Speaker 1: Appogie Production.
Speaker 2: Hi, my name's beck Woodbine and welcome to Tenderness for Nurses.
Speaker 1: Do you need to burn out to have those insights?
Speaker 2: While I'm talking about it now?
Speaker 1: But you know, came to educate the world about it.
Speaker 2: But I didn't want anyone to know that I was
Speaker 2: so unwell. I don't know when it was ever okay
Speaker 2: to yell or scream or abuse somebody. We need to
Speaker 2: have support and know where to look for support, and
Speaker 2: know how to look after ourselves, not just professionally, but
Speaker 2: personally as well. It was quite profound and I learned
Speaker 2: a lot from that one action. Welcome back to Tenderness
Speaker 2: for Nurses. Today, we are chatting with Jason Harrison, who
Speaker 2: is also a nurse practitioner based out of Rocky and
Speaker 2: works in the drug and alcohol space. Fill us in
Speaker 2: a little bit on your background.
Speaker 3: I've been working in drug and alcohol probably for the
Speaker 3: past eighteen plus two years. Been a nurse practitioner since
Speaker 3: about twenty thirteen working in this space. Prior to that,
Speaker 3: I worked in corrections and basically been living in Central
Speaker 3: Queensland probably thirty plus years now working in the dragon
Speaker 3: Ail coll Sector've been providing a lot of things like
Speaker 3: withdrawal management, opiate treatment programs. Prior to becoming a nurse practitioner,
Speaker 3: I used to do a lot of counseling and therapy
Speaker 3: with patients to address their dragon al cohoal issues. I'm
Speaker 3: also a member of DANA and I'm currently the chair
Speaker 3: of the Nurse Practitioner Group within DANA. Previously the Secretary
Speaker 3: for the Australian College Nurse Practitioners and currently a delegate
Speaker 3: for the first Nurse Practitioner Queensland Nurses and Midwives Union
Speaker 3: in Australia.
Speaker 2: So you're right in amongst it.
Speaker 3: Yes, very much, so very much. A big strong advocate
Speaker 3: of nurse practitioners.
Speaker 2: Can just explain for everyone what DANA is done.
Speaker 3: As the Drug and Alcohol Nurses Australasia. It's a peak
Speaker 3: nursing group for drug and alcohol nurses and so we
Speaker 3: represent nursing in that drug and alcohol field. What I do
Speaker 3: now is probably a lot more brief interventions motivational interviewing.
Speaker 3: I do prescribing of the opiate treatment program. I also
Speaker 3: do withdrawal management, so if a patient comes in and
Speaker 3: they're withdrawing and they can do an ambulaitary detox, say
Speaker 3: for alcohol, not so much methamphetamines and cannabis because they're
Speaker 3: sort of long term stuff. But you know, we can
Speaker 3: do that for those sorts of patients as well as
Speaker 3: Benzo's sort of just gradually tapering dass and stuff. I'll
Speaker 3: do the work with that, or I'll work with a
Speaker 3: GP too with their patients to gradually taper down and
Speaker 3: do just support them through that. So I work across
Speaker 3: the Rockhampton, the Capricorn Coast and Gladston, but I also
Speaker 3: go as far out as Emerald, Blackwater, Marah and Billa
Speaker 3: Wheeler for clinics as well.
Speaker 2: So do you think because they're big mining communities, you
Speaker 2: know there's typically you know, the money around mining and
Speaker 2: that sort of thing. Is it classes an epidemic out there?
Speaker 2: Is it a problem?
Speaker 3: Look, it's pretty much the same everywhere. There's drug and
Speaker 3: alcohol use across Australia. I mean, if you really want
Speaker 3: to get down to it, and you ask most people
Speaker 3: what's the most widely used drug Australia, they'll gay things
Speaker 3: like heroin, alcohol and it's actually caffeine. But look look
Speaker 3: within Central Queens and we have higher rates of tobacco
Speaker 3: use than the average for the state alcohol use might
Speaker 3: be just slightly above the average state and stuff like that.
