WEBVTT - Drugs & alcohol in nursing revisted 0:00:05.921 --> 0:00:07.281 Appogie Production. 0:00:11.201 --> 0:00:14.601 Hi, my name's beck Woodbine and welcome to Tenderness for Nurses. 0:00:15.081 --> 0:00:17.160 Do you need to burn out to have those insights? 0:00:17.161 --> 0:00:18.520 While I'm talking about it now? 0:00:18.681 --> 0:00:22.001 But you know, came to educate the world about it. 0:00:22.041 --> 0:00:25.680 But I didn't want anyone to know that I was 0:00:25.721 --> 0:00:28.841 so unwell. I don't know when it was ever okay 0:00:29.041 --> 0:00:33.681 to yell or scream or abuse somebody. We need to 0:00:33.760 --> 0:00:36.441 have support and know where to look for support, and 0:00:36.481 --> 0:00:39.520 know how to look after ourselves, not just professionally, but 0:00:39.641 --> 0:00:44.561 personally as well. It was quite profound and I learned 0:00:44.561 --> 0:00:48.001 a lot from that one action. Welcome back to Tenderness 0:00:48.081 --> 0:00:52.081 for Nurses. Today, we are chatting with Jason Harrison, who 0:00:52.200 --> 0:00:55.721 is also a nurse practitioner based out of Rocky and 0:00:56.601 --> 0:00:59.961 works in the drug and alcohol space. Fill us in 0:01:00.041 --> 0:01:01.721 a little bit on your background. 0:01:01.840 --> 0:01:03.961 I've been working in drug and alcohol probably for the 0:01:04.001 --> 0:01:07.361 past eighteen plus two years. Been a nurse practitioner since 0:01:07.401 --> 0:01:10.521 about twenty thirteen working in this space. Prior to that, 0:01:10.560 --> 0:01:14.521 I worked in corrections and basically been living in Central 0:01:14.601 --> 0:01:17.720 Queensland probably thirty plus years now working in the dragon 0:01:17.761 --> 0:01:19.640 Ail coll Sector've been providing a lot of things like 0:01:19.640 --> 0:01:23.881 withdrawal management, opiate treatment programs. Prior to becoming a nurse practitioner, 0:01:23.881 --> 0:01:25.841 I used to do a lot of counseling and therapy 0:01:25.840 --> 0:01:29.001 with patients to address their dragon al cohoal issues. I'm 0:01:29.000 --> 0:01:33.321 also a member of DANA and I'm currently the chair 0:01:33.401 --> 0:01:37.121 of the Nurse Practitioner Group within DANA. Previously the Secretary 0:01:37.161 --> 0:01:40.280 for the Australian College Nurse Practitioners and currently a delegate 0:01:40.321 --> 0:01:45.481 for the first Nurse Practitioner Queensland Nurses and Midwives Union 0:01:45.721 --> 0:01:47.121 in Australia. 0:01:46.601 --> 0:01:48.721 So you're right in amongst it. 0:01:48.961 --> 0:01:51.801 Yes, very much, so very much. A big strong advocate 0:01:51.841 --> 0:01:53.401 of nurse practitioners. 0:01:52.921 --> 0:01:55.961 Can just explain for everyone what DANA is done. 0:01:55.961 --> 0:02:00.081 As the Drug and Alcohol Nurses Australasia. It's a peak 0:02:00.161 --> 0:02:03.401 nursing group for drug and alcohol nurses and so we 0:02:03.521 --> 0:02:07.121 represent nursing in that drug and alcohol field. What I do 0:02:07.241 --> 0:02:10.721 now is probably a lot more brief interventions motivational interviewing. 0:02:11.001 --> 0:02:14.681 I do prescribing of the opiate treatment program. I also 0:02:14.761 --> 0:02:16.961 do withdrawal management, so if a patient comes in and 0:02:16.960 --> 0:02:19.641 they're withdrawing and they can do an ambulaitary detox, say 0:02:20.001 --> 0:02:23.960 for alcohol, not so much methamphetamines and cannabis because they're 0:02:23.960 --> 0:02:25.800 sort of long term stuff. But you know, we can 0:02:25.921 --> 0:02:28.121 do that for those sorts of patients as well as 0:02:28.161 --> 0:02:31.321 Benzo's sort of just gradually tapering dass and stuff. I'll 0:02:31.321 --> 0:02:33.280 do the work with that, or I'll work with a 0:02:33.401 --> 0:02:36.841 GP too with their patients to gradually taper down and 0:02:36.881 --> 0:02:40.001 do just support them through that. So I work across 0:02:40.001 --> 0:02:43.721 the Rockhampton, the Capricorn Coast and Gladston, but I also 0:02:43.800 --> 0:02:47.121 go as far out as Emerald, Blackwater, Marah and Billa 0:02:47.161 --> 0:02:48.881 Wheeler for clinics as well. 0:02:49.001 --> 0:02:51.361 So do you think because they're big mining communities, you 0:02:51.401 --> 0:02:53.721 know there's typically you know, the money around mining and 0:02:53.721 --> 0:02:56.521 that sort of thing. Is it classes an epidemic out there? 