By Alison Bulman, senior editorial coordinator
How much of your nursing education focused on how to handle drug addicts and substance abuse? Probably not much, according to speakers at a recent event I attended with my colleague Christine Moffa, AJN’s clinical editor, at the Center for Health, Media, and Policy at Hunter College.
The event was focused around a clip (longer than the one above) from “Bevel Up: Drugs, Users and Outreach Nursing,” an award-winning film by Canadian documentary filmmaker Nettie Wild. (A photo of a street nurse from the program appeared on AJN’s cover in July 2009, along with an article about the program.) Fiona Gold, BA, RN, and Juanita Maginley, MA, BSN, RN, whose work in Vancouver is the subject of the film, spoke on the panel about the value of harm reduction and about the systemic flaws and tendency to stigmatize drug addicts that prevent health care from reaching this population.
The powerful clip showed street nurses searching the city’s alleys and housing complexes for drug addicts, dealers, and sex workers. They carry bags full of syringes, condoms, and crack pipe mouthpieces which they deliver to those willing to take them. They ask street patients whether they might be pregnant, have unsafe sex, may have a disease, and if they want to have the nurses draw blood for testing.
The outreach project started in response to Vancouver’s alarming increase in HIV infections. Medical services were not reaching the most vulnerable people, so nurses devised a plan to go to them, a strategy they referred to as “meeting the client where they are.”
The nurses in the film show an amazing ability to balance gentle persistence and respect for the autonomy of their patients. We all know that some health care workers, including nurses, can be contemptuous of drug addicts, and may perceive addiction as self-indulgent and little more than a burden to the system. And far more money is spent on criminalizing drug use than on treating drug addiction as a disease.
My colleague Christine’s reaction to the clip reflected her experience as a nurse: ED nurses’ job “is difficult, and patients who are using drugs are not always easy to deal with.” But she also stressed that nurses don’t have a choice who they work with, and that the best approach we can take is to make sure they get enough training, both at school and at work, to meet the needs of this population.
To order the DVD of this film, which includes a teaching module, go here. It’s sure to start some lively conversations among health care workers.