Speaker 3: It's probably no different to some of those communities when
Speaker 3: you're talking about a lizards. It's across the spectrum. It
Speaker 3: just varies depending on where you are. But I don't
Speaker 3: think it's worse than any other part of the state
Speaker 3: in particular things. But certain communities may have particular issues
Speaker 3: with a particular substance at any one time, and it's
Speaker 3: just about how do we build that community resilience to
Speaker 3: be better address it in the long term. But look,
Speaker 3: mining does bring interesting drugs to communities because of money.
Speaker 3: You do see things that pop up in things like cocaine,
Speaker 3: heroin and stuff from time to time. Cocaine more prevalent. Definitely,
Speaker 3: you do see that pop up, and not just because
Speaker 3: purely that there's people that have money that can afford
Speaker 3: that type of drug, because it's a rich man's drugg.
Speaker 2: My daughter is studying intelligence in the States and she
Speaker 2: just did a bit assignment on fentanyl and how they
Speaker 2: lay sing cocaine with fentanyl in the States to get
Speaker 2: people really cooked. Is that something you're seeing here.
Speaker 3: Look, we do see different substances being added to particular drugs,
Speaker 3: say with the methamphetamines, what we have seen as I
Speaker 3: have things seen with patients, I'll tell me that they're
Speaker 3: using inm fhetamines and when we've drug test and it
Speaker 3: will show up that they've got methamphetamines and fetamines in
Speaker 3: the system, but also things like ketamine.
Speaker 1: We have had fetanyl in regards.
Speaker 3: To that, and even sometimes even with the cannabis users,
Speaker 3: we've seen that where there's been sort of added derivatives,
Speaker 3: you know, such as ketamine, and that we have had
Speaker 3: the things with the xenx bars and that floating around
Speaker 3: in the community. Patients use the dark web and are
Speaker 3: quite a fae with it, so we do see all
Speaker 3: those sorts of things popping through, but it varies from.
Speaker 1: Place to place.
Speaker 3: What I see in Gladstone is different to what I
Speaker 3: see in rock Hampton, to what I see at the
Speaker 3: Cap Coast, to what I see out in the mining areas,
Speaker 3: So there will be similar as yeah, if I talk
Speaker 3: rock Campton's managed prescription APIs your fentanyls, your ms Cottons,
Speaker 3: your oxy.
Speaker 1: But if I go to your pain I.
Speaker 3: May see things like more of the methodone genis staff,
Speaker 3: the hydromorphone, which is being removed from PBS and stuff
Speaker 3: like that, and that's related to more prescribing habits and
Speaker 3: stuff within the sector and stuff down there for treatment
Speaker 3: of system pain conditions and stuff. And then if I
Speaker 3: go to Gladston which has a port, then I'll start
Speaker 3: to see that more of heroin, fentanyl, oxycadine and stuff
Speaker 3: like that down there. So it varies and it depends
Speaker 3: on what populations have come through. So when they did
Speaker 3: the big curticile and gas stuff, our NSP went through
Speaker 3: the roof with needles and syringes for inphetamine use and
Speaker 3: steroid use. It's always interesting when you at different times
Speaker 3: when certain industries are booming certain things and they've got
Speaker 3: a big population of people coming through that you may
Speaker 3: see changes in the substance use within their community.
Speaker 2: That is fascinating. Do you think it's becoming more prevalent
Speaker 2: because there's just so much more stress around, People aren't coping,
Speaker 2: people aren't as connected as they were.
Speaker 3: If I get down to it, most people always think
Speaker 3: the illicids caused the most amount of harm in Austray.
Speaker 1: It's actually alcohol. It's a legal drug.
Speaker 3: Why do people use drugs predominantly it's all about feeling good.
Speaker 3: And I always use the analogy of if you've got
Speaker 3: a pain in your ear, you take two penetal to
Speaker 3: get through to the pain, you feel good.
Speaker 1: So in regards to that, that's why people use it.