0:02:56.641 --> 0:02:57.321 Is it a problem? 0:02:57.361 --> 0:02:59.520 Look, it's pretty much the same everywhere. There's drug and 0:02:59.520 --> 0:03:02.161 alcohol use across Australia. I mean, if you really want 0:03:02.201 --> 0:03:03.681 to get down to it, and you ask most people 0:03:03.680 --> 0:03:06.761 what's the most widely used drug Australia, they'll gay things 0:03:06.800 --> 0:03:10.201 like heroin, alcohol and it's actually caffeine. But look look 0:03:10.201 --> 0:03:12.881 within Central Queens and we have higher rates of tobacco 0:03:13.041 --> 0:03:16.960 use than the average for the state alcohol use might 0:03:17.001 --> 0:03:19.800 be just slightly above the average state and stuff like that. 0:03:19.881 --> 0:03:22.561 It's probably no different to some of those communities when 0:03:22.601 --> 0:03:25.481 you're talking about a lizards. It's across the spectrum. It 0:03:25.561 --> 0:03:28.081 just varies depending on where you are. But I don't 0:03:28.081 --> 0:03:30.520 think it's worse than any other part of the state 0:03:30.761 --> 0:03:34.321 in particular things. But certain communities may have particular issues 0:03:34.361 --> 0:03:37.281 with a particular substance at any one time, and it's 0:03:37.361 --> 0:03:39.641 just about how do we build that community resilience to 0:03:39.681 --> 0:03:42.961 be better address it in the long term. But look, 0:03:43.201 --> 0:03:47.921 mining does bring interesting drugs to communities because of money. 0:03:48.361 --> 0:03:51.161 You do see things that pop up in things like cocaine, 0:03:51.201 --> 0:03:54.681 heroin and stuff from time to time. Cocaine more prevalent. Definitely, 0:03:54.761 --> 0:03:56.521 you do see that pop up, and not just because 0:03:56.601 --> 0:03:59.841 purely that there's people that have money that can afford 0:03:59.881 --> 0:04:01.681 that type of drug, because it's a rich man's drugg. 0:04:01.961 --> 0:04:04.401 My daughter is studying intelligence in the States and she 0:04:04.481 --> 0:04:07.761 just did a bit assignment on fentanyl and how they 0:04:07.921 --> 0:04:11.521 lay sing cocaine with fentanyl in the States to get 0:04:11.561 --> 0:04:14.440 people really cooked. Is that something you're seeing here. 0:04:15.001 --> 0:04:19.481 Look, we do see different substances being added to particular drugs, 0:04:19.521 --> 0:04:21.520 say with the methamphetamines, what we have seen as I 0:04:21.561 --> 0:04:23.881 have things seen with patients, I'll tell me that they're 0:04:23.961 --> 0:04:25.961 using inm fhetamines and when we've drug test and it 0:04:26.001 --> 0:04:28.361 will show up that they've got methamphetamines and fetamines in 0:04:28.361 --> 0:04:30.320 the system, but also things like ketamine. 0:04:30.721 --> 0:04:32.841 We have had fetanyl in regards. 0:04:32.401 --> 0:04:35.441 To that, and even sometimes even with the cannabis users, 0:04:35.481 --> 0:04:38.201 we've seen that where there's been sort of added derivatives, 0:04:38.281 --> 0:04:40.841 you know, such as ketamine, and that we have had 0:04:40.841 --> 0:04:43.321 the things with the xenx bars and that floating around 0:04:43.361 --> 0:04:46.041 in the community. Patients use the dark web and are 0:04:46.121 --> 0:04:48.041 quite a fae with it, so we do see all 0:04:48.041 --> 0:04:50.921 those sorts of things popping through, but it varies from. 0:04:50.721 --> 0:04:51.440 Place to place. 