Core Competencies: values and ethics as well as roles and responsibilities

The presentation, Needle Exchange Program, delivered by Kerri Barton, was a wonderful opportunity to learn about the harm reduction and substance use prevention services in Portland, Maine. Substance use disorder (SUD) is a chronic disease involving the inability to control one’s use of legal and illegal substances such as street drugs, alcohol, or medications. SUD is a challenging disease to overcome, and it often takes various treatment interventions and numerous attempts to achieve long-term recovery with many individuals relapsing multiple times and some never fully recovering. Typically, individuals suffering from SUD are in and out of treatment programs throughout their lives. Therefore, harm reduction is critical for these individuals to alleviate the negative social and physical consequences of substance use. Harm reduction incorporates strategies that promote safer drug use, abstinence, and it is about bringing people together who use drugs for support in their continuum of recovery and ensuring that they are safe throughout the process. Harm reduction has been shown to reduce drug-related deaths, life-threatening infections due to unsterile needles, and chronic diseases such as hepatitis and HIV. 

For this section, I am going to focus on how this lecture is associated with the core competency of ‘values and ethics’. Prior to this lecture, I was aware that harm reduction concentrates on a set of practical strategies that are directed at lessening the negative consequences associated with substance use disorders with particularly focus on six generalized principles utilized in health care, including humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. However, my preconceived thoughts about harm reduction and the Needle Exchange Program focused primarily on ways to educate the public on the harms of illicit and licit drug use and to prevent harm from happening to individuals suffering from SUD, but truly, this program focuses on the fact that society needs to accept, for better or for worse, that drug use is a phenomena, whether illicit or licit, that needs to be managed. It is a public health crisis that cannot be ignored. Thus, in this lecture, I learned that these programs focus on working to reduce SUD’s harmful effects instead of overlooking or condemning them. Although this program does supply aid to help those with treatment and recovery, it is not simply preventing drug use from occurring and forcing people into treatment but educating individuals on safer ways to use drugs and allow them access to resources to keep them as safe as possible to reduce harm from happening. The programs also promote wellness and recovery. Harm reduction is a strategy involving approaches that engage directly with those suffering from SUD’s to prevent overdoses and infectious diseases while improving the physical, mental, and social well-being of those suffering and to offer substance use disorder treatments and health care services. As a nurse, I intend to educate those suffering from SUD about various proactive and preventive programs. I will work diligently to assist people to find harm reduction services such as the needle exchange program to help them reduce risks such as overdoses and transmissible diseases.

Regarding values and ethics, one important takeaway I learned from today’s lecture is that health and health inequalities play a huge role in substance abuse, which I believe is not readily acknowledged by the public and it should be part of the discussion. For example, poverty, trauma history, gender discrimination, class, race discrimination, and several other social inequalities play a crucial role in affecting an individual’s vulnerability to substance abuse and can also affect how successful or unsuccessful they may be in accessing/continuing treatment and achieving recovery. Lack of education, and support mechanisms as well as socioeconomic disadvantages often influence SUD outcomes. As a nurse, I will therefore, ensure that I assess all these factors for a patient suffering from substance abuse and will take efforts to assist them to access treatment throughout their potential recovery. 

Furthermore, as a nurse, I will ensure to implement many techniques I have learned today and include them in my patient care for those suffering from SUD. I will ensure to uphold the roles and responsibilties associated with a nurse working with those suffering from SUD. For example, I consider including harm reduction by promoting access to safer use supplies and use of drugs counseling on how to be aware of and respond to an overdose- blue lips and nails, slow, shallow breath, slurred speech, and pinpoint pupils. Also, I will discuss antidotes such as naloxone to reverse the effects of an overdose. Finally, I would educate the individual to seek assistance immediately in such a situation if needed. I would also help with access to community-based groups, counseling, etc., to help them with recovery and treatment. I would also teach them prevention strategies, such as never using drugs alone, reducing the frequency and intensity of drug use, going slow when using a substance, and testing it first because strengths can vary. Overall, because of this excellent presentation, I have learned to do all I can to assist my patients in achieving the best outcomes possible for each individual. Therefore, this lecture reflects the roles and responsibilities of a nurse working with patients who have SUD as well as the ethics and values associated with these situations.