Sadie Lavelle Cafferkey - Nurse-led Addiction Model of Care

Sadie Lavelle Cafferkey is a registered nurse working on in the Republic of Ireland. She is currently doing a PhD with Trinity College Dublin.  Her project is looking at developing integrated nurse led addiction services for rural communities.   Episode summary: 01.10  Sadi tells us about her professional background and how she became involved in the field of addiction. 04.00  What has your research shown about historical data on addiction in rural hospitals in Ireland? 07.35  What are some of the triggers for addiction in rural Ireland? 08.15  What services are currently available in rural areas? 10.15  What is an addiction cycle? 13.40  Why are you advocating for nurse-led models of care? 16.50  What would need to be implemented or changed to enable nurse-led models of care? 19.15  What is your advice for health professionals supporting people with addiction in rural areas? 25.50  What do we need to be aware of in regard to the experience of people with addiction in rural areas? 30.50  What are the main findings of your research so far? 30.25  What are her three recommendations for how to move forward?   Key messages:  During her masters she learned about the lack of resources in urban settings relating to addiction services, she became interested in exploring the situation for rural areas. Her PhD is focusing on providing a nurse led addiction model of care for resource poor and rural settings and it is a mixed method study. A 10 year retrospective analysis showed that alcohol is a significant issue but there are also pockets of certain substance abuse in different hospitals.   Nurse led model of care will not be a one size fits all, it will need to take into account what the patients need, what the hospital needs and what the nurses need to make this approach work.  Local rural services are inundated, hospitals are seeing a rise in people suffering from alcohol and substance abuse.  However there are no addiction services to refer them to. A person will come into the hospital while under the influence of a substance, they have their medical condition treated and they might be offered detox.  Following this they are discharged without any support offered in the community.  The person then slips back into addiction.   Why nurse-led care? Nurses make up nearly half of all healthcare professionals, this makes them accessible.  They provide 24 hour, 7 day a week care.  Nurses are good with health education. Nurses are adaptable.  Nurse led care is very safe and very effective, it saves governments a lot of money.  Patients trust their nurses.  Nurses advocate for their patients.   What would need to change to enable this approach?  The way that things are recorded and reported.  Nurses need to be able to specialise in addiction care and they need to be able to prescribe.  We need to change minds to allow for changes to happen. Rural communities benefit from nurse-led models of care. Taskforce for drug and alcohol, they can be a resource for supporting clinicians.   The "Healthy Options Clinic" was something that the nurses started to reduce the stigma of attending the surgery for substance use issues. Access to services, access to the internet, access to public transport, all of these factors can be barriers to seeking help.  It is not just a healthcare issue, we need support from other sectors to enable good care.   The environment needs to be stigma free and safe. The nurses need training and upskilling along with support form leadership and management Nurse prescribing is important in substance use clinics. Having rapport with patients is important for providing care and finding out what they need. We need a better reporting system to gather good quality data. We need better digital services in rural areas.   How to move things forward? Digital, nurse prescribing and good quality reporting system.     Online course on addiction treatment: https://www.mooc-list.com/course/addiction-treatment-clinical-skills-healthcare-providers-coursera  https://www.mooc-list.com/course/managing-addiction-framework-successful-treatment-edx    Contact Sadie at: [email protected]    Thank you for listening to the Rural Road to Health! Rural Health Compass