0:04:51.481 --> 0:04:54.001 What I see in Gladstone is different to what I 0:04:54.001 --> 0:04:55.640 see in rock Hampton, to what I see at the 0:04:55.641 --> 0:04:57.721 Cap Coast, to what I see out in the mining areas, 0:04:58.201 --> 0:05:00.801 So there will be similar as yeah, if I talk 0:05:00.880 --> 0:05:04.201 rock Campton's managed prescription APIs your fentanyls, your ms Cottons, 0:05:04.241 --> 0:05:04.880 your oxy. 0:05:05.041 --> 0:05:06.841 But if I go to your pain I. 0:05:06.921 --> 0:05:10.760 May see things like more of the methodone genis staff, 0:05:10.761 --> 0:05:13.321 the hydromorphone, which is being removed from PBS and stuff 0:05:13.361 --> 0:05:16.681 like that, and that's related to more prescribing habits and 0:05:16.721 --> 0:05:19.361 stuff within the sector and stuff down there for treatment 0:05:19.361 --> 0:05:22.081 of system pain conditions and stuff. And then if I 0:05:22.161 --> 0:05:24.760 go to Gladston which has a port, then I'll start 0:05:24.801 --> 0:05:29.041 to see that more of heroin, fentanyl, oxycadine and stuff 0:05:29.121 --> 0:05:31.721 like that down there. So it varies and it depends 0:05:31.761 --> 0:05:33.880 on what populations have come through. So when they did 0:05:33.921 --> 0:05:37.841 the big curticile and gas stuff, our NSP went through 0:05:37.880 --> 0:05:41.561 the roof with needles and syringes for inphetamine use and 0:05:41.641 --> 0:05:44.880 steroid use. It's always interesting when you at different times 0:05:44.880 --> 0:05:48.041 when certain industries are booming certain things and they've got 0:05:48.081 --> 0:05:50.321 a big population of people coming through that you may 0:05:50.361 --> 0:05:53.961 see changes in the substance use within their community. 0:05:53.601 --> 0:05:57.080 That is fascinating. Do you think it's becoming more prevalent 0:05:57.161 --> 0:06:01.281 because there's just so much more stress around, People aren't coping, 0:06:02.041 --> 0:06:04.281 people aren't as connected as they were. 0:06:04.641 --> 0:06:07.201 If I get down to it, most people always think 0:06:07.281 --> 0:06:10.481 the illicids caused the most amount of harm in Austray. 0:06:10.521 --> 0:06:12.561 It's actually alcohol. It's a legal drug. 0:06:12.761 --> 0:06:16.161 Why do people use drugs predominantly it's all about feeling good. 0:06:16.241 --> 0:06:18.321 And I always use the analogy of if you've got 0:06:18.320 --> 0:06:19.961 a pain in your ear, you take two penetal to 0:06:20.001 --> 0:06:21.281 get through to the pain, you feel good. 0:06:21.641 --> 0:06:24.081 So in regards to that, that's why people use it. 0:06:24.081 --> 0:06:25.841 It's about how do you make yourself feel good when 0:06:25.841 --> 0:06:28.880 you've got particular problems in life or stresses. But there's 0:06:28.880 --> 0:06:30.921 a number of factors as to why someone may or 0:06:30.961 --> 0:06:34.281 may not develop a substance use disorder. There's obviously genetics 0:06:34.281 --> 0:06:36.521 do pay a part. So if you've got the prevalence 0:06:36.561 --> 0:06:38.481 of someone having a substance use disorder in your family, 0:06:38.521 --> 0:06:40.241 it does increase your risk. It doesn't mean you will 0:06:40.241 --> 0:06:42.921 develop one, but there is potential for that. And then 0:06:42.921 --> 0:06:45.001 if you go back down to it, then there's what's 0:06:45.121 --> 0:06:47.921 role modeled within the household. You know, if Dad's coming 0:06:47.921 --> 0:06:50.081 home and has six peers and he's using that as 0:06:50.081 --> 0:06:51.880 a stress relief, and that's what you're seeing, you're starting 0:06:51.921 --> 0:06:54.561 to learn some of those behaviors. Obviously, Then there's peer 0:06:54.841 --> 0:06:56.281 you know, when you get out there and as you 0:06:56.281 --> 0:06:59.320 get older, in engaging with your peers and what's happening 0:06:59.320 --> 0:07:01.481 around in that space as to what your substance US 0:07:01.521 --> 0:07:04.281 may look at and obviously there's learned behaviors yourself and 0:07:04.361 --> 0:07:06.801 what you learn as to how to sell, soothe or 0:07:06.880 --> 0:07:08.001 make yourself feel better. 