Using spatial video geonarratives to improve nursing care for people who use drugs and experience homelessness: A methodology for nurses.

BACKGROUND: People who are insecurely housed and use drugs are disproportionately affected by drug poisonings. Nurses are uniquely positioned to utilize harm reduction strategies to address the needs of the whole person. Needle debris encompasses drug paraphernalia discarded in public spaces. Studying needle debris provides a strategic opportunity to identify where drugs are being used and target public health strategies accordingly. AIM: Our aim in this article is to illustrate how spatial video geonarratives (SVG) combined GPS technology interviews, and videos of locations with needle debris, can elicit valuable data for nursing research. METHODS: Using SVG required knowledge of how to collect data wearing cameras and practice sessions were necessary. A Miufly camera worn at waist height on a belt provided the stability to walk while interviewing stakeholders. We wore the cameras and conducted go-along interviews with outreach workers, while filming the built environment. Upon completion of data collection, both the interview and GPS information were analysed using Wordmapper software. CONCLUSIONS: This methodology resulted in data presented uniquely in both a visual map and narrative. These data were richer than if a single modality had been used. These data highlighted specific contextual factors that were related to the location of needle debris, which created opportunities for nursing interventions to support people experiencing vulnerability.

The Importance of Nurse-Patient Relationships in the Midst of Substance Misuse: Support for Rural Youth Well-Being.

Nurses working in rural acute and community-based settings are often asked for substance use treatment guidance and education in a health care system with minimal treatment services available. Nursing science provides an alternative answer for nurses to lean on in their clinical practice when working with rural-dwelling youth in the midst of substance misuse. Practical strategies are offered, which nurses may integrate into their routine clinical care to strengthen the nurse-patient relationship and enhance positive attributes among youth. Connective caring practice is essential to support rural youth well-being and recovery in the midst of substance misuse. [Journal of Psychosocial Nursing and Mental Health Services, 62(6), 7-11.].

[Surftherapy, an innovative mediation in an addiction treatment program]. / La surfthérapie, une médiation innovante dans un parcours de soins en addictologie.

Imagine a dream where ocean waves become allies for the caregiver. This vision took shape in a project begun in 2020 at the Clinique de l'Odet, the addictology department of the public mental health establishment in South Finistère: surf therapy as a tool for addictology care, the ocean as an ecological framework for rehabilitation. In this exceptional adventure, the dream of a care team to support patients' recovery through surfing has become a reality, where every wave is a step towards freedom; every take-off a victory on the road to recovery.

"The Future of Nursing: Accelerating gains made to address the continuum of substance use".

PURPOSE: Guided by four key messages from the decade-old Institute of Medicine (IOM) report, "The Future of Nursing," this paper highlights the progress made by the nursing profession in addressing substance use and its related disorders and offers recommendations to sustain and advance efforts to enhance care for persons who use substances, one of the most stigmatized and vulnerable populations. RESULTS: Patterns of substance use have shifted over the past 10 years, but the associated harms remain consequential. As awareness of the continuum of substance use has expanded, the care of persons with substance use has also expanded, from the domains of psychiatric-mental health and addictions nursing specialties to the mainstream of nursing. Now, greater efforts are being undertaken to identify and intervene with persons at risk for and experiencing substance use disorders. Nurses have advanced the knowledge and skills necessary for substance-related nursing care including education and training, leadership, care innovations, and workforce expansion and can drive efforts to increase public knowledge about the health risks associated with substance use. Recommendations aligned with each of the four IOM key messages are offered. CONCLUSIONS: As a profession, nursing has a responsibility to expand the progress made in addressing substance use - from prevention and early intervention to tertiary care. Nurses at all levels of education and practice are in key positions to carry out the recommendations herein to accelerate the changes needed to provide high quality care for persons impacted by substance use.

Mental Health Issues and Substance Use in the United States: Pulling the Power Levers.

