10. How do I deliver a brief intervention for alcohol prevention in practice?

Patient in clinic room having wound dressed by ED nurse/ staff member:

"Nurse: So that’s the first questions done now for your initial assessment but I just want to ask you a few questions about your lifestyle if that’s ok.

Patient: Yeah, fine.

Nurse: OK, so do you smoke?

Patient: I don’t, no.

Nurse: Have you ever smoked?

Patient: No I’ve never smoked - no.

Nurse: Ok that’s great and do you drink any alcohol?

Patient: I like a glass of red wine in the evenings with my meals, yeah.

Nurse: Ok so can you tell me a little bit more about that, so how many nights a week would you normally drink?

Patient: Oh probably 4 nights a week - probably.

Nurse: Ok, erm and how much do you drink when you are drinking?

Patient: Erm well, we only ever get a bottle really we never go into a second bottle, so a bottle in the evening.

Nurse: OK and you share that between you and your wife?

Patient: Yeah, we never open a second bottle so we share a bottle between us - yeah.

Nurse: Ok, so you’re drinking 4 nights a week and you’re probably drinking half a bottle of wine.

Patient: Yeah, I would say that - yeah.

Nurse: OK, so drinking that much does put you at higher risk, had you ever considered the impact drinking might be having on your health?

Patient: No I’d never considered it, I always thought red wine was reasonably healthy.

Nurse: Lots of patients say that when I speak to them about their alcohol but drinking at that level does put you at higher risk of lots of health conditions like heart disease, cancer and depression, it could even be causing this abdominal pain that you came in with today.

Patient: Oh wow, I’d never considered that.

Nurse: Have you ever considered cutting down?

Patient: Er, I’d not really thought about it no.

Nurse: Ok so what I can do is I can give you a leaflet, erm it’s got some further advice in there about how you can cut down, but it’s also got some helplines if you wanted any further advice or someone to call.

Patient: Ok, right well fine thank you - I’ll take the leaflet and read it and see what we can do.

Nurse: Ok, I’ll get you a leaflet on my way out.

Patient: Ok, thanks for your help.

Nurse: No worries."

Patient in assessment room with Nurse:

"Nurse: Clive, I’ve just looked at your alcohol screening and you’re drinking at an increased risk.

Patient: Really, I’d not considered that, is that not healthy?

Nurse: It’s not healthy to be drinking that much, have you not seen the posters in the waiting room or the adverts on TV?

Patient: I have seen them yeah…

Nurse: So you should be drinking less that 14 units a week.

Patient: Oh dear, what’s 14 units anyway?

Nurse: Well it’s definitely less than what your drinking, it’s bad for your heath to be drinking that much.

Patient: Erm, oh well its only red wine I drink and I thought that was reasonably healthy.

Nurse: Well, you need to cut down. It’s bad for your health and your health needs to come first, I’d take a leaflet on the way out if I were you.

Patient: Ah - Ok I’ll grab one, thanks for that.