Through the days of the Bubonic or Black Plague, through measles and AIDs, whenever the citizens of the globe were suffering and casualty rates were high, nurses were in the thick of things. Today's opioid epidemic, already killing 130 people per day according to Centers for Disease Control figures, will be no different: Nurses will play a critical role.
"Nurses are on the front lines screening and identifying patients with substance use disorders," said Emory University Nell Hodgson Woodruff School of Nursing assistant professor Brenda Baker.
In epidemic times past, nurses may have been simple healers armed with herbal remedies and splints. And while today's nurses may have technology and medication at their disposal, the challenge is still momentous, each casualty wrenching. How will nurses in Georgia and throughout the U.S. define their role, and make it one that reflects the compassion and dedication of the profession?
Some of the choices will be made for nurses and decided in board rooms, not by individual nurses faced with individual patients. For example, a nurse practitioner's role in prescribing opioid treatments has been restricted by the laws of many states, according to U.S. News and World Report. A study from University of California, San Francisco published in April 2019 noted that at least six states with soaring opioid addiction rates are the same ones with strict rules against NPs prescribing the buprenorphine that could help opioid-addicted patients.
"NPs in states requiring that they practice under physician supervision or collaboration are much less likely to get waivers to prescribe these medications, and many of these same states have the highest rates of opioid overdose and addiction," study co-author and Director for Research at the Healthforce Center Joanne Spetz explained in a news release. "If their supervision or collaboration regulations cannot be changed, states should try to develop programs to help connect NPs with physicians willing to supervise them in offering buprenorphine," she added.
It is just that type of advocating, grouping and regrouping and making concessions as necessary that are the only ways nurses can define their role in the opioid epidemic even as the epidemic sweeps the nation. One of the many problems is, the epidemic is swelling so swiftly that extra time spent passing, say, new NP state laws one by one, will mean more casualties.
Other strategies for nurses to help stem the tide of the opioid epidemic are slowly falling into place, however. On the micro-scale, there are efforts like the Emory grant funding that will let some School of Nursing faculty teach an elective course at the School of Nursing on SUD. "It's such a big topic for nurses now," Baker says simply. "Substance use disorders used to only be taught in a mental health class, but we now incorporate the topic in almost every population. We're teaching nursing students how to ask appropriate questions without shame or stigma associated with addiction."
Nursing organizations are also wading in to define nurse roles on a national scale. The American Association of Colleges of Nursing, for example, has stated its intentions as part of its Opioid Epidemic Resources for Nurse Educators. "AACN is committed to addressing the prescription drug abuse and heroin epidemic in the United States," it specified. "AACN is committed to mobilizing the academic nursing response by joining the National Academy of Medicine's Action Collaborative on Countering the U.S. Opioid Epidemic. As part of this new initiative, AACN is reaching out to all member schools — not only those with APRN programs — to rally support for taking action at the local level."
And all the while, nurses know it will never be enough for them to take steps if society doesn't also respond.
Baker, a registered nurse and clinical nurse specialist, gets up close and personal with women who have substance use disorder. She's the research and program director for Motherhood Behind Bars, a program for pregnant women prisoners, a population riddled with substance use disorder. "As a society we have to move beyond the shame and stigma associated with substance use disorders," Baker insists. "We have to start addressing and treating substance use disorder as a health issue, with far-reaching consequences.
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