A unique nursing role in the Beaumont Hospital is tackling the chronic problem of people ending up in hospital due to their drinking habits. Liz Gilligan is the first alcohol liaison nurse in the country and sees approximately 700 patients in a year.
Patients may present at hospital with other issues such as seizures, falls, gastro-intestinal disturbances. However, Liz will step in if the underlying cause of the problems is alcohol abuse. “My role is to help anyone who is admitted to Beaumont who has alcohol abuse issues on their journey through the hospital and ensure we make it the best it can be,” she explained.
For example, if somebody falls when they are drunk and sustains hip fracture, I will manage the alcohol issue while the fracture is being repaired. I will meet with the patient and discuss their alcohol use. If they wish, I will refer them on for further help in the community and will create a treatment pathway before they are discharged. If I refer somebody for rehab, I will make sure the rehab people make contact with the patient by phone prior to their discharge from hospital. It is so important that the initial contact is made so the patient doesn’t feel as scared or intimidated by the process ahead of them.
“I also help with family members. Often they have had enough of their loved one misusing alcohol and are desperate for us to “fix” their relative. If the person refuses to stop drinking, it is important to look after the family too and I would refer them on for counselling to help them.”
Some 30pc of Emergency Department (ED) costs are alcohol-related. The Department of Health found that annual alcohol-related illness cost the healthcare system €1.5bn. In EDs countrywide, every night there are between 300 and 600 trolleys occupied by patients with alcohol-related issues.
Liz highlighted the importance of intervention to reduce incidences of alcohol-related admissions. “It is good to have somebody to address the issue. Ideally I would like to see three Alcohol Liaison Nurses in Beaumont to ensure there is always an alcohol liaison nurse on duty, especially at the weekend. It is important to talk to the young man who comes in with the broken jaw after a drunken fight, to tell him that he is a harmful drinker, it is dangerous and that he needs to pull back.”
While her background is in general and psychiatric nursing, Liz’s position is attached to the Office of Liaison Psychiatry, working alongside Consultant Liaison Psychiatrist Dr. Siobhan McHale.
She explained that education is a key part of the alcohol liaison nurse role. “I educate student nurses, graduate nurses, medical students, and those in the TY programme. You cannot be effective on your own, you need to cascade your knowledge to other staff members. ” said Liz.“Now the nurses know the protocols and can ensure implementation of these when I am not here. The aim is to have one person on every ward who knows what to do in terms of detox guidelines doses.”
The role itself has effectively been shaped by Liz herself through assessing what is needed. The role was developed by Consultant Liaison Psychiatrist Siobhan McHale. She previously worked in Edinburgh where they had these well established nursing roles. She believed that it would work well here too. Liz travelled to Edinburgh and shadowed three of the alcohol liaison nurses there.
Siobhan explained that there are plans to expand the services. “The Alcohol Liaison Nurse CNS post is a core part of the Liaison Psychiatry team. The post was prioritised in response to the escalating numbers of patients presenting with alcohol related problems, as well as the significant behavioural disturbance associated with many of these admissions,” she said.
It reflected national increases in alcohol presentation to hospital, including a recognition that up to a third of all male in-patients have alcohol-related problems. There is national and international evidence for the cost effectiveness of screening and brief intervention following referral to an a role like the alcohol liaison nurse.
“Liz’s work has contributed to a reduction in the numbers of alcohol-related admissions, contrary to national trends, as well as average length of stay. The response to the post has been extremely positive throughout the hospital”
If you need support, call HSE Alcohol Helpline 1800 459 459 Monday to Friday 9.30am to 5.30pm or email email@example.com
For information on how alcohol impacts your physical and mental health, visit www.askaboutalcohol.ie