0:07:08.281 --> 0:07:09.961 So there's number of factors that go into it. 0:07:10.041 --> 0:07:12.281 There's no one thing that just causes someone to have 0:07:12.321 --> 0:07:13.561 a substance USUS order. 0:07:13.761 --> 0:07:15.881 Everything comes together at one point and boom. 0:07:16.001 --> 0:07:17.961 COVID was probably a big stress and what we could 0:07:18.041 --> 0:07:19.401 learn out of it. A lot of people we used 0:07:19.441 --> 0:07:22.241 alcohol to manage stress and anxiety and stuff. 0:07:22.441 --> 0:07:23.481 Life is high paced. 0:07:23.721 --> 0:07:25.761 Drug use has probably changed from when I was a 0:07:25.841 --> 0:07:28.241 kid compared to what I see my kids coming into. 0:07:28.321 --> 0:07:31.961 What's they're exposed to. You know, what's acceptable alcohol? You know, 0:07:32.121 --> 0:07:35.001 that was a rite of passage and stuff. So cannabis 0:07:35.081 --> 0:07:38.361 was around and I had plenty of mates that smoked it. Nowadays, 0:07:38.361 --> 0:07:41.201 what you see is a lot more of MDMA, people 0:07:41.361 --> 0:07:44.921 experimenting with methan fetter means pills. Then you've got the 0:07:44.921 --> 0:07:47.561 synthetic stuff that sort of pops out GHB. 0:07:48.081 --> 0:07:51.481 It's interesting. A friend of mine went over to Germany 0:07:51.521 --> 0:07:54.241 for a dance rave things, I don't know. 0:07:55.121 --> 0:07:56.121 Whatever, Yeah, raves. 0:07:56.321 --> 0:07:59.761 They didn't drink, They took tablets and they had a 0:07:59.761 --> 0:08:02.761 little machine that tested to make sure that the tablets 0:08:02.761 --> 0:08:04.841 were pure and that's what everyone over there did. 0:08:05.121 --> 0:08:06.961 Ye look, they are looking at it. In Australia, there 0:08:07.041 --> 0:08:08.961 was some stuff there. It was a little bit difficult 0:08:08.961 --> 0:08:11.081 to get in. I think that we're looking at some 0:08:11.121 --> 0:08:13.001 of the raves and stuff because pill testing is really 0:08:13.041 --> 0:08:16.561 important at those events because sometimes when people buy stuff, 0:08:16.601 --> 0:08:18.601 what they think they're getting is not what's actually in 0:08:18.641 --> 0:08:21.441 the tablet, and people actually then make an informed decision. 0:08:22.041 --> 0:08:23.641 And that's the big thing, even when you're coming to 0:08:23.681 --> 0:08:26.841 drugonelk or the biggest thing I'm teaching people, even whether 0:08:26.841 --> 0:08:29.601 I'm putting on programs or not, or doing motivation anything, 0:08:29.881 --> 0:08:32.281 is how to make an informed decision. You know, So 0:08:32.361 --> 0:08:34.521 you're asking them when you're talking about a substance use, 0:08:34.601 --> 0:08:35.241 you know, what's. 0:08:35.041 --> 0:08:36.040 The good things you get out of it? 0:08:36.081 --> 0:08:37.361 And I'll give you a list of things and then 0:08:37.401 --> 0:08:39.081 you'll going to talk about what they're not so good 0:08:39.121 --> 0:08:41.681 things are and what you'll include. And those sorts of 0:08:41.681 --> 0:08:44.761 things are the four ls your liver, your lover, your livelihood, 0:08:44.801 --> 0:08:46.801 and the law. So how does that impact you, know, 0:08:46.841 --> 0:08:48.321 your life? The good looks at how much is it 0:08:48.361 --> 0:08:50.761 costing you the liver is looking at what's the impact 0:08:50.801 --> 0:08:52.481 on your health and your mental health. Your lover is 0:08:52.521 --> 0:08:55.001 how is it impacting on those relationships around you? And 0:08:55.041 --> 0:08:59.281 now that's not just home life, that's your work life, relationships, 0:08:59.401 --> 0:09:01.441 your social relationships, et cetera. 