Speaker 3: It's about how do you make yourself feel good when
Speaker 3: you've got particular problems in life or stresses. But there's
Speaker 3: a number of factors as to why someone may or
Speaker 3: may not develop a substance use disorder. There's obviously genetics
Speaker 3: do pay a part. So if you've got the prevalence
Speaker 3: of someone having a substance use disorder in your family,
Speaker 3: it does increase your risk. It doesn't mean you will
Speaker 3: develop one, but there is potential for that. And then
Speaker 3: if you go back down to it, then there's what's
Speaker 3: role modeled within the household. You know, if Dad's coming
Speaker 3: home and has six peers and he's using that as
Speaker 3: a stress relief, and that's what you're seeing, you're starting
Speaker 3: to learn some of those behaviors. Obviously, Then there's peer
Speaker 3: you know, when you get out there and as you
Speaker 3: get older, in engaging with your peers and what's happening
Speaker 3: around in that space as to what your substance US
Speaker 3: may look at and obviously there's learned behaviors yourself and
Speaker 3: what you learn as to how to sell, soothe or
Speaker 3: make yourself feel better.
Speaker 1: So there's number of factors that go into it.
Speaker 3: There's no one thing that just causes someone to have
Speaker 3: a substance USUS order.
Speaker 2: Everything comes together at one point and boom.
Speaker 3: COVID was probably a big stress and what we could
Speaker 3: learn out of it. A lot of people we used
Speaker 3: alcohol to manage stress and anxiety and stuff.
Speaker 1: Life is high paced.
Speaker 3: Drug use has probably changed from when I was a
Speaker 3: kid compared to what I see my kids coming into.
Speaker 3: What's they're exposed to. You know, what's acceptable alcohol? You know,
Speaker 3: that was a rite of passage and stuff. So cannabis
Speaker 3: was around and I had plenty of mates that smoked it. Nowadays,
Speaker 3: what you see is a lot more of MDMA, people
Speaker 3: experimenting with methan fetter means pills. Then you've got the
Speaker 3: synthetic stuff that sort of pops out GHB.
Speaker 2: It's interesting. A friend of mine went over to Germany
Speaker 2: for a dance rave things, I don't know.
Speaker 1: Whatever, Yeah, raves.
Speaker 2: They didn't drink, They took tablets and they had a
Speaker 2: little machine that tested to make sure that the tablets
Speaker 2: were pure and that's what everyone over there did.
Speaker 3: Ye look, they are looking at it. In Australia, there
Speaker 3: was some stuff there. It was a little bit difficult
Speaker 3: to get in. I think that we're looking at some
Speaker 3: of the raves and stuff because pill testing is really
Speaker 3: important at those events because sometimes when people buy stuff,
Speaker 3: what they think they're getting is not what's actually in
Speaker 3: the tablet, and people actually then make an informed decision.
Speaker 3: And that's the big thing, even when you're coming to
Speaker 3: drugonelk or the biggest thing I'm teaching people, even whether
Speaker 3: I'm putting on programs or not, or doing motivation anything,
Speaker 3: is how to make an informed decision. You know, So
Speaker 3: you're asking them when you're talking about a substance use,
Speaker 3: you know, what's.
Speaker 1: The good things you get out of it?
Speaker 3: And I'll give you a list of things and then
Speaker 3: you'll going to talk about what they're not so good
Speaker 3: things are and what you'll include. And those sorts of
Speaker 3: things are the four ls your liver, your lover, your livelihood,
Speaker 3: and the law. So how does that impact you, know,
Speaker 3: your life? The good looks at how much is it
Speaker 3: costing you the liver is looking at what's the impact
Speaker 3: on your health and your mental health. Your lover is
Speaker 3: how is it impacting on those relationships around you? And
Speaker 3: now that's not just home life, that's your work life, relationships,
Speaker 3: your social relationships, et cetera.
Speaker 1: And obviously the law, whether it's legal or not.
Speaker 3: When you take a person through that journey, it's just
Speaker 3: teaching them because we're not all taught how to make
Speaker 3: an informed decision about when it comes to substance use.
