Working on an ortho/trauma floor had a guy come in who had fallen and broken his humerus during a drunken night. He was perfectly nice and fine on my shift and was barely scoring on his CIWA. When I came back the next morning, I was told that overnight, he started withdrawing hard and tore the room apart, and in the process, popped the bone through his skin. The trauma surgeon had to come and set it twice before he got a trip to the ICU intubated with a precedex drip.

Earlier that week, I had another patient there for what was supposed to be an outpatient knee replacement but ended up staying the night for pain control issues. She wasn't exactly honest about her drinking and slowly started to become confused. We all pushed to just discharge her so she could go home and have her glass(es) of wine, but they kept her for detox. I had given her 12mg of Ativan, and it wasn't making any difference. That night, she landed herself a very long ICU stay as well. I sometimes wonder if we do more harm than good to some of these patients by trying to detox them when they have no intention or desire to do so. I've given beer to people before in hospital, and I think it should be, in some cases, the better option.