0:09:02.001 --> 0:09:03.961 And obviously the law, whether it's legal or not. 0:09:05.121 --> 0:09:07.801 When you take a person through that journey, it's just 0:09:07.881 --> 0:09:09.841 teaching them because we're not all taught how to make 0:09:09.841 --> 0:09:12.561 an informed decision about when it comes to substance use. 0:09:12.841 --> 0:09:16.561 Well, I stopped drinking. It'll be five years next year, 0:09:16.801 --> 0:09:19.641 and I kept an app as to like how many 0:09:19.881 --> 0:09:21.801 days I haven't drunk. I actually looked at the other 0:09:21.881 --> 0:09:24.761 day because we're having a conversation around you know, drug 0:09:24.761 --> 0:09:28.121 and alcohol use, and I just put down that I 0:09:28.161 --> 0:09:30.361 had a bottle of wine a night, five nights a week, 0:09:30.401 --> 0:09:32.841 so one hundred dollars a week. I didn't take into 0:09:32.881 --> 0:09:35.561 account ubers. I didn't take into account you know, buying 0:09:35.601 --> 0:09:38.561 that odd French champagne or you know, having a few 0:09:38.601 --> 0:09:41.881 drinks on more drinks on the weekend. And in that time, 0:09:41.921 --> 0:09:44.201 I've saved thirty five thousand dollars. 0:09:44.521 --> 0:09:47.201 Yep, I've had similar eats. 0:09:47.201 --> 0:09:49.321 I had one fella that was smoking pot for ten 0:09:49.441 --> 0:09:51.161 years and when we worked out if you had a 0:09:51.441 --> 0:09:53.361 not smoke that, I think it's been about one hundred 0:09:53.361 --> 0:09:57.761 and thirty two thousand dollars in that ten years on cannabis. Ah, 0:09:57.801 --> 0:09:59.201 And I said, what could you have done with that? 0:09:59.241 --> 0:10:00.601 And he said, I could have bought a house at 0:10:00.641 --> 0:10:01.921 that top. You know, it would have been a good 0:10:01.961 --> 0:10:04.561 deposit on a house. I said, when you put it 0:10:04.561 --> 0:10:07.441 into that with patients, it does open their eyes out 0:10:07.521 --> 0:10:09.681 to what that financial impact is having on them. 0:10:09.921 --> 0:10:11.401 Tobacco use is a good one at. 0:10:11.321 --> 0:10:13.441 The moment because I always discuss that with a lot 0:10:13.481 --> 0:10:15.441 of my patient because they're still smokers and we're looking 0:10:15.481 --> 0:10:16.681 at ways to reduce risk. 0:10:16.801 --> 0:10:18.921 So how much is that cigarettes? Sound? 0:10:19.001 --> 0:10:21.801 I know, pouchs tobacco fifty grams of white ox is 0:10:21.841 --> 0:10:24.241 about eighty to one hundred sandly two dollars a gram. 0:10:24.641 --> 0:10:27.921 Cigarettes are about anywhere from thirty dollars for a packet 0:10:27.921 --> 0:10:30.521 of twenty, so it's over a dollar a cigarette. So 0:10:30.801 --> 0:10:32.921 you know, I get some patients that still smoke and 0:10:32.961 --> 0:10:35.041 tailor mades and they're doing twenty or thirty a day. 0:10:35.241 --> 0:10:36.641 I always go back and said. 0:10:36.561 --> 0:10:38.321 I gave up when it was five bucks a packet, 0:10:38.321 --> 0:10:39.721 but I was doing two packets a day. I said, 0:10:39.721 --> 0:10:42.761 I couldn't afford to smoke these days, and they. 0:10:42.681 --> 0:10:45.401 Laugh, But it is true. It's just what we thinks. 0:10:45.441 --> 0:10:47.601 And it always comes back to when you're talking about 0:10:47.601 --> 0:10:50.161 a substance use disorder with some patient. I always go 0:10:50.241 --> 0:10:53.121 back to that Maslow's hierarchy and stuff. And when you're 0:10:53.161 --> 0:10:57.321 in that throes of using a certain substance, whether it's tobacco, alcohol, 0:10:57.641 --> 0:11:00.041 and fetamines and that that becomes the number one priority 0:11:00.081 --> 0:11:02.241 in your life and it is a hard one to 0:11:02.641 --> 0:11:05.361 work on and an address and stuff. At that time, say, 0:11:05.521 --> 0:11:07.481 it's not until someone gives you on tape shody you 0:11:07.521 --> 0:11:09.241 need to do something about it, or you've sort of 0:11:09.241 --> 0:11:12.281 come to that your own realization that when you start 0:11:12.801 --> 0:11:15.201 re examinating, then you can have a look at how 0:11:15.201 --> 0:11:17.561 it is impacting on your life and stuff and how 0:11:17.641 --> 0:11:20.401 