Speaker 2: Well, I stopped drinking. It'll be five years next year,
Speaker 2: and I kept an app as to like how many
Speaker 2: days I haven't drunk. I actually looked at the other
Speaker 2: day because we're having a conversation around you know, drug
Speaker 2: and alcohol use, and I just put down that I
Speaker 2: had a bottle of wine a night, five nights a week,
Speaker 2: so one hundred dollars a week. I didn't take into
Speaker 2: account ubers. I didn't take into account you know, buying
Speaker 2: that odd French champagne or you know, having a few
Speaker 2: drinks on more drinks on the weekend. And in that time,
Speaker 2: I've saved thirty five thousand dollars.
Speaker 1: Yep, I've had similar eats.
Speaker 3: I had one fella that was smoking pot for ten
Speaker 3: years and when we worked out if you had a
Speaker 3: not smoke that, I think it's been about one hundred
Speaker 3: and thirty two thousand dollars in that ten years on cannabis. Ah,
Speaker 3: And I said, what could you have done with that?
Speaker 3: And he said, I could have bought a house at
Speaker 3: that top. You know, it would have been a good
Speaker 3: deposit on a house. I said, when you put it
Speaker 3: into that with patients, it does open their eyes out
Speaker 3: to what that financial impact is having on them.
Speaker 1: Tobacco use is a good one at.
Speaker 3: The moment because I always discuss that with a lot
Speaker 3: of my patient because they're still smokers and we're looking
Speaker 3: at ways to reduce risk.
Speaker 2: So how much is that cigarettes? Sound?
Speaker 3: I know, pouchs tobacco fifty grams of white ox is
Speaker 3: about eighty to one hundred sandly two dollars a gram.
Speaker 3: Cigarettes are about anywhere from thirty dollars for a packet
Speaker 3: of twenty, so it's over a dollar a cigarette. So
Speaker 3: you know, I get some patients that still smoke and
Speaker 3: tailor mades and they're doing twenty or thirty a day.
Speaker 1: I always go back and said.
Speaker 3: I gave up when it was five bucks a packet,
Speaker 3: but I was doing two packets a day. I said,
Speaker 3: I couldn't afford to smoke these days, and they.
Speaker 1: Laugh, But it is true. It's just what we thinks.
Speaker 3: And it always comes back to when you're talking about
Speaker 3: a substance use disorder with some patient. I always go
Speaker 3: back to that Maslow's hierarchy and stuff. And when you're
Speaker 3: in that throes of using a certain substance, whether it's tobacco, alcohol,
Speaker 3: and fetamines and that that becomes the number one priority
Speaker 3: in your life and it is a hard one to
Speaker 3: work on and an address and stuff. At that time, say,
Speaker 3: it's not until someone gives you on tape shody you
Speaker 3: need to do something about it, or you've sort of
Speaker 3: come to that your own realization that when you start
Speaker 3: re examinating, then you can have a look at how
Speaker 3: it is impacting on your life and stuff and how
Speaker 3: you get there. But it's not our simple journey. It's
Speaker 3: a lifelong journey for a lot of people. It's not
Speaker 3: something I just stop it and that's it and I
Speaker 3: can move on with my life. It's always there, and
Speaker 3: it's always having those skills and tools to be able
Speaker 3: to manage it.
Speaker 2: And I think our culture in Australia is the drinking culture,
Speaker 2: because when I go to the States to visit my
Speaker 2: daughter over there, you go and you look at the menu,
Speaker 2: they've got a whole page or page and a half
Speaker 2: of mocktails and non alcoholic drinks and that sort of thing,
Speaker 2: like it's just the norm. And they think, Australians, you
Speaker 2: have more than a couple of drinks, I actually think
Speaker 2: you're an alcoholic, Like they'll have an intervention if you
Speaker 2: have more than three drinks, whereas you know, most people
Speaker 2: would do that at nighttime here in Australia and not
Speaker 2: think twice about it. It's an interesting thing culturally.
Speaker 1: It is.
Speaker 3: And even when I've trained some of the medicads that
Speaker 3: have come through AIDS and stuff, especially when they've been
Speaker 3: from overseas countries your Southeast Asia sort of specific areas
Speaker 3: and stuff where drinking is not in part of their culture.
