Substance Use and Abuse Cases

Abstract

The use of illicit, and non-illicit substances can be harmful and even fatal. Substance use and abuse has become very common in America today. The abuse of substances can range from tobacco, nicotine, marijuana, alcohol, or opioids. Abuse can begin from early stages of life, as drug addicted newborns or can become a habit in the later stages of life. Substances can be abused through prescriptions that turn into dependence or recreational use of illicit and non-illicit drugs. Nicotine and alcohol can be accessed in early ages than their legal range of age. Marijuana and opioids in the use of recreational purposes have become very common in the past decade. The use of substances can affect your body in numerous ways and should be educated more thoroughly to Americans. Although there are treatments and rehabilitation centers all throughout the world there are still several Americans who believe illicit and non-illicit drug use is a common use and problems cannot be acquired.

Keywords: [nicotine, alcohol, opioids, marijuana, tobacco]

Substance Use and Abuse

A nurse's role in patient care is significant. A patient is cared for by a nurse their entire stay at the hospital. The nurse's roles and responsibilities are to provide the best care they can for each patient they are given. A nurse's role in caring for a patient goes beyond passing medications and assisting patients in everyday roles. Nurses spend the most time with their patients ranging anywhere from teaching and education to providing support and communication. As a nurse you can educate your patient on their diagnosis and treatment, allowing them to be more comfortable in the situation they are in. Providing support through difficult times can go beyond physical nursing care and create bonds with patients. The roles and responsibilities of nurses affect patient care inside and outside of the room. Proper documentation of a patient is crucial and can allow the nurse to make goals and achieve them. It allows the nurse to see what goals the nurse has set for the patient and the type of care that is needed to achieve them goals. Communication with a patient can give subjective data on how the patient is feeling and allow the nurse to thoroughly understand the care that needs to be provided for them. Substance use and abuse is very common in our healthcare system today. Abusing and using of drugs can change patients care and nursing prospective. Although it is crucial that patient care can come without any form of judgement it is a common problem among nurses today. Judgement on the use illicit drugs plays a big role in a nurse's care. Legal and illegal use of alcohol, opioids, and tobacco can change the care needed for the patient. Another common misconception in substance abuse in nursing is education. Substance abuse education is not thorough, and nurses do not understand addiction.

How Substance Abuse affects the body.

The use of substances can affect the body in several ways. Smoking cigarettes can not only affect lung function, but it can affect your brain and heart. Smoking can lead to pneumonia, chronic bronchitis, and even chronic obstructive pulmonary disease. The leading cause to smoking is an increased risk of lung cancer. In nursing care with patients with a social of smoking it can lead to the use of oxygen, decreased oxygen levels and strict monitoring of oxygenation. A decrease in oxygen in the lungs can cause patients to become weak and restless. Nurses must monitor patient's oxygen levels and monitor their activity level. The use of alcohol can affect the blood and your brain. Alcohol affects the brain by loss of memory, and mood behavior. If a patient is intoxicated they may not be able to tell you accurate information due to memory loss or become very agitated and become aggressive. Memory loss can affect documentation for nurses. Without accurate information of the condition of the patient, proper care cannot be provided to the patient. Patients can become aggressive and can put themselves and the nurse providing care for them in danger. Alcohol can also dehydrate and thin the blood. If the blood is already thin from alcohol abuse and the patient is in a severe accident that causes loss of blood or the need for immediate surgery, it can result in too much blood loss. This can affect the care of nursing to provide proper care and even push back the potential need for surgery. If too much blood is lost it can result in the need for a blood transfusion. Opioids can affect your lungs, heart and brain. Opioid abuse can lead to a decrease in oxygen and supply to the heart. Opioids can slow the breathing rate down and lack of oxygen to the lungs. Proper patient care with decreased breathing involve closely monitoring oxygen levels and making sure the patient oxygen saturated is within a desirable range. Placing the patient in an upright sitting position can allow for easier breathing. Opioids side effects include sedation and drowsiness. The nurse must closely monitor breathing patterns of the patient, and make sure the patient is safely left when leaving a room. Including the call bell in reach, the bed in the lowest position and side rails up.

Proper Education for Substance Abuse.

In the investigation of nurses this study was to investigate nurses' perceptions of caring for hospitalized medical-surgical patients with comorbid conditions of substance abuse and dependence. In this investigation nurses expressed concerns of opioid abuse, the nurses reported instances of inappropriate judgment such as falsely blaming patients with abuse/dependence on missing or damaged items or the belief that because abuse/dependency was self-inflicted these patients should not receive hospital care (Neville, K., 2014). In the nursing practice it is important not to have inappropriate judgment towards patients with or without the illegal/legal use of illicit drugs. A non-biased judgement towards patients can allow them to openly express their concerns about their drug misuse. Drug misuse should not affect the way of care in the hospital setting. A patient should be able to express pain without form of judgement throughout their care. In this study it crucially revealed that nurses need more education on the use and misuse of substances. Most nurses in this study expressed that they do not like working with patients with a substance abuse record stating that they are needy and take time away from sick patients who are dependent on my care. These statements represented a broad category of challenges of care and addressed many aspects involved in their care, such as fear, safety, frustration, lack of education, and the perception of being manipulated (Neville, K., 2014). Proper education on therapeutic communication is crucial in the nursing profession. Patients with or without the use of illicit drugs should all be cared for and treated equally with respect from health care providers.

Disconnection between the nurse and the patient.

 In another study involving care for patients that were using illicit drugs it expressed concern lacking education on illicit drugs within nurses. The nurses expressed concerns of not understanding the use and abuse of illicit drugs in patients. Expressing that they do not understand the addiction process, what to look for in withdrawals, and understanding the user's views in the illicit drug users (Monks, R., 2013). The nurses expressed that they disconnected and minimized interaction with the illicit drug users. This was a negative reaction in patient care. Every patient should be cared for equally on the floor. Disconnection between the nurse and the patient does not allow for proper communication between the patient and the nurse. The patient can then begin to feel like a last resort to the nurse and can potentially elongate the hospital stay of the patient or result in a self-discharge. Proper education given to these nurses could have allowed proper patient care to be given at all times of the investigation. As a nurse you should be able to see the person in the patient like stated above. Putting judgement aside of the social actions of the patient should be immediate. The nurse should always keep a non-judgement open mind with their patients. In the investigation of patients who used needle injecting substances such as heroin, the patients felt as if the pain tolerance levels of withdrawals were not significant. An avid user of a substance has a higher tolerance to pain medication, a patient can acquire a higher medication tolerance and need more of a dosage.  For patients with known or suspected substance use disorders, the authenticity of pain complaints is frequently questioned, even in the context of an objective pain etiology (Summers, P. J., 2018).  Pain was frequently questioned by the nurses in the study because they did not fully know when the patient was experiencing pain or if they just wanted opioids. In order to achieve timely, complete, and compassionate care, pain and withdrawal symptoms among PWIH must be addressed. However, effective empirically-supported protocols to achieve this appears to be lacking for many emergency and inpatient facilities (Summers, P. J., 2018). This is a common problem today. Nurses should keep an open mind when providing care for substance abusers. If an opioid prescription is given for every six hours for example and a patient needs that medication every six hours, it should be distributed as prescribed without question. If the physician ordered the medication for the patient, then it should be given as intended without judgement or questioning from the nurse.

Recovery options.

In study of the stigma perceived by nurses in substance abuse patients it expressed that although the nurses were strict about the care that was being provided for the patient the nurses set goals and tried to achieve them with these patients. Some of the patients involved in this study expressed that the nurses cared and wanted them to do better when they were out of the hospital. One expressed the nurse made all of the phone calls and listened to the concerns. As a nurse, patients express a lot of emotions to you, active listening can allow the patient to trust you and allow you to learn about them and their abuse more. Talking with the patients and being able to understand them and see them for who they are can put all judgement aside within the nurse. This can allow the nurse to accommodate the needs of each patient. It is important for a nurse to provide options of care to patients without their opinion. If a nurse is to teach a patient about options of rehabilitation and giving information of addiction recovery it should be stated as an option or a choice for the patient to make. A biased opinion can be perceived as judgement of the patient's choices in substance abuse. Information can be given to the patient but not pushed upon them in their decision to seek for help. This can allow the nurse to gather information and data of how the patient feels about recovery from their addiction.

In conclusion whether a patient is an illicit or non-illicit drug user the plan of care for the patient should not vary. The nurse should care for each patient equally and provide exceptional care to each individual. The lack of education and knowledge of substance abuse is a common factor in today's health care system. Education of substance use and abuse and how addiction affects the patient should be given to nurses and nursing student across the globe. Due to the increase of substance abuse this will be crucial in implementing and providing proper care for patients. Judgement of patients with and without substance abuse is necessary in nursing. Nurses should be willing to listen and provide positive feedback to patients when necessary. Proper education given to patients on potential rehabilitation centers for addiction can allow nurses to learn while teaching patients options of receiving help. This should be given in a non-biased judgment free tone. Allowing the communication to be open and express their concerns to the nurse.

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