A grounded theory study exploring the experiences of illicit drug users and nurses caring for them on medical wards

Background: There has been a significant year
on year increase in the use of illicit drugs
since the 1980’s. Consequently the rate of
emergency admissions of people with physical
complications of drug use to acute medical
wards has increased. Negative attitudes held
by health care staff towards illicit drugs users
(McLaughlin et al, 2000) alongside repeated
calls for education to better equip Adult
registered nurses (Nkowane and Saxena, 2004)
have largely gone unheard. This may ultimately
contribute to inappropriate and ineffective care
in non specialist secondary care settings.
Aim: This study sought to examine the everyday
experiences of nurses delivering and illicit drug
users receiving care in medical wards to reveal
the primacy of care.
Method: A constructivist grounded theory
approach was adopted for this study using
the techniques and procedures described by
Strauss and Corbin (1998). Semi-structured
interviews were undertaken with a purposive
sample of nurses (n=29) and illicit drug users
(n=12) in a Northern NHS Trust. Data collection
and analysis was undertaken using constant
comparison and data capture was directed by
theoretical sampling.
Results: Three categories and the core category
that emerged from the data analysis will be
presented. These were; knowledge to care,
perceptions of distrust and detachment, and
providing nursing care.
Discussions: These are integrated to form the
core category ‘dissonant care management of
illicit drug users within medical wards’ which
describes the paradoxes inherent in care
delivery for a client group whose behaviour
was perceived by nurse informants as complex,
disruptive and challenging.
Conclusion: This study reinforced the urgent
need for education to enable RN’s working
in non-specialist settings to deliver effective
care. It also highlighted the necessity for a
coherent approach for supporting illicit drug
users in order to reduce/avoid readmission and
capitalise on the opportunity to facilitate entry
to rehabilitation.