Speaker 3: And I go to him, I said, you know, if
Speaker 3: you talk to most Austrains and if they drink six
Speaker 3: beers a day and they turn up to work every day,
Speaker 3: don't have sickies, and you say that you've got an
Speaker 3: alcohol use disorder.
Speaker 1: Even whether it's mild or moderate or whatever.
Speaker 3: They will become quite offended because culturally you don't have
Speaker 3: a problem because you're turning up to work, you're putting
Speaker 3: food on the table, you're paying for everything. They do
Speaker 3: not think they have a problem. But if you go
Speaker 3: under looking at the DSM five or look at they're
Speaker 3: actually drinking, especially if you're doing more than six heavy
Speaker 3: beers or more than four standard drinks, your risk to
Speaker 3: yourself actually quite increases.
Speaker 1: Probably have got a mind alcohol use disorder, and.
Speaker 3: It is quite prevalent in nursing as well, because one
Speaker 3: of my colleagues who works for Danna, they did a
Speaker 3: survey of nurses and did a paper on it.
Speaker 1: We love a drink.
Speaker 3: It's within our culture, but also within nursing as well
Speaker 3: as culture.
Speaker 2: Absolutely work hard and party hard. I mean we used
Speaker 2: to go out between late ship and earlies.
Speaker 1: Yes to the nightclubs. Ring in sick from a nightclub,
Speaker 1: say what's that? Nothing?
Speaker 3: Or you turn up the next day if you're an
Speaker 3: essential in the sense of that you're going to be
Speaker 3: short if you didn't turn up, so you'd be there.
Speaker 2: Honestly, I mean we were tough as back then. But
Speaker 2: when I think about it. Probably some of the things
Speaker 2: we did, I don't know if it was that appropriate.
Speaker 3: I think when it comes to alcohol within Australia, it's
Speaker 3: part of our culture. But also we do have a
Speaker 3: very powerful lobby group in the liquor industry in starts
Speaker 3: of keeping it going, and that's why there's reluctance to change.
Speaker 3: Whilst they put things in place, there's a reluctance to
Speaker 3: ever get rid of it or anything like that. You know,
Speaker 3: you only have to see the amount of violence that
Speaker 3: goes with alcohol, and they have done things like curfews
Speaker 3: and things like that, you know, lockouts and stuff like
Speaker 3: that to reduce it. But I know, like on state
Speaker 3: of origin, it's the amount of assaults that comes up
Speaker 3: that's related to alcohol, fuel and violence is phenomenal. Yeah,
Speaker 3: it spikes at those three times the year.
Speaker 2: Really, I mean, it doesn't surprise me, but it's interesting
Speaker 2: that statistics are there.
Speaker 3: The funniest thing is that we do big investments in
Speaker 3: things like methampheta means probably affects less than five percent
Speaker 3: of the population, yet there's a heavy investment because what
Speaker 3: we see, what the media portrays is all this negativity
Speaker 3: around it. And that all these people are causing that problems.
Speaker 3: But out of that group, there's probably only a small proportion,
Speaker 3: you know, the twenty percent that caused the problems out
Speaker 3: of the one hundred percent that use. But they're the
Speaker 3: ones you see on the media and stuff and causing
Speaker 3: all the dramas. And it's not to say methmphetamans is
Speaker 3: a safe drug or anything like that, but when you
Speaker 3: compare it to alcohol, it's small when you look at
Speaker 3: how much alcohol impacts on driving offenses, fatalities, alcohol related violence,
Speaker 3: DV and stuff, and all that sort of negative impact
Speaker 3: that it has because we've got a bigger proportion of
Speaker 3: the population using it because we don't want to change
Speaker 3: our culture.
Speaker 2: No, it's true. I mean, you can't turn the TV
Speaker 2: on and watch football without there either being gambling or alcohol.
Speaker 1: And that's pretty much what it is now.
