Letter to the Editor by Ali Duncan to “Opiate Crisis and Healthcare Reform in America: A Review for Nurses”

Healthcare Reform: Nurses Impact Policy

July 15, 2018

Response by Ali Duncan to “Opiate Crisis and Healthcare Reform in America: A Review for Nurses” by Susan G. Painter (May 31, 2017)

With Reply from Author

Dear Editor:

I am writing in response to Painter’s May 2017 article titled, “Opiate Crisis and Healthcare Reform in America: A Review for Nurses”. Recently with the increase in the discussion about the opioid crisis in America, I have a new interest to figure out my responsibility as a healthcare professional to address this issue. Painter provides compelling statistics that bring to life the current opioid crisis. This national emergency can no longer be ignored and healthcare professionals must step up to provide the care opioid addicted patients so desperately need. As a new graduate nurse, I have cared for several patients with opiate addiction, and I believe additional education catered to this population of patients would be extremely beneficial.

As I have cared for this patient population, I sometimes find it difficult to communicate with them effectively without bias and judgment. It seems that while we learn in school about how to care for them from a medical perspective, I feel that nursing education has missed the psychosocial component that is so crucial for these patients. A continuing education class, perhaps taught by a mental health professional who specializes in substance abuse would certainly be a benefit to all clinical staff. I personally do not want to provide care based on individual stereotypes of substance abuse users, which seems to be a barrier in properly caring for these patients. I feel a responsibility to care for these patients as if they were any other patient with a chronic illness.

I have also found when receiving change of shift report, there is a negative attitude toward these patients. There have been many times I received a biased perspective of the patient’s clinical situation by the nurse’s report. For example, I often hear: “He/she just calls out all the time,” or “He/she just wants pain medicine every five minutes.” This always paints a negative picture of the patient for me before I even walk into the patient’s room. I think that if all staff members were required to take an educational course concerning the psychosocial aspect of addiction we could hopefully dissolve some of these negative stigmas. Staff members could hold each other accountable as we strive to work together to care for these patients and treat them medically appropriate and ethically respectful.

Understanding how best to communicate with patients with substance abuse is crucial as we strive to build rapport and ultimately identify their individual needs. If nurses feel comfortable asking questions of these patients and approaching them with compassion, perhaps these patients will feel more comfortable speaking to us about their addiction. Creating a safe and confidential environment for the patient to express concerns would certainly be beneficial for the patient and nurse. I hope to learn how to communicate with this patient population and in turn, the patient will feel comfortable under my care. The patient will then receive the help they need.

This article, along with various news broadcasts, has compelled me to learn more about this opioid crisis and about what I can do as a healthcare professional to support interventions to dissolve this national crisis. I believe that additional education about this vulnerable population would certainly benefit nurses in the clinical setting, dissolve various stigmas, and create a positive response when working with these patients. It certainly is going to take various members of the healthcare team and the community for us to be able to provide empathy, awareness, safety, and guidance as these patients pursue a road to recovery.


Ali Duncan, RN


Painter, S. G. (2017). Opiate crisis and healthcare reform in America: A review for nurses. OJIN: The Online Journal of Issues in Nursing, 22(2), Manuscript 3. Available: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-22-2017/No2-May-2017/Opiate-Crisis-and-Healthcare-Reform-in-America.html