
had driven was clearly too drunk to drive and handed me the keys to the car. My judgement
became impaired as a result of alcohol and reckless behavior, resulting in a crash that
eventually killed two of the men that were in the car. There’s a ripple effect that occurs with any
traumatic injury. And maybe first it affects the individual, then it affects their family,
their friends, their jobs, their co-workers, it affects multiple aspects. If I can help
prevent that one injury from occurring, I can help be a part of preventing that ripple
effect. There’s not any one particular healthcare provider that I think has a higher impact
on that. I remember what it was like to be rushed into
the emergency room and be surrounded by people taking blood, doing all kinds of assessment
of myself. In came another emergency room nurse, her name was Athena, and I remember
what it was like as she looked into my eyes and said “I know that whatever happens to
you as a result of this, you’re going to be different and you’re going to be a better
person from the experience that you’ve gone through.” I don’t think that we’re normally
ready to receive or take to heart seriously the messages people have for us. The emergency
room is a very different situation; all of our being is open in that emergency room and
nurses have an access to a private, a sacred time in our lives at which a big difference
can be made even by a few words. As a nurse you have to wear many hats so you
have to provide medical care for those patients but also interact with them and show compassion.
If they want to make a change in their life with their alcohol use, we want to provide
them with a realistic plan, and it has to be the patient’s choice, it can’t be our choice. The nurse, he didn’t come across as judging
me in any which way or form. The way that he presented himself. More or less we took
it like a joke in passing, but it was a fact. That made me realize what direction I was
going, what steps I had to take. He gave me this flyer and it was stating what alcohol,
how it affects you and I looked at it I was just like alright, you know, made me think
about it. No, I’m not an alcoholic but I feel that if I continue, I could be. It’s the same as sending a child out into
the community. We wouldn’t do that. We wouldn’t send a child out into the community without
a child safety seat. Or, we provide information to our cardiac patients about smoking cessation
or diabetics about changing their diet. I have information to give them to show them
what’s low-risk, what’s high-risk based on the information that they’ve given me. And
then I give them the information and I let them decide what it is they need to do, what
it is they want to do SBIRT is screening, brief intervention, and
referral to treatment. Screening is using a tool that identifies at-risk or high-risk
drinkers and then provides a brief intervention identifying that they have at-risk behaviors
with alcohol. And then a referral to treatment if they need to have further treatment or
they need a professional to talk to then you can refer them to a treatment center. This got started by recognizing that many
people who present to healthcare settings have never been screened for alcohol misuse
and it turns out in both hospital, and particularly ED and trauma settings like I work in, there
are many people who drink alcohol at problematic levels and most treatment in American society
is geared towards people who really are dependent on alcohol, whereas if we can detect people
with alcohol use disorders, or even the potential for developing alcohol use disorders, we can
actually provide very short forms of therapy that can alter their problematic alcohol use
later and decrease their chances of them becoming dependent drinkers.

One Comment

  • Md. Shakir Ahmed Shohag

    ▬▬► Hi friends. If yyyyou or a loved one needs help with drugs or alcooohol addiction CALL ►►► 1-888-966-2616 (Toll-Free)
    Don't wait until its toо late where there is life there is hope peace and blessings!

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