Student Name: Dave Jay S. Manriquez April 11, 2016Class No: 201509

JOURNAL (WEEK 1)

Observation: Today I noticed that some residents are lining up and asking for an alcoholic drink to the nurse. The LPN I am shadowing told me to go with her to their MAPA (Managed Alcohol Program Administration) room to help her serve the alcoholic drink. When we arrived inside the room she told me to take a baseline temperature to the residents that is under the program. They have a non-touch scanner to use to take the temperature. I am only taking the temperature for the residents who will be having their first drink on a 24 hours cycle. Inside the room they have a very big fridge where they put the alcoholic drinks to be serve cold. They are serving vodka, white wine, and a beer depending to the resident’s choice as being outline by their program and approved by the doctor who prescribed it to them. After serving their drinks everything should be documented on a sheet of paper that they have in the room, this will enable the nurse and mental health worker to track down how much alcohol the residents consume throughout the day. Every resident’s that is in the program has maximum amount of alcohol that they can consume in 24 hours, if they reach their limit in that particular day they are no longer being serve. The one serving the drink need to affix his/her signature, what kind of alcohol the patient receive, and number of times or bottles the residents have in the paper for documentation. Every hour we are serving the drinks to the residents, if they miss it we put a mark to indicate it in the paper. I noticed that they have also an exchange program, where a resident exchange their Listerine, and cough syrup with an alcoholic drink.

Reaction/Reflection: My Immediate reaction was I said at the back of my mind “Wooh, why are they doing this?” I am really confuse and curious to ask the nurse why they have this kind of program. I am thinking that instead of helping the residents to become sober, they are promoting the residents to be more addicted to alcohol. I felt bad for the resident’s situation who is under the program, I want to voice out my opinion, but I decided to keep it inside me and hoping that I will get a good explanation from the nurse. While serving the alcoholic drinks, I am desperately looking for an answer. I want to know the end goal of the program and how they are helping the resident’s.

Interpretation/Internal Analysis: The way I reacted after knowing that the agency has this kind of program is just natural. Being concern and wanting the best for the resident’s by making them aware and move them away from their addiction is always the paramount of my care. At first there are so many questions in my mind and I need some answers to satisfy my curiosity. As explained to me by the LPN that I am working with, the agency have this program to control the alcohol consumption of the residents throughout the day, the residents who is in the program is limited to a number of servings within a 24 hours cycle. As I interpreted what the nurse have told me, this program will really help with their alcohol addiction in a longer timeframe. The end goal of the program is to minimize their alcoholic consumption that may have a great impact in terms of their health. On the following day I sat down with the LPN and asked the questions, what if the agency doesn’t have this program for those residents who is highly addicted with alcohol? She answered, “Will they go out on the street, ask for drink from anyone, sometimes they put themselves in trouble by stealing someone’s drink, they get inside a bar and may stole some

alcoholic drink, when they have alcohol in their position they drink all of it until they pass out on the street which is more troublesome, some resident that is highly addicted with alcohol even drink rubbing alcohol, Listerine a mouthwash, and cough syrup.” After hearing this from the LPN, I want to research more about MAPs and I found this great information from the internet. “As part of Station Street Alcohol Harm Reduction program the MAPs was born to provide regulated doses of alcohol to residents in supportive accommodation to address seemingly intractable health and social problems experienced by people with alcohol dependence” (www.uvic.ca). “The program is use as a harm reduction strategy to decrease the adverse consequences of substance use without requiring abstinence. Subject enrolled in MAP were dispensed alcohol on an hourly basis” (www.ncbi.nlm.nih.gov). “The program improved most resident’s in terms of maintaining housing, expressing high satisfaction in life, improve social relationship, reduction in several alcohol-related harms like financial and withdrawal seizures. There are also challenges and concern brought up against the program as most of the participant self-rated physical health declined, a liver function test deteriorated, and lastly alcohol consumption increase for some residents in 6 months. It is concluded that there is no firm conclusions can be drawn about the program effectiveness but overall housing and harm reduction objectives appear to have been met in relation to reducing acute social and health-related problems” (www.uvic.ca). The LPN also shared that Station Street has the program for almost 7 years and it is the only site under PHS that has this kind of program for their alcohol dependent residents. Basing from what the LPN said, the program really works and they are continuing it, but again more research and studies are still done until today regarding the program. After doing a thorough investigation my perception has change because it makes me see what is beyond in doing the program. And also, it impact me on how I think with its effectiveness on the lives of the residents.

Decisions/Determination: After reflecting and doing my researched I realize that I need to be open minded that there is a program that help to minimize people addiction to substances but not requiring them to make abstinence and one of this is the MAPs. In the next two weeks I want to get myself involve and help serving the alcoholic drinks to the resident’s under the program. I want to do this because I want to see for myself how they react, what are their attitudes and behavior when they have their drinks and after they drink. I want also to talk to the residents who is under this program to get some insight, if they want to share it to me the reason why they are drinking. I am also determine to practice my communication skill, I think this is a great opportunity and venue for me to do it.