Attributes of Substance-Use Nurses
Describe the general Characteristics and relevant Demographic Information of the Clientele.
A substance-use nurse has different attributes. They are independent, engage in multifaceted activities, patient-facing and have a structured approach to the provision of drug-and-substance treatment services (Johnston, 2017). In regard to independence, these nurses can independently provide pain management services and also single-handedly regulate the treatment process of individuals addicted to drugs and substances. Secondly, substance-use nurses are patient-facing as they focus on directly engaging each individual patient in one-on-one teachings on the dangerous effects of drug use and addiction. They thus provide patient-centred care that is tailor-made for the patients and those at risk, knowing well that treatment options vary among persons (Wilkinson et al, 2015). Thirdly, these nurses are multifaceted and therefore able to manage different interacting factors that influence care for substance and drug use addicts. They can work as social workers, handle mental health problems and also effectively administer medical treatment of cases. Partly as a social worker, a Substance Abuse Nurse plays a role in supporting individuals that have little else than addiction in their lives. Further, a substance-use nurse plays a structured role and thus has a well-planned approach to the treatment of their patients (Roden & Jarvis, 2012). Through their structured care, they are able to administer and regulate treatment, teach the public, patients and their families on dangers of drug and substance abuse. Their structured care enables them provide the appropriate physical and/or emotional support to these groups.
Primary healthcare involves providing integrated and accessible healthcare services particularly by clinicians that are accountable in addressing numerous personal healthcare needs, creation of sustainable partnership with their patients and further, practicing within the context of both family and the community. Substance abuse nursing meets the threshold to be a role of primary health care as it involves effective treatment of patient’s substance use problem and therefore addressing their “personal health care need” as envisaged in primary healthcare requirements (Roden & Jarvis, 2012). In line with their attributes, substance-use nurses works within the context of family and the community. This therefore indicates that substance abuse nursing is a role in primary healthcare.
A substance-use nurse provides primary healthcare services to individuals, families and the community which are mainly aimed at preventing, managing and controlling drug and substance abuse (Thomas & Staiger, 2012). Their clientele’s main characteristics include; persons requiring drug-use related psychological counselling; individuals seeking substance use withdrawal and rehabilitation services and further, those that require pharmacotherapy to manage their drug and substance addiction. A case of Victoria state in Australia, a substance abuse nurse serves a clientele of about 40, 000 people annually who are under the state’s specialist drug, alcohol and other substance use treatment programs(Wilkinson et al, 2015). The nurse can provide these services within the community-based treatment centres. In Victoria the clientele include; the youth-a population that is most vulnerable to dug and substance use; the aboriginal population, whose health outcomes are worse than those of non-indigenous Australians; all citizens within Victoria that need these services as directed by the Victorian Severe Substance Dependence Treatment Act of 2010 (Thomas, & Staiger,2012). According to the Act the state’s specialist drug, alcohol and other substance use treatment centres should offer compulsory treatment to residents with severe substance dependence. Further, the clientele would include groups and persons that require family and peer support services to aid their peers in the treatment process.
Substance Abuse Nursing as Primary Healthcare
From the clientele characteristics, the most outstanding health issue of concern is the need for culturally appropriate substance-use interventions for the aboriginal Australians. Understanding that culturally competent health care is paramount in reducing gap between the healthcare disparities between the aboriginal and non-indigenous Australians, I determined that cultural competence in substance use nursing for aboriginal communities in Victoria is imperative. A nurse should thus ensure that their services are appropriate and culturally acceptable to the aboriginal community (D’Abbs & Chenhall, 2013). Their community and residential based drug-and-substance treatment services must meet the specific healthcare needs of the aboriginal Australians across Victoria. There are several justifications as to why the nurses must take action to ensure that the substance use nursing services provided are culturally appropriate. First, primary healthcare emphasizes that healthcare providers should effectively deliver services which meet cultural, linguistic and social needs of their patients (D’Abbs & Chenhall, 2013). Secondly, culturally competent health providers can ensure that there is improvement in the health outcomes and the quality of care of patients within their catchment. Further, culturally competent system of health can also contribute effectively on eliminating racial and/or ethnic disparities in health.
Several initiatives are in place within victoria to ensure that the aboriginal communities receive culturally competent substance-use nursing care. The first initiative is aimed at promoting access to alcohol and other substances treatment services for aboriginal residents. The Victoria state government through the Aboriginal Community Controlled Organizations offers accessible aboriginal-specific substance use nursing services (Campbell et al, 2017). These organizations accept referrals which come from in-take services within the catchment areas to enrol them on alcohol and substance treatment services. They also accept direct referrals from different treatment centres to boost accessibility. Aboriginal people also have a choice of utilizing the mainstream services via the existing intake services in different catchments in Victoria. Further, health facilities give first priority to the Aboriginal people in the provision of treatment services for alcohol and other drugs in the state; ensuring that this group finds maximum access to the services (Johnston, 2017). Accessibility to primary healthcare as promoted in these initiatives agrees with the Ottawa Charter’s strategies including the one on the need to build healthy public policies. It is evident that the policies guiding the Aboriginal Community Controlled Organizations in Victoria are healthy as they are tailor-made to ensure equity in healthcare for all Australians disregarding their demographic status (Campbell et al, 2017). The initiative also creates a supportive environment for Aboriginal Australians to develop good self-health-seeking behaviour, as envisaged in the second action plan of the Ottawa Charter (Tilford, 2017). This is consideration that they take up these services and own the initiatives under implementation in their areas.
