Home > "You're kind of at war with yourself as a nurse": perspectives of inpatient nurses on treating people who present with a comorbid opioid use disorder.

Horner, Gabrielle and Daddona, Jeff and Burke, Deirdre J and Cullinane, Judith and Skeer, Margie and Wurcel, Alysse G . (2019) "You're kind of at war with yourself as a nurse": perspectives of inpatient nurses on treating people who present with a comorbid opioid use disorder. PLoS ONE, 14 (10) https://doi.org/10.1371/journal.pone.0224335

URL: https://journals.plos.org/plosone/article?id=10.13...

BACKGROUND: In the midst of an opioid epidemic, health care workers are encountering an increasing number of patients who have opioid use disorder in addition to complex social, behavioral and medical issues. Of all the clinicians in the hospital, nurses spend the most time with hospitalized patients who have opioid use disorder, yet there has been little research exploring their experiences in caring for this population. The objective of this study was to assess the attitudes, perceptions, and training needs of nurses in the inpatient setting when caring for patients who have opioid use disorder.

METHODS: One-on-one in-depth interviews were conducted with nurses working at a large academic medical center in Boston, MA, using a semi-structured interview guide. Nurses were recruited via email notifications and subsequent snowball sampling. Interviews were recorded, transcribed and analyzed using a grounded theory approach.

RESULTS: Data from in-depth interviews with 22 nurses were grouped into six themes: (1) stigma, (2) assessing & treating pain, (3) feelings of burn out, (4) communication between providers, (5) safety & security, and (6) opportunities for change. These themes were organized within four ecological levels of the Socio-Ecological Model: I) societal context, II) hospital environment, III) interpersonal interactions, and IV) individual factors. Nurses were cognizant of the struggles that patients who have opioid use disorder confront during hospitalization such as pain, withdrawal and stigma, and elaborated on how these challenges translate to professional and emotional strain among nurses. Nurses offered recommendations by which the hospital could streamline care for this population, including expanded role support for nurses and more structured policies regarding care for patients who present with a comorbid opioid use disorder.

CONCLUSION: Our results highlight the need for the development of programs targeting both organizational culture and the inpatient nurse quality of life to ultimately enhance quality of care for patients who present with opioid use disorder.


Item Type:Evidence resource
Drug Type:Opioid
Intervention Type:AOD disorder, AOD disorder treatment method, Psychosocial treatment method
Date:October 2019
Page Range:e0224335
Volume:14
Number:10
EndNote:View
Subjects:B Substances > Opioids (opiates)
F Concepts in psychology > Attitude and behaviour > Attitude toward substance use > Attitude toward substance user
G Health and disease > Substance related disorder > Dual diagnosis (comorbidity)
G Health and disease > Substance related disorder > Substance related mental disorder
J Health care, prevention and rehabilitation > Treatment and maintenance > Provider / worker / staff attitude toward treatment
J Health care, prevention and rehabilitation > Care by type of problem > Mental health care
T Demographic characteristics > Nurse / Midwife
VA Geographic area > United States

Repository Staff Only: item control page