you get there. But it's not our simple journey. It's 0:11:20.441 --> 0:11:22.561 a lifelong journey for a lot of people. It's not 0:11:22.601 --> 0:11:24.401 something I just stop it and that's it and I 0:11:24.401 --> 0:11:26.441 can move on with my life. It's always there, and 0:11:26.441 --> 0:11:28.561 it's always having those skills and tools to be able 0:11:28.561 --> 0:11:29.121 to manage it. 0:11:29.321 --> 0:11:32.281 And I think our culture in Australia is the drinking culture, 0:11:32.521 --> 0:11:34.721 because when I go to the States to visit my 0:11:34.801 --> 0:11:37.041 daughter over there, you go and you look at the menu, 0:11:37.121 --> 0:11:39.241 they've got a whole page or page and a half 0:11:39.281 --> 0:11:42.721 of mocktails and non alcoholic drinks and that sort of thing, 0:11:42.761 --> 0:11:45.601 like it's just the norm. And they think, Australians, you 0:11:45.601 --> 0:11:47.041 have more than a couple of drinks, I actually think 0:11:47.081 --> 0:11:49.281 you're an alcoholic, Like they'll have an intervention if you 0:11:49.361 --> 0:11:52.801 have more than three drinks, whereas you know, most people 0:11:52.801 --> 0:11:55.521 would do that at nighttime here in Australia and not 0:11:55.721 --> 0:11:59.121 think twice about it. It's an interesting thing culturally. 0:11:58.881 --> 0:11:59.241 It is. 0:11:59.281 --> 0:12:02.201 And even when I've trained some of the medicads that 0:12:02.201 --> 0:12:04.561 have come through AIDS and stuff, especially when they've been 0:12:04.601 --> 0:12:08.881 from overseas countries your Southeast Asia sort of specific areas 0:12:08.881 --> 0:12:11.161 and stuff where drinking is not in part of their culture. 0:12:11.321 --> 0:12:13.001 And I go to him, I said, you know, if 0:12:13.041 --> 0:12:15.121 you talk to most Austrains and if they drink six 0:12:15.161 --> 0:12:18.481 beers a day and they turn up to work every day, 0:12:18.481 --> 0:12:20.561 don't have sickies, and you say that you've got an 0:12:20.561 --> 0:12:21.641 alcohol use disorder. 0:12:21.841 --> 0:12:23.601 Even whether it's mild or moderate or whatever. 0:12:24.201 --> 0:12:27.601 They will become quite offended because culturally you don't have 0:12:27.641 --> 0:12:29.761 a problem because you're turning up to work, you're putting 0:12:29.761 --> 0:12:32.361 food on the table, you're paying for everything. They do 0:12:32.441 --> 0:12:34.361 not think they have a problem. But if you go 0:12:34.521 --> 0:12:37.201 under looking at the DSM five or look at they're 0:12:37.201 --> 0:12:39.881 actually drinking, especially if you're doing more than six heavy 0:12:39.881 --> 0:12:42.681 beers or more than four standard drinks, your risk to 0:12:42.721 --> 0:12:45.081 yourself actually quite increases. 0:12:45.281 --> 0:12:48.121 Probably have got a mind alcohol use disorder, and. 0:12:48.641 --> 0:12:51.601 It is quite prevalent in nursing as well, because one 0:12:51.641 --> 0:12:53.921 of my colleagues who works for Danna, they did a 0:12:54.041 --> 0:12:56.841 survey of nurses and did a paper on it. 0:12:56.921 --> 0:12:57.681 We love a drink. 0:12:57.841 --> 0:13:00.201 It's within our culture, but also within nursing as well 0:13:00.201 --> 0:13:00.721 as culture. 0:13:00.921 --> 0:13:03.601 Absolutely work hard and party hard. I mean we used 0:13:03.601 --> 0:13:06.401 to go out between late ship and earlies. 0:13:06.321 --> 0:13:11.241 Yes to the nightclubs. Ring in sick from a nightclub, 0:13:11.281 --> 0:13:12.401 say what's that? Nothing? 0:13:14.481 --> 0:13:16.001 Or you turn up the next day if you're an 0:13:16.081 --> 0:13:17.801 essential in the sense of that you're going to be 0:13:17.801 --> 0:13:19.521 short if you didn't turn up, so you'd be there. 0:13:19.641 --> 0:13:21.881 Honestly, I mean we were tough as back then. But 0:13:22.441 --> 0:13:24.121 when I think about it. Probably some of the things 0:13:24.161 --> 0:13:26.441 we did, I don't know if it was that appropriate. 