Speaker 2: Just a couple of questions around nursing and what avenues
Speaker 2: do nurses have if they think that they've got an
Speaker 2: alcohol or drug problem.
Speaker 3: Look, you're probably going to work with your GP in
Speaker 3: the first instance. I'm probably going to say to you,
Speaker 3: go and see a private practicing psychologist or a private
Speaker 3: practicing service. Sometimes if you come through the public service.
Speaker 3: The first initial thing was that people will be worried
Speaker 3: about if you're using alcohol or other substances, that there
Speaker 3: may be an impact to patient care or something like that,
Speaker 3: and there's likely to be a report to OPRA. Now,
Speaker 3: my experience with dealing with a few people that have
Speaker 3: been through the opera experience and the impact that it's
Speaker 3: had on registration, it can be quite an arduous, costly
Speaker 3: process and it is not affordable and a lot of
Speaker 3: times you can't gain employment because sometimes the restrictions that
Speaker 3: they put on your practice is that someone's got to
Speaker 3: be there and supervise you. Makes it very hard for
Speaker 3: people to hold positions little lane try and demonstrate that
Speaker 3: their use of a particular substance isn't impacting on patient care.
Speaker 1: So it's a difficult one.
Speaker 3: But look, you know, we have had patients come through
Speaker 3: and work through it, but most of the time they've
Speaker 3: either ended up with a psychiatrist looking after him because
Speaker 3: there was other issues going on, and done it through
Speaker 3: private services. But the ones that have come through the
Speaker 3: public service, there has been apper notifications and then it's
Speaker 3: working with the patients and even when they're on a
Speaker 3: program appro date.
Speaker 1: Look at that as a safety mechanism.
Speaker 3: So I've had a patient that had a codeine use
Speaker 3: disorder that ended up on the program, was doing well,
Speaker 3: but obviously an APPER notification went in and then the
Speaker 3: amount of requirements they made, the.
Speaker 1: Hoops and the difficulties of it.
Speaker 3: You've got to do counseling that you've got to submit
Speaker 3: to drug testing, and it's all at the cost of
Speaker 3: the patient. Now whatls the counseling might be through through
Speaker 3: a drug and apical service. If you're on a program
Speaker 3: such as the opia treatment program, that's great. That helps
Speaker 3: with that, but then there's always the barriers to practice
Speaker 3: that you can't access an say, covert unless there's a
Speaker 3: secondary person there that's going to supervise your practice. If
Speaker 3: you're working in the age care sector, or if you're
Speaker 3: working in a community nursing sector, no service or agency
Speaker 3: wants to pick you up. And if you're try and
Speaker 3: get a job in the public system, even they will
Speaker 3: make it difficult in providing that level of supervision. Being
Speaker 3: able to commit to that these days, especially with the
Speaker 3: nursing shortages, it really leaves us at a loss. Now,
Speaker 3: if I talk about medicine, they will do everything to
Speaker 3: keep that person in the profession, so it's not an issue.
Speaker 3: They'll find a supervisor, they'll find someone there to assist
Speaker 3: the person and monitor practice or whatever.
Speaker 1: It's not a thing because they see that they've invested
Speaker 1: a lot.
Speaker 3: Of money into the individual to hold that profession, and
Speaker 3: just because they've got a problem with a particular substance
Speaker 3: or alcohol doesn't mean that they're not a good person
Speaker 3: or a good practitioner. It just means that that particular
Speaker 3: time they may have had a problem and that's what
Speaker 3: they've used to cope with. We're nursing. I don't think
Speaker 3: we value people enough in the sense of that we're
Speaker 3: not doing enough to look after and retain our skilled
Speaker 3: staff just because at some point of their life they
Speaker 3: may have developed a drug and alcohol issue.
Speaker 1: And it's not to.
Speaker 3: Say, you know that we shouldn't have something that people
Speaker 3: have got to aspire to or anything like that to
Speaker 3: make sure that a the individual's being looked after and
Speaker 3: has options to support rectifying the particular problem within their life,
Speaker 3: you know, the substance use disorder or anything like that,
Speaker 3: and be supported to do that. But we shouldn't also
Speaker 3: make it a financial impediment on them that they can't
Speaker 3: earn a living, they can't do the job that they've
Speaker 3: signed up because they love it as well. So you know,
Speaker 3: we've got to find that better happy medium. And I
Speaker 3: think it's too far, it's too punitive the way Apraa
Speaker 3: looks at at the moment.
