2. Drug Addiction Whitney Ayers

3. Nursing Care Problem Nurses perception of the quality of care they give to hospitalized drug addicts. Stereotypes Violent Dangerous Low socioeconomic class Low cognitive level Unhygienic Family with low cognitive Has contagious disease level Uncultured Weak Character Scary Dangerous

4. Nursing Theory Betty Neuman’s Systems Theory “Health is a condition in which all parts and subparts are in harmony with the whole of the client” Variables  Intrapersonal-occurs within a person  Interpersonal-occurs between individuals  Extrapersonal –occurs outside an individual

5. Methods- Descriptive statistic study Questionnaire Variables  Attitudes  Stereotypes  Subjective norms  Intention  Behavior The study and questionnaire were approved by the research ethics committee of the Nursing Department at the Pat Matthews Academic School of Nursing. Respondents were briefed on the aims of the study and written consent was obtained.

6. Results/Limitations  Moderately negative attitudes  Stereotypes lead to decreased perception of quality of care given to drug addicted patients.  Dependent variable- self-reporting of behavior by nurses.  Leads to idealization.

7. 1.IDENTIFY… the variables in this situation 36 yo male Heroin addict Overdosed Requesting to leave AMA Fears withdrawal High anxiety level Requesting pain medication 2. RELATE… Or put the variables together to form propositions. Primary Proposition: “Pt requesting specific pain medication due to fear of withdrawal symptoms.” Possible Assumptions: “Pt only wants pain medication to get high” Possible Confounding Variables: “Fear of becoming sick from heroin withdrawal symptoms that are begging to manifest.” 3. UNDERSTAND… the importance of the propositions, assumptions, and confounding variables. Proposition: “If withdrawal symptoms are not addressed it could be a potential risk to the health of the patient.” Significance of Assumptions: “If the patient is trying to leave AMA and his medical needs are not addressed it could be a risk to the patient, and his condition could worsen.” Possible Confounding Variables: “If the patients leaves AMA and does not know the dangerous signs and symptoms of withdrawal, he may not receive the medical help he needs.” The patient is a heroin addict and will be looking for heroin as soon as he leaves the facility. Situation: Mr. Patterson is a 36 yo male who was admitted last night with a heroin overdose. He was treated in the ED for the overdose and was admitted to the floor at 3am. He is requesting to leave the facility AMA for fear of withdrawal symptoms, and states the nurses are “treating him poorly and not giving him the proper amount of pain medication”. The patient is very agitated and is beginning to show signs of withdrawal requesting specific narcotic pain medication. The nurse is a 26 yo BSN prepared RN and a recent graduate, who has minimal exposure to addiction and patients who abuse substances.

8. 4. EXPLAIN… the significance of the situation to those involved based on their individual KSVME Proposition: Calmly, and in a way the patient can understand, explain to him why it is important for him to get medical treatment for his condition. Explain that his symptoms will be controlled so that he will not feel sick. Assumptions: Explain to him how his symptoms will be managed and that his pain will be under control to the best of your ability. Variables: explain the different symptoms he may experience when withdrawing from heroin and how the hospital is the safest place to treat these symptoms. 5. PREDICT… what will happen in this situation if one or more variables are not changed. Proposition: If the patient is not informed of the risks of withdrawal without medical intervention, then he may leave AMA and encounter dangerous symptoms outside the hospital, or overdose again. Assumptions: If the patient will trust the medical staff, then his symptoms can be managed and he will not leave AMA. Confounding Variables: If the patient does not leave AMA and his symptoms are treated properly, then his risk of dangerous symptoms will be decreased. He may also feel that the staff is taking better care of him. 6. INFLUENCE… someone to change one or more variables in order to achieve a desired outcome or prevent an undesirable one. Proposition: Make sure pt know that his symptoms will be treated to reduce the fear of withdrawal. Administer proper medication to treat symptoms. Assumptions: Make sure the pt understands the importance of being monitored with withdrawing from heroin. Instruct him on what he can do to help with withdrawal symptoms. Confounding Variables: Discuss the willingness for the pt to get treatment for addiction. Identify the benefits of treatment and how the different options offered to him. 7. CONTROL… one or more variables in order to achieve a desired outcome or prevent an undesirable one. To control isn’t an issue of wanting to dominate or do what is unreasonable or unwanted, but simply a matter of changing one or more variables in order to bring about a desired outcome when influence is not possible, realistic, or advisable. Pt must abide by hospital rules while admitted to the unit.

9. Advocate Role Research shows nurses treat these patients differently. Addiction is a disease Nurses can make a difference in their lives These patients can recover Know one knows what the patient is going through or what they have been through.

10. Nursing Significance Making nurses aware! Could impact the quality of care More people may seek treatment Nurses see this disease in almost every field

11. What Addiction Can Do

12. References Colley, (2014), NURS 441 Nursing Theory 3 [Syllabus]. Natan, M., Beyil, V., & Neta, O. (2009). Nurses’ perception of the quality of care they provide to hospitalized drug addicts: Testing the Theory of Reasoned Action. International Journal of Nursing Practice, 15, 566-573. Nursing Theories: a companion to nursing theories and models. (2012). http://currentnursing.com/nursing_theory/Neuman.html