0:13:26.841 --> 0:13:29.521 I think when it comes to alcohol within Australia, it's 0:13:29.641 --> 0:13:32.321 part of our culture. But also we do have a 0:13:32.721 --> 0:13:36.721 very powerful lobby group in the liquor industry in starts 0:13:36.761 --> 0:13:40.721 of keeping it going, and that's why there's reluctance to change. 0:13:40.841 --> 0:13:43.721 Whilst they put things in place, there's a reluctance to 0:13:43.881 --> 0:13:46.481 ever get rid of it or anything like that. You know, 0:13:46.521 --> 0:13:47.961 you only have to see the amount of violence that 0:13:48.001 --> 0:13:51.081 goes with alcohol, and they have done things like curfews 0:13:51.081 --> 0:13:53.761 and things like that, you know, lockouts and stuff like 0:13:53.841 --> 0:13:56.561 that to reduce it. But I know, like on state 0:13:56.601 --> 0:13:59.521 of origin, it's the amount of assaults that comes up 0:13:59.561 --> 0:14:02.721 that's related to alcohol, fuel and violence is phenomenal. Yeah, 0:14:02.881 --> 0:14:05.681 it spikes at those three times the year. 0:14:06.041 --> 0:14:08.961 Really, I mean, it doesn't surprise me, but it's interesting 0:14:08.961 --> 0:14:10.041 that statistics are there. 0:14:10.161 --> 0:14:12.321 The funniest thing is that we do big investments in 0:14:12.401 --> 0:14:15.481 things like methampheta means probably affects less than five percent 0:14:15.521 --> 0:14:18.681 of the population, yet there's a heavy investment because what 0:14:18.721 --> 0:14:22.001 we see, what the media portrays is all this negativity 0:14:22.001 --> 0:14:24.601 around it. And that all these people are causing that problems. 0:14:24.801 --> 0:14:27.161 But out of that group, there's probably only a small proportion, 0:14:27.441 --> 0:14:29.481 you know, the twenty percent that caused the problems out 0:14:29.521 --> 0:14:31.321 of the one hundred percent that use. But they're the 0:14:31.401 --> 0:14:33.241 ones you see on the media and stuff and causing 0:14:33.241 --> 0:14:35.921 all the dramas. And it's not to say methmphetamans is 0:14:35.921 --> 0:14:38.201 a safe drug or anything like that, but when you 0:14:38.281 --> 0:14:40.881 compare it to alcohol, it's small when you look at 0:14:40.921 --> 0:14:47.441 how much alcohol impacts on driving offenses, fatalities, alcohol related violence, 0:14:47.601 --> 0:14:50.281 DV and stuff, and all that sort of negative impact 0:14:50.521 --> 0:14:53.041 that it has because we've got a bigger proportion of 0:14:53.041 --> 0:14:55.441 the population using it because we don't want to change 0:14:55.441 --> 0:14:55.961 our culture. 0:14:56.161 --> 0:14:57.841 No, it's true. I mean, you can't turn the TV 0:14:57.921 --> 0:15:01.721 on and watch football without there either being gambling or alcohol. 0:15:01.921 --> 0:15:03.801 And that's pretty much what it is now. 0:15:04.121 --> 0:15:09.521 Just a couple of questions around nursing and what avenues 0:15:09.601 --> 0:15:13.081 do nurses have if they think that they've got an 0:15:13.121 --> 0:15:14.601 alcohol or drug problem. 0:15:14.761 --> 0:15:16.721 Look, you're probably going to work with your GP in 0:15:16.721 --> 0:15:19.481 the first instance. I'm probably going to say to you, 0:15:19.601 --> 0:15:23.321 go and see a private practicing psychologist or a private 0:15:23.361 --> 0:15:26.601 practicing service. Sometimes if you come through the public service. 