Speaker 1: But I go back to nursing. Nursing's always ate their young,
Speaker 1: and this is.
Speaker 3: Different where they really eat someone that may have had
Speaker 3: a little bit of a problem. Now, if you had
Speaker 3: diabetes and stuff and it was impacting in your care,
Speaker 3: they do everything to make sure that was fine.
Speaker 1: But drug and alcohols always.
Speaker 3: Looked at as a self inflicted problem and it's not
Speaker 3: looked at as like from a disease model law. You know,
Speaker 3: it's multi factorial as to why someone may develop one
Speaker 3: and about how are we supporting and they don't take
Speaker 3: into the pressures of work life that's going on for
Speaker 3: a lot of people that can end up with that problem,
Speaker 3: and how we support them to get back onto in
Speaker 3: their recovery so that they can go out and continue
Speaker 3: to be a productive member of society like they have been.
Speaker 2: If a nurse is off work having to pay for
Speaker 2: all her or his own drug tests, then counseling as
Speaker 2: well as seeing psychiatrists psychologists GPS. That's a huge expense.
Speaker 3: It is a huge expense, and some of the stuff
Speaker 3: you can mitigate some of the stuff sometimes, like through
Speaker 3: mental health care plans and trying to link them into
Speaker 3: GP services at bulk bill psychiatry. Sometimes some of them
Speaker 3: if you're in the health profession, may give you a
Speaker 3: little bit of lenience and stuff like that with billing
Speaker 3: and stuff like that, but that's not always the case.
Speaker 3: It is a difficult one in regards to that about
Speaker 3: how do you support people with those costs, But there's
Speaker 3: an expectation you'll just afford it. But most people live
Speaker 3: on the threshold of day to day, especially when you're nursing,
Speaker 3: and depending on where you're working, So if you're working
Speaker 3: in a public system, you're going to probably be better paid
Speaker 3: than someone that's working in a private hospital or someone
Speaker 3: working in a non government facility, or if you're working
Speaker 3: in general practice, and general practice is probably the most
Speaker 3: poorly paid out of nursing compared to a lot of
Speaker 3: the others.
Speaker 2: There shouldn't even be that disparity, really.
Speaker 1: No, they shouldn't be. Look we won't go into the
Speaker 1: equity stuff, but that's the whole conversation.
Speaker 3: Because we talk about this currently within the Union. We're
Speaker 3: talking about the gender inequity, you know, especially for a
Speaker 3: lot of females and stuff when you're talking about super
Speaker 3: payments and stuff, because a lot of female staff have
Speaker 3: time off for pregnancy and stuff like that, so you
Speaker 3: lose a lot out of super.
Speaker 1: And stuff and they're disadvantaged.
Speaker 3: And the thing that I raise, well, if you work
Speaker 3: in general practice and you do that, you're even more
Speaker 3: because you're lower paid, so your super is never going
Speaker 3: to be as good in regard to that. So they're
Speaker 3: like a third tier when you're talking about gender actuity. Now,
Speaker 3: nursing is female dominated, don't get me wrong, but when
Speaker 3: you compare it against other industries on how much is
Speaker 3: our time valued, it could be done better. I think
Speaker 3: it should be more valued. We're undervalued at times. But
Speaker 3: governments and that always look at us that we're the
Speaker 3: biggest work force, we cost the most, but they forget
Speaker 3: the amount of knowledge and skills that we bring to
Speaker 3: an area. And the humanity side in patient care, touching,
Speaker 3: looking after people, giving that comfort when people, especially at
Speaker 3: the end of life and stuff, and sometimes explaining when
Speaker 3: the medicads have left, explaining well what did the doctor
Speaker 3: mean by that?