BACKGROUND: Promising treatment avenues have been developed and studied that align well with the skills of psychiatric-mental health (PMH) nurses. The treatments are relationship-driven, nimble and accessible, and recovery-guided. They emphasize a whole-person approach with care delivered by a team of experts working in a contextually coordinated way. AIMS: To describe the challenges facing the United States with regard to mental illness and substance use disorders and the ways in which PMH nurses can use their skills to mitigate these challenges. METHOD: Published research and government reports were reviewed to obtain current mental health and substance use data. RESULTS: The number of people not being treated for mental illnesses-particularly serious mental illness, major depressive episode, and suicidal thoughts-has not improved since 2009. Although inroads have been made in reducing the rate of smoking in the United States, we are facing an opioid crisis. There are limited data on marijuana use, but it is apparent that many Americans use cannabis routinely. According to the Substance Abuse and Mental Health Administration, approximately 44.7 million people need mental health treatment and 20.1 million Americans need substance use treatment, but only 10% to 30% receive it. CONCLUSIONS: PMH nurses must take a leading role in retooling the therapeutic relationship and partnering with clients, families, and caregivers to improve the quality of life and well-being of those dealing with mental illness and substance use disorders. To accomplish this essential task, the PMH nursing workforce must be robust and distributed throughout the United States.

Addressing substance use disorder in primary care: The role, integration, and impact of recovery coaches.

BACKGROUND: Only 10% of people with substance use disorder (SUD) receive treatment, partially due to inadequate access to specialty SUD care and limited management within primary care. "Recovery coaches" (RCs), peers sharing the lived experience of addiction and recovery, are increasingly being integrated into primary care to help reach and treat people experiencing SUD, yet little is known about how their role should be defined or about their clinical integration and impact. METHODS: Semistructured interviews with RCs (n = 5) and their patients (n = 16) were used to explore patient and RC perspectives on the RC role. Maximum variation sampling was employed to select patients who displayed diversity across gender, RC, housing status, and number of contacts with an RC. Patients were sampled until no new concepts emerged from additional interviews, and a semistructured interview guide was used for data collection. To analyze interview transcripts, the constant comparative method was used to develop and assign inductively developed codes. Two coders separately coded all transcripts and reconciled code assignments. RESULTS: Four core RC activities were identified: system navigation, supporting behavior change, harm reduction, and relationship building. Across these activities, benefits of the RC role emerged, including accessibility, shared experiences, motivation of behavior change, and links to social services. Challenges of the RC model were also evident: patient discomfort with asking for help, lack of clarity in RC role, and tension within the care team. CONCLUSIONS: These findings shed light on RCs in primary care. Many patients and coaches perceived that RCs play a valuable role within primary care, providing both tangible system navigation and intangible, social support that promote recovery and might not otherwise be available. Enhanced communication between RCs and health center leadership in defining the RC role may help resolve ambiguity and related tensions between RCs and care team members.

Competencies of the nurse in educational institutions: a look from educational managers. / Competencias de la enfermera en instituciones educativas: una mirada desde los gestores educativos.

OBJECTIVE: Describe and analyze the attributes of the nurse competencies in caring of students since the manager look of educational institutions. METHOD: Qualitative descriptive-exploratory study. Seven principals of educational institutions of Trujillo (Peru) participates in a non-structured interview during the first semester of 2016 and the analysis of oral discourse was used. RESULTS: Empirical categories: The nurse in the promotion of educational community health; The nurse in the prevention of the educational community illness; The student nurse articulating health - education in the everyday life of students. FINAL CONSIDERATIONS: This study contributes to the conceptual support of the competencies of the student nurse for the intersectoral health - education action and the setting-up of health with students in the educational institutions.

Improving the physical health of people with mental health problems.

Emeritus Professor Alan Glasper, from the University of Southampton, discusses the looming crisis in managing the physical health of people who have mental health problems, and how it will be tackled.

Substance misuse: can midwives really make a difference?