0:15:26.961 --> 0:15:29.561 The first initial thing was that people will be worried 0:15:29.601 --> 0:15:34.161 about if you're using alcohol or other substances, that there 0:15:34.161 --> 0:15:36.721 may be an impact to patient care or something like that, 0:15:37.521 --> 0:15:40.881 and there's likely to be a report to OPRA. Now, 0:15:41.001 --> 0:15:43.841 my experience with dealing with a few people that have 0:15:43.921 --> 0:15:48.081 been through the opera experience and the impact that it's 0:15:48.121 --> 0:15:51.521 had on registration, it can be quite an arduous, costly 0:15:51.641 --> 0:15:54.561 process and it is not affordable and a lot of 0:15:54.601 --> 0:15:58.281 times you can't gain employment because sometimes the restrictions that 0:15:58.281 --> 0:16:00.441 they put on your practice is that someone's got to 0:16:00.521 --> 0:16:03.601 be there and supervise you. Makes it very hard for 0:16:03.641 --> 0:16:08.361 people to hold positions little lane try and demonstrate that 0:16:09.121 --> 0:16:13.081 their use of a particular substance isn't impacting on patient care. 0:16:13.521 --> 0:16:15.281 So it's a difficult one. 0:16:15.481 --> 0:16:17.841 But look, you know, we have had patients come through 0:16:17.921 --> 0:16:20.721 and work through it, but most of the time they've 0:16:20.761 --> 0:16:23.601 either ended up with a psychiatrist looking after him because 0:16:23.601 --> 0:16:26.041 there was other issues going on, and done it through 0:16:26.161 --> 0:16:28.681 private services. But the ones that have come through the 0:16:28.721 --> 0:16:33.201 public service, there has been apper notifications and then it's 0:16:33.241 --> 0:16:35.801 working with the patients and even when they're on a 0:16:35.841 --> 0:16:37.361 program appro date. 0:16:37.401 --> 0:16:39.041 Look at that as a safety mechanism. 0:16:39.521 --> 0:16:42.001 So I've had a patient that had a codeine use 0:16:42.081 --> 0:16:44.881 disorder that ended up on the program, was doing well, 0:16:44.921 --> 0:16:48.121 but obviously an APPER notification went in and then the 0:16:48.201 --> 0:16:50.201 amount of requirements they made, the. 0:16:50.161 --> 0:16:51.801 Hoops and the difficulties of it. 0:16:51.801 --> 0:16:54.041 You've got to do counseling that you've got to submit 0:16:54.121 --> 0:16:56.841 to drug testing, and it's all at the cost of 0:16:56.881 --> 0:16:59.441 the patient. Now whatls the counseling might be through through 0:16:59.441 --> 0:17:01.321 a drug and apical service. If you're on a program 0:17:01.721 --> 0:17:04.321 such as the opia treatment program, that's great. That helps 0:17:04.361 --> 0:17:08.041 with that, but then there's always the barriers to practice 0:17:08.080 --> 0:17:11.200 that you can't access an say, covert unless there's a 0:17:11.241 --> 0:17:14.321 secondary person there that's going to supervise your practice. If 0:17:14.360 --> 0:17:16.641 you're working in the age care sector, or if you're 0:17:16.681 --> 0:17:21.680 working in a community nursing sector, no service or agency 0:17:21.721 --> 0:17:23.840 wants to pick you up. And if you're try and 0:17:23.840 --> 0:17:26.441 get a job in the public system, even they will 0:17:26.481 --> 0:17:30.081 make it difficult in providing that level of supervision. Being 0:17:30.080 --> 0:17:32.041 able to commit to that these days, especially with the 0:17:32.120 --> 0:17:35.280 nursing shortages, it really leaves us at a loss. Now, 0:17:35.281 --> 0:17:37.880 if I talk about medicine, they will do everything to 0:17:38.561 --> 0:17:42.080 keep that person in the profession, so it's not an issue. 0:17:42.080 --> 0:17:45.001 They'll find a supervisor, they'll find someone there to assist 0:17:45.080 --> 0:17:47.681 the person and monitor practice or whatever. 0:17:48.321 --> 0:17:50.201 It's not a thing because they see that they've invested 0:17:50.241 --> 0:17:50.600 a lot. 0:17:50.481 --> 0:17:54.720 Of money into the individual to hold that profession, and 0:17:54.840 --> 0:17:57.240 just because they've got a problem with a particular substance 0:17:57.321 --> 0:17:59.761 or alcohol doesn't mean that they're not a good person 0:17:59.801 --> 0:18:02.441 or a good practitioner. It just means that that particular 0:18:02.481 --> 0:18:04.041 time they may have had a problem and that's what 0:18:04.080 --> 0:18:06.881 they've used to cope with. We're nursing. I don't think 0:18:06.921 --> 0:18:10.201 we value people enough in the sense of that we're 0:18:10.241 --> 0:18:13.521