Speaker 1: Because you know they're too frightened to ask the question.
Speaker 3: You go, well, this is what they want to do
Speaker 3: to You want to do this, this and this, and
Speaker 3: you know, speaking in that layman's term to the patient.
Speaker 1: So they get it.
Speaker 2: Career nurses are getting less and less, you know, nurses
Speaker 2: instead of nurse like me for thirty five years. There's
Speaker 2: not a huge number of us surround anymore.
Speaker 3: The problem is we're a dying breed. People look at
Speaker 3: nursing as a stepping stone. Now, I suppose I look
Speaker 3: at my kids and they're from twenty to sixteen, they'll
Speaker 3: probably have a minimum three to.
Speaker 1: Four jobs in their lifetime.
Speaker 2: They say seven.
Speaker 3: Now, yeah, so it's even more so, you know, their
Speaker 3: diversity will be there in regards to it, and they
Speaker 3: don't stay at anything that long unless it benefits, you know,
Speaker 3: and suits their needs and purposes. So in some ways
Speaker 3: they've got some things right. It is all about them,
Speaker 3: but it's looking after themselves.
Speaker 2: Yeah.
Speaker 3: I think the gen x's and the baby boomers we
Speaker 3: really looked at you know, it was a career choice.
Speaker 3: You're always there for the longevity, and you'd work your
Speaker 3: way through and you'd start at the bottom work your
Speaker 3: way up. But it was also about that community benefit,
Speaker 3: you know, that social benefit to the community and stuff
Speaker 3: as to why we stayed in employment and stuff, because
Speaker 3: we could see the benefits to others and other people,
Speaker 3: especially in nursing.
Speaker 2: We're interesting breed, aren't we.
Speaker 3: It's always play hard, have fun, but always doing the
Speaker 3: best that you can for the people that you look after.
Speaker 3: I think that was always the motto within that generation
Speaker 3: of nursing. You know, it was always about looking after
Speaker 3: patients and providing that holistic care to them.
Speaker 1: I look at it now and I.
Speaker 3: Don't see that same level of care sometimes for the
Speaker 3: patients and stuff, and even the way people engage with
Speaker 3: patients and asking the questions, even what to do with patients.
Speaker 3: I got called to our cancer ward the other day
Speaker 3: because I worried about a patient withdrawing from cannabis. He's
Speaker 3: got brain mets and stuff, and they go, what do
Speaker 3: we do? And I go, well, I'll go and have
Speaker 3: ITTI well, I did you know. Look, reality is yes,
Speaker 3: in the ideal world, you'd say, well, can you have
Speaker 3: some medicinal cannabis and stuff like that.
Speaker 1: Is there any opportunity now?
Speaker 3: Obviously with the nose making stuff, the ability to vape
Speaker 3: or anything like that, probably not likely to happen. But
Speaker 3: that's where we haven't caught up with some of that stuff,
Speaker 3: that access to medicinal cannabis for all some patients you
Speaker 3: know who want to use that as part of their treatment.
Speaker 1: But what I did.
Speaker 3: Was, he wasn't no regular pain relief, he didn't have
Speaker 3: anything there just to manke get a little bit of anxiety.
Speaker 1: So my thing is I went up to seeing the patient.
Speaker 1: He's not in withdrawal or anything like that, but.
Speaker 3: I just said to the patient, I said, look, in
Speaker 3: the ideal world, you'd be able to have a cup
Speaker 3: of cone somewhere and that'll be your nighttime sleep to
Speaker 3: get you off and you'd be right.
Speaker 1: And I said, but unfortunately we don't have that ability.
Speaker 3: Now. I'll put in the notes alternatively to see if
Speaker 3: they could access some CBD oil or something like that
Speaker 3: from the medicinal cannabis stuff, to see whether that may
Speaker 3: be an option. But it's probably going to be told
Speaker 3: may But what I can do is like a news
Speaker 3: conventional stuff. So let's get you written up for some
Speaker 3: basic stuff like some ENDO and five miligrams Q ideas
Speaker 3: or baseline with some PRN and if you want it,
Speