“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

English version

Autoři: Gabrielle Horner ^aff001; Jeff Daddona ^aff001; Deirdre J. Burke ^aff002; Judith Cullinane ^aff003; Margie Skeer ^aff001; Alysse G. Wurcel ^aff001
Působiště autorů: Tufts University School of Medicine, Department of Public Health and Community Medicine, Boston, Massachusetts, United States of America ^aff001; Tufts Medical Center, Department of Medicine, Division of Geographic Medicine and Infectious Diseases, Boston, Massachusetts, United States of America ^aff002; Tufts Medical Center, Department of Nursing, Boston, Massachusetts, United States of America ^aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0224335

Souhrn

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.

Klíčová slova:

Allied health care professionals – Nurses – Patients – Psychological stress – Addiction – Opioids – Pain management – Inpatients

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