Substance misuse makes a woman vulnerable. During pregnancy, in particular, the issues surrounding Substance misuse and its treatment are very emotive. Pregnancy often prompts women who substance misuse to seek help for their addiction for the first time, but for some it is part of a cycle of failure and loss: failure at rehabilitation and facing the loss of yet another child, be it through child protection issues or from the medical complications of addiction. As a midwife only engages with a woman for a relatively short period of time, can their actions have a lifelong impact on the woman and her unborn child? This article aims to examine the stigma of substance misuse and the role a midwife plays, not just as a maternity care provider but also in the continued journey of the woman and her child.

[Pathway of a patient within a healthcare unit]. / Parcours d'un patient au sein d'une unité sanitaire.

Care in prison must be based as much as possible on the model used for the general population. The system of psychiatric care in prisons comprises three levels of provision. The presentation of the pathway of a young patient with severe mental disorders shows the possibilities and the difficulties involved in caring within a healthcare unit.

Agency and addiction in a harm reduction paradigm: French nurses' perspectives.

French psychiatric nurses' perspectives on individuals addicted to drugs and their treatments are influenced by French socio-cultural norms. In this study, steps of the ethnographic method were used to elicit the intertwining of French professional and cultural perspectives on drug addiction. Emergent themes from nurses' interviews and cultural participant-observations suggest that drug addiction management in France's harm reduction paradigm challenges nurses' beliefs about addicted individuals' agency and conformity to treatment goals, and is influenced by European Union membership, changes in health care, drugs and demographics. Novel nursing strategies emergent from these themes might be applicable in other cultural contexts.

Supporting women with substance use issues: trauma-informed care as a foundation for practice in the NICU.

Infants with neonatal abstinence syndrome and their mothers require extended support through health and social service systems. Practitioners are interested in exploring innovative approaches to caring for infants and mothers. There is now compelling evidence linking women's substance use to experiences of trauma and violence. A significant shift in the fields of addiction and mental health has been awareness of the impact of trauma and violence on infants and children, women, their families, and communities. In this article, the current state of knowledge of trauma-informed care is reviewed, in particular for application to practice within the NICU. Trauma survivors are at risk of being retraumatized because of health care providers' limited understanding of how to work effectively with them. Recognizing the impact of trauma and implementing evidence-based trauma-informed practices in the NICU holds promise for improving outcomes for women and their infants.

Managing misuse of novel psychoactive substances.

Misuse of novel psychoactive substances, also known as legal highs, is growing in the UK. These substances include more than 200 psychoactive chemicals and are associated with harm to physical and mental health, but are not controlled under the Misuse of Drugs Act 1971 or regulated as a medicine. This article reviews the evidence relating to psychosocial interventions for illegal substance misuse to identify how therapies could improve rates of abstinence and awareness in adults who are misusing novel psychoactive substances. The evidence is limited and there is a need for further research and increased awareness among health professionals and the general population of this growing problem.

[Psychological containment put to the test by a crisis]. / La contenance psychique á l'épreuve de la crise.

In the first-time admission unit, psychological containment is based essentially on receivingthe patient in crisis. While the management of the crisis is inseparable from containment, the drawing up of the patient's history, centred on observation, transfer and the clinical aspect, is a key stage in the patient's care. In an institution, the nursing team will, through its creativity, invent the care, seeking a possible alliance.

Peer Facilitator Training for Diabetes Prevention in a Nigerian Drug Treatment Center.

