“Beyond Addiction,” Advance for Nurses magazine, December 2003
article by Emily Marchesani

Although not universally acknowledged, drug and/or alcohol addiction is a disease, as defined by the American Medical Association. Caring for people fighting to get sober is close to the hearts of nurses at Willingway Hospital, Statesboro, GA. The 40-bed facility has specialized in the treatment of alcoholism and drug dependency for more than 30 years. “Addiction is a pattern, and people struggle and try so hard to overcome this disease,” said Kathryn York, RN, director of nursing.  “Caring for these people gets in your blood.  It’s a state of the heart to work here.  You have to love people when they’re the most unlovable.” “Our patients deserve nurses who love it [this type of nursing],” added Julie Cowart, BSN, RN, a detox and rehab nurse who has been a nurse at Willingway for more than 20 years. “A lot of people don’t like this type of work.  You either love it or you don’t.  For whatever reason, I love it.”

The Willingway Hospital tradition extends back to 1959 when founders Dr. John Mooney, a physician, and his wife, Dot, began helping alcoholics get sober in their home. After a long struggle with drugs and alcohol, the Mooneys achieved sobriety and set up a makeshift 3-bed detox unit in their dining room. Patients would regain consciousness under the bright lights of the chandelier. At the time, very little was known about alcoholism and addiction, and people would call from across the country to speak to the “alcoholic doctor” who could help. 

In 1971, the Mooneys built Willingway, the first hospital in Georgia to specialize in the treatment of alcoholism and drug dependency, on 11 acres near their home. The hospital has been continuously accredited by JCAHO since 1974. Today, the chandelier hangs above the detox unit where the intensive care unit nurses work.  Under the chandelier, Willingway nurses treat patients like family, just as they did at the original Mooney home.  Although John passed away in 1983, his spirit is very much alive at the hospital. Dot Mooney remains involved in the activities of family-owned Willingway, and acts as a strong leader and role model for those in recovery. 

“It takes a unique individual to be a nurse at Willingway. It is more than just a job,” said Rachel Mooney, granddaughter of the founders and an employee at Willingway. “Our nurses are role models both in and outside the workplace, and play an important role in making miracles happen in our patients’ lives.” Since its inception, Willingway Hospital – named by Dot Mooney from the saying “When there’s a will, there’s a way” – has treated more than 20,000 patients and family members. It is known as one of the premier addiction treatment facilities in the nation. The hospital is situated in a small college town, which is home to a large recovering population.  In fact, quite a few of Willingway’s employees and their families have gone through the treatment program and now work in different capacities at the hospital. All remain active in their own recovery programs. The community of Statesboro hosts roughly 70 12-step meetings such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA) and Al-Anon a week.

“I have the utmost respect for recovering alcoholics and addicts,” said Barbara Lewis, FNP, CS, who works at Willingway. “Having gone through it myself, these people hold a special place in my heart and I’m able to have empathy rather than get angry. To people not familiar with addiction, this field would be shocking.” Both Lewis and her daughter are actively involved in their programs of recovery. “My daughter got sober and I saw recovery work in her life, “ Lewis said. “Willingway [also] believed in me enough to put me to work, and now it’s gratifying to see patients come in angry and leave with the desire to live a different life.  Their attitudes turn around.”  “Anyone can get physically better, but it means a lot of our staff has empathy and the patients know you care,” Cowart observed. “I [personally] know many recovering alcoholics; and I knew as a young woman that this profession was special to me because I believe strongly in the principle.” 

Each year, Willingway hosts a homecoming for past patients (“alumni”) who return to the facility to celebrate their sobriety and thank their supporters.  Throughout the year former patients also contact nurses and counselors, and families often send flowers or cards of thanks. 

Internationally recognized as a leader in alcohol and drug abuse treatment, Willingway Hospital has a core program that includes all levels of treatment: detoxification, inpatient/residential, intensive outpatient, a family program, and aftercare.  “A person can enter our doors and follow a continuum of care,” York said. “It provides a great foundation for someone who wants to enter into recovery.” The detoxification unit handles acute medical situations and provides safe and consistent medical intervention. The inpatient/residential unit focuses on emotional stabilization, education about the illness, development of recovery resources and skills, and personal adoption of recovery principles. Following the continuum, the intensive outpatient program offers therapy for patients residing outside the hospital, and the 5-day family program allows members of a patient’s family to participate in education program, meetings with physicians and counselors, aftercare conferences, and family counseling sessions while their loved one is in treatment. Aftercare further encourages maintaining sobriety, as well. It includes attending AA or NA meetings, having a sponsor and living in a non-toxic environment that promotes recovery. “We provide encouragement and tell our patients to take one day at a time,” said Faye Hill, LUN, who has been at Willingway for 19 years. “All we have is today.” 

Nursing is an integral part of a patient’s recovery at all levels of treatment, York said. Nurses at Willingway work as a team and often float between units on 8- and 12-hour shifts. One of the busiest units at Willingway is detox.  Here, nurses assess patients, monitor vital signs and patient progress, take blood samples for analysis, give medications, handle paperwork and treatment plans, take admissions as needed, and report to nurses on the next shift. The nursing station is located in the center of the unit, and the rooms surrounding it have glass doors.  Patients have their own room and stay on the detox unit anywhere from 4 days to several weeks, depending on attitude and physical condition. “The nurses’s No. 1 goal is safe medical detox of the patient,” York said. 

Nurses also comfort and encourage patients, and with physicians’ recommendations help decide who has progressed enough to move to the inpatient/residential unit.  “Patients also become very close and support each other,” Lewis said.  “They get honest about their disease, form bonds and prepare to stay sober for the rest of their lives.”  In addition, nurses receive approximately 15-20 telephone calls a day from family members – visiting hours are not permitted at the hospital – who are concerned or would like information on a patient’s progress, Hill said. 

The hard work of Willingway nurses does not stop at detox.  On the inpatient/residential unit, nurses continue to medically monitor approximately 22 patients.  Although patients need a slightly less critical level of care than when in detox, patients can experience a second wave of withdrawal, and nurses must ensure patients receive appropriate care.  Nurses on the rehab unit are required to use communication skills and play a larger counseling role as well.  Because the hospital does not allow visitors, the Willingway staff must be the family, friends and support system for the patients.  “You need compassion, but it’s a different type of nursing because you can’t have a fear of the patient,” said Mary Ann Spieth, RN, charge nurse on the detox unit and a Willingway nurse for 20 years.  “The patients may confront you and you have to be one step ahead of them.  You must let them know you’re trying to help them.”  In addition, nurses work with patients on the other units, and help them learn new living skills, treat health problems and stay sober.  “There are a lot of things in other departments that anyone can do, but most people can’t do the nurse’s job,” Cowart said.  “It’s quite a responsibility.” 

Willingway Hospital is proud of the low turnover among its core nursing staff, who have 300 years of cumulative nursing experience; 110-120 of those years are in addiction medicine or behavioral health, York boasted.  That success is due in part to an emphasis on education, which was championed by Dr. John Mooney in the 1970s.  Today, Willingway serves as a clinical site for local programs including Georgia Southern University’s nursing program.  Medical professionals from foreign countries as well as medical residents from the Eisenhower Army Medical Center, Augusta, GA, also visit the facility regularly.  Many rehabilitation programs have based their programs on Willingway’s successful model of treatment.  Perhaps the most significant reason behind Willingway’s staff longevity is its passion and strong work ethic.  Willingway Hospital has never had to employ an agency nurse, York said, recalling a story she heard when she first came on board at Willingway:  “If you want to go where they do it [take care of addiction patients] better than anyone in the United States, you need to work at Willingway.” 

“My highest compliment is that I would allow [nurses at Willingway] to take care of my family member,” York said.  “Their care is what I want – gentle, kind, not prejudicial.  I’m so proud of Willingway; I think it’s phenomenal.  It’s the family legacy, the tradition, the passion.  I like that I can touch other people’s lives and educate other healthcare workers about it.”