I’ve been working as a correctional nurse in a county jail for 8 years. One phrase that seems to come out of my mouth time and time again is “It’s not always detox.” I have learned that even though the signs and symptoms of any condition could be right there slapping you in the face, there could always be something hiding in the shadows.
A few years ago I had the privilege of working as infirmary dayshift charge nurse. During report the off-going charge nurse told me of a patient with a history of drug abuse. Due to the amount he used he was automatically housed in the infirmary and treated for detox. He was approximately three days into the withdrawal protocol but not showing much improvement.
When I assessed him he was lying in bed – a slender white male in his mid-40’s. As he sat up I could see he was weak with fine motor tremors. He denied any specific symptoms, but said he felt sick. A little over a week ago he was diagnosed with tonsillitis and never fully felt better. He reported feeling worse the last two days. His blood pressure mildly elevated and his pulse was in the 140’s. I made a call to the doctor immediately. His diagnosis after we drew stat labs was acute Hashimoto’s thyroiditis. With treatment, he was like a new man. He left the jail being diagnosed and treated for an illness he had no idea he had; and he was fully detoxed from a drug that took over 20 years of his life.
One thing I have learned working corrections is sometimes there will be a zebra in your herd of horses. You always need to keep your eyes open in case one comes your way. Also don’t always assume” it’s just detox” when a patient with a drug history is looking and feeling ill because sometimes IT’S NOT!
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