INTRODUCTION AND BACKGROUND: Individuals with substance use disorders (SUDs) are at an increased risk of developing comorbid medical conditions, including Type 2 diabetes. Although the diabetes prevention program (DPP) is efficacious and cost-effective, there is no published evidence to support its implementation in Nigeria or within SUD treatment settings. In this first known DPP within an SUD treatment program, we implemented a multiphased, nurse-led DPP at a small outpatient drug treatment center in Nigeria. The aim of this article was to describe only the processes utilized for the initial peer facilitator (PF) training (Phase 1). METHODS: In Phase 1, a diabetes prevention master trainer delivered a virtual DPP training to the facility's lead nurse, who return-demonstrated the DPP workshop skills and competencies over four 4-hour sessions. The lead nurse then independently delivered four 8-hour training sessions to a small number of client volunteers (n = 4) who subsequently delivered the DPP lifestyle interventions to their peers in the outpatient treatment program. RESULTS: The client volunteers attended all PF workshop sessions and were observed to be proficient in all aspects of implementation. They indicated that the training objectives were easily achieved and expressed enthusiasm for delivering DPP content to their peers. The need to better contextualize the DPP curriculum specific to Nigerian food preferences was identified. CONCLUSION: The Phase 1 training process appears to be an appropriate and effective approach for preparing PFs to deliver health programs, like the DPP, in environments with limited resources for populations facing numerous challenges.

Youth Advisors Driving Action: hearing the youth voice in mental health systems of care.

The Children's Mental Health Initiative (CMHI) is funded by the Center for Mental Health Services within the Substance Abuse and Mental Health Services Administration. CMHI assists communities in developing comprehensive, coordinated services for children with serious emotional disturbances and their families. Broadly speaking, these systems are designed to be child centered, youth guided, family driven, community based, and culturally competent. To assure implementation of the "youth-guided" core value in the national evaluation, an advisory group of youth coordinator/youth teams representing communities across the country was developed. This group chose the name YADA-Youth Advisors Driving Action. YADA has made a substantive contribution to national evaluation efforts by bringing the youth perspective and voice to its audience at the community and national levels. This article describes YADA's founding and development, as well as related implications for psychosocial nurses.

[Therapeutic activities for adolescents in crisis]. / Des activités thérapeutiques pour adolescents en crise.

The treatment of adolescents in crisis can be based around therapeutic activities. Professionals organise and lead workshops. These workshops can help professionals gain a better understanding of the patients and find suitable answers.

[Mental healthcare in Brussels: a model?]. / La santé mentale à Bruxelles: un modèle?

Different psychiatric trends in Europe have influenced the mental healthcare model in Brussels. This institutional complexity gives rise to a mosaic-style care system. The reform of psychiatry in Belgium invites professionals to work on an outpatient basis to create another type of organisation, greater coherence and in order to change mentalities.

Mental health nursing in emergency departments: the case for a nurse practitioner role.

AIMS AND OBJECTIVES: This paper aims to explore the effectiveness of the mental health nurse practitioner role in the emergency department in the context of the growing use of special units or segregated areas to manage particular kinds of mental health presentations, often complicated by substance use. BACKGROUND: In recent years, there has been a significant increase in mental health presentations to emergency departments, often complicated by substance abuse. Emergency departments have introduced a variety of mechanisms to address this growing problem. With the introduction of mental health nurse practitioners, opportunities arise to reconsider these mechanisms. DESIGN: Discursive paper. METHODS: In this discursive paper, contemporary practices are described in relation to 'special care areas', 'psychiatric emergency centres' and 'short-stay units'. The mental health nurse practitioner role in training and capacity building is also explored and the notion of 'locational processes' described. Rather than being presented as an alternative to short-stay units, the mental health nurse practitioner role is explored in its potential to enhance mental health nursing practice in a sometimes difficult clinical environment. RESULTS: The paper provides evidence from literature and practice that the clinical outcome for consumers is enhanced through the mental health nurse practitioner role. CONCLUSIONS: It is argued that the introduction of the mental health nurse practitioner role in the emergency department leads to increased staff competence and confidence in interacting with those presenting with mental health issues. The mental health nurse practitioner role also addresses the serious problem of stigma associated with those with a mental health issue. RELEVANCE TO CLINICAL PRACTICE: It is expected that those presenting with mental health issues to the emergency department will benefit through the increased assessment and management skills of staff.