Read on Twitter
Nurses of twitter, I know we're busy :) but what do you think about providing #harmreduction in the hospital? ( #nursetwitter #tweetorial)
For an intro to harm reduction, read this excellent concept analysis by Dominique Denis-Lalonde: https://www.ncbi.nlm.nih.gov/pubmed/31666391
1/10
For an intro to harm reduction, read this excellent concept analysis by Dominique Denis-Lalonde: https://www.ncbi.nlm.nih.gov/pubmed/31666391
1/10
As per @rs_mcneil et al. (and many other studies) the hospital is a ‘risk environment’ for people who use drugs (PWUD):
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951660/
They are dopesick, in pain, feel judged and imprisoned. The abstinence often imposed on them is deadly.
2/10
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951660/
They are dopesick, in pain, feel judged and imprisoned. The abstinence often imposed on them is deadly.
2/10
I tweeted this paper out earlier this month – clear documentation of the kind of policies (nevermind “unofficial” practices) which make inpatient stays untenable ( https://insights.ovid.com/medsurg-nursing/mednu/2019/03/000/care-heroin-addicted-inpatient/4/00008484): security sweeps, mandatory gowns, no visitors
3/10
3/10
Nurses in particular do not know how to treat PWUD when they are admitted to hospital ( https://www.ncbi.nlm.nih.gov/pubmed/31648259 ). The ‘rituals and routine’ of both nursing AND substance use are often at odds with one another ( https://pubmed.ncbi.nlm.nih.gov/20846223/ ).
4/10
4/10
But if you think about the principles behind harm reduction ( https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-017-0196-4) they look like some modern NSG theories (e.g. Gottlieb’s strength-based care). A big difference? The involvement of PWUD in planning/implementation/delivery of harm reduction programs.
5/10
5/10
So what should harm reduction in the hospital look like? We should ask PWUD what harm reduction means to them, and how they want health services to be provided (hint: it’s not just needles)… https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-017-0145-2
6/10
6/10
This guide from Alberta, Canada was written with input from both PWUD and staff! Including a FAQ section and philosophy of service: https://crismprairies.ca/management-of-substance-use-in-acute-care-settings-in-alberta-guidance-document/ (Thanks @DrKLMeador)
7/10
7/10
. @BerniePauly
has written at length about what providing ‘culturally safe care’ for PWUD means. This is a great guide every nurse should read: https://www.uvic.ca/research/centres/cisur/assets/docs/bulletin11-creating-culturally-safe-care.pdf
8/10
has written at length about what providing ‘culturally safe care’ for PWUD means. This is a great guide every nurse should read: https://www.uvic.ca/research/centres/cisur/assets/docs/bulletin11-creating-culturally-safe-care.pdf
8/10
Check out this thread started by @kelseycpriest
where she is starting to compile a list of what hospitals are doing with HR: https://twitter.com/kelseycpriest/status/1236429345356312577?s=20
What is your hospital doing? What are some of the barriers you would face in providing ‘culturally safe care’ for PWUD?
9/10
where she is starting to compile a list of what hospitals are doing with HR: https://twitter.com/kelseycpriest/status/1236429345356312577?s=20
What is your hospital doing? What are some of the barriers you would face in providing ‘culturally safe care’ for PWUD?
9/10
Let me know if you need help finding any of these articles! This thread is in lieu of a few talks I was going to give this spring. Now more than ever I'm hoping that people see the value in providing quality patient-centred care to ALL populations.
10/10
10/10