Clientele Characteristics and Specific Healthcare Needs
The second initiative includes the Bunjilwarra Koori Youth Alcohol and Drug Healing Service. This service is state-wide and it comprises of 12-bed residential rehabilitation and/or healing services specifically meant for young people of age 16-25 years from the Aboriginal communities in Victoria (D’Abbs & Chenhall, 2013). The service is conducted by the Victorian Health Service and the Youth Support and Advocacy Service. These services are however supported by the state Aboriginal and non-indigenous health services. Further, the Aboriginal Metropolitan Ice Partnerships, an initiative under Victoria’s Ice Action Plan is currently being implemented in four metropolitan parts of the state. It is aimed at helping Aboriginal people in the areas to have improved access to substance use nursing services for those affected by ice and other drugs(Campbell et al, 2017). This is carried out via partnerships of different Aboriginal community Controlled organizations and the mainstream substance and drug treatment service providers. The organizations carry out assertive outreach and/or treatment services and help in streamlining accessibility to even more intensive services when necessary. This approach agrees with the Ottawa Charter strategy on the need to re-orient primary healthcare towards illness prevention and promote health (Fry & Zask, 2016). By partnering with different institutions, it is clear that this program plays a major role in preventing drug and substance-use negative effects and at the same time promotes the available health care services for Aboriginal Australians to access.
A primary healthcare nurse can initiate two responses in order to address the need for a culturally appropriate substance-use nursing for aboriginal Australians. First, a nurse must effectively create a culturally appropriate environment within their areas of jurisdiction as an authority, which will attract Aboriginal people in Victoria to approach him/her for drugs-and-substance-use treatments (Johnston, 2017). The goal of this initiative will be to offer a culturally safe, welcoming and friendly service to the Aboriginal people in different catchment areas in Victoria. The objective of this initiative mainly includes the intention to promote access of treatment services for those at risk and already engaging in substance abuse from the aboriginal communities. This is in regard to the understanding that primary healthcare must meet the health needs of each social group to effectively prevent and control adverse health conditions. Among the strategies to create a culturally safe, friendly and welcoming environment, nurses should be willing to accept any drug-and-substance user referral cases including self-referrals, direct referrals especially from other facilities and those from intake services in catchment areas (Wilkinson et al, 2015). This will make them Aboriginal people feel accepted and prioritized in regard to the efforts towards improving their health.
Cultural Considerations for Substance Abuse Nursing
Another initiative includes carrying out health education of the patients, relatives and the public on drug-and-substance adverse effects. This agrees with the Ottawa Charter strategy on inculcating skills among the people to prevent and/or ameliorate disease conditions (Fry & Zask, 2016). The main goal of this strategy will be to ensure that by the end of the teachings, individual aboriginal people visiting the primary healthcare facility will be aware of the dangers of substance use and the approaches to prevent them. The main objective thus includes ensuring that all patients enrolled on substance use treatment therapy are fully informed of their likely health deterioration if they persist on the use of substances (Zimmermann et al, 2012). This will also improve their compliance levels to rehabilitation services and even make them share out the information to other community members. The strategies as borrowed from Strobbe (2013) will include holding brief learning sessions, providing learning materials like brochures, and engaging in focus groups to teach visiting aboriginal patients and those at risk from the catchment areas on the dangers and the importance of quitting drugs-and-substance use.
References
Campbell, M., Hunt, J., Scrimgeour, D., Davey, M., & Jones, V. (2017). Contribution of Aboriginal Community-Controlled Health Services to improving Aboriginal health: an evidence review. Australian Health Review.
d’Abbs, P., & Chenhall, R. (2013). Spirituality and Religion in Response to Substance Misuse Among Indigenous Australians. Substance Use & Misuse, 48(12), 1114-1129.
Fry, D., & Zask, A. (2016). Applying the Ottawa Charter to inform health promotion programme design. Health Promotion International, daw022.
Johnston, D. (2017). Cultural Competence Training In Sydney Local Health District Australia. Primary Health Care Open Access, 07(02).
Kovitwanichkanont, T., & Day, C. (2017). Prescription Opioid Misuse and Public Health Approach in Australia. Substance Use & Misuse, 1-6.
Patouris, E., Scaife, V., & Nobes, G. (2016). A behavioral approach to adolescent cannabis use: Accounting for nondeliberative, developmental, and temperamental factors. Journal Of Substance Use, 21(5), 506-514.
Roden, J., & Jarvis, L. (2012). Evaluation of the health promotion activities of Paediatric Nurses: Is the Ottawa Charter for Health Promotion a Useful Framework?. Contemporary Nurse, 365-403.
Strobbe, S. (2013). Addressing substance use in primary care. The Nurse Practitioner, 38(10), 45-53.
Thomas, A., & Staiger, P. (2012). Introducing mental health and substance use screening into a community-based health service in Australia: usefulness and implications for service change. Health & Social Care In The Community, 20(6), 635-644.
Tilford, S. (2017). From the Ottawa Charter 1986 to the Vienna Declaration 2016. International Journal Of Health Promotion And Education, 55(3), 173-174.
Wilkinson, C., Allsop, S., & Dare, J. (2015). Alcohol, ageing and Australia. Drug And Alcohol Review, 35(2), 232-235.
Zimmermann, A., Lubman, D., & Cox, M. (2012). Tobacco, caffeine, alcohol and illicit substance use among consumers of a national community managed mental health service.
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