Speakers - WNSC 2023

Abstract

Background: Studies have shown that the prevalence of drug and alcohol addiction as well as misuse of substances such substances as opioids, benzodiazepines, marijuana, methamphetamines, and cocaine has increased over the past few years (Department of Health 2016, Irish Medical Organisation 2015). Consequently, addiction to these substances has detrimental effects on the physical and mental well-being of the affected individuals; hence they may require admission to an addiction treatment service. However, addiction nursing is a rare specialty with very few nurses specialized in that field particularly in Europe (Dalal 2020). Thus, due to the scarcity of specialized addiction nurses, General Nurses (GN) are employed to work in most addiction treatment services (Public Health England 2017). In Ireland studies show that addiction nursing has not been well documented, however, it is understood through the Irish policy response to the treatment of substance misuse, drug and alcohol use as well as dual diagnosis (Clancy et al 2019, Rani and Byrne 2012).

Aim: This study aims to explore the challenges experienced by General Nurses working within addiction services.

Objective: The study’s main objective is to establish some of the challenges and barriers to the retention of GNs in an addiction setting.

Methodology: An interpretative qualitative systematic review of seven studies was conducted using a meta-ethnographic approach (Noblit and Hare 1988) to explore different sources of literature in relation to the challenges experienced by General Nurses working in addiction services. An electronic search was conducted in databases such as CINHAL, Pub Med, Cochrane Library, and Pych-Info. The ENTREQ tool was incorporated to guide the systematic review. Findings were analyzed to come up with themes.

Results: The systematic review revealed the following as the challenges experienced by general nurses working within the addiction services: degree of knowledge on addiction nursing, challenging behavior by clients such as poor compliance to treatment, legal issues and aggression, physical and psychological work environment, stigma and nursing practice issues.

Conclusion: This study examined a contemporary problem in the management of SUDs. Various challenges experienced by nurses in the addiction treatment sector were revealed. Hence, it is relevant to all stakeholders in the addiction treatment sector including program developers and course leaders at nurse training institutions, leadership and management at addiction treatment services as well as nurses working within and outside the addiction services. Therefore, the findings from this study can be the starting point in the mitigation of the challenges experienced by nurses, thereby improving the retention of nurses and thus improving the quality of care at the addiction services.

Recommendations: The following recommendations were made: training institutions to develop a structured training program covering all aspects of caring for clients' SUDs, comprehensive induction for new nurses to settle well into the job, policies, guidelines, and procedures to protect the client, staff and the organization, multidisciplinary collaboration, for example, police (Garda) liaison on issues of illicit substances found in the service, consistent clinical supervision and support will allay anxiety, peer group meetings for staff to share their concerns and experiences help identify problems and interventions early.