The U.S. opioid epidemic continues to rage. The national rate of opioid-related emergency department (ED) visits increased 99 percent from 2005 to 2014. Inpatient stays increased 64 percent.
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In 2016, EDs in Cuyahoga County (Ohio), where Cleveland Clinic is based, treated an average of more than 20 patients per day with drug-related injuries. More than 500 victims died. That’s double the number from 2015. Numbers for 2017 are expected to double again.
“Our caregivers have been dealing with the opioid epidemic for years, but we don’t believe it has peaked yet,” says Jennifer Johns, Director of Government Relations at Cleveland Clinic.
In response, Cleveland Clinic launched an opioid task force of close to 200 thought leaders from all areas of the organization, including clinical, administration and business operations. Johns is the chair.
Nurses were particularly motivated to participate, since they are on the front lines of caring for overdose victims, says Meredith Lahl-Foxx, MBA, MSN, APRN, Executive Director and Associate Chief Nursing Officer of Advanced Practice Nursing at Cleveland Clinic.
“Our Nursing Legislative and Health Policy Council also has been focusing on the opioid crisis,” she says. “Nurses in that group were given an opportunity to participate in the organization-wide opioid task force.”
Lahl-Foxx praises the nation’s growing addiction prevention efforts, but nurses need support to handle the acute crises that are still happening, she says.
“Burnout is a real problem for nurses who care for patients with opioid addiction. We have patients that end up in our EDs time and time again. We’ve had visitors sneak drugs in for patients. Nurses walk a fine line of trying to be empathetic and caring, while enforcing boundaries that keep patients safe.”
Stress on the job is only half the problem. Lahl-Foxx says nurses are conflicted about how to help people with addiction that they encounter when not at work. How much responsibility do they have?
“People expect nurses to have information and resources,” she says. “What is the role of nurses when they see someone who has overdosed in a parking lot, for example? There are many unanswered questions.”
Because the opioid crisis is top-of-mind for nurses, several, including Lahl-Foxx, volunteered to represent their colleagues on the opioid task force, which began meeting in early 2017. Nurses participate in all three focus areas:
Other projects include:
“If a friend brings a patient heroin while he’s in the ED, what should a nurse say? What should a nurse do?” asks Lahl-Foxx. “The task force is rising to challenges like this and developing guidance.”
All three focus areas will have a direct effect on nurses — providing training, resources or other support to ease the burden of caring for patients with addiction. They also will help keep patients safer, says Lahl-Foxx.
“Addiction affects all types of people in all types of communities,” she says. “We need to empower nurses with the resources and support to manage it. Their involvement with the task force already shows how willing they are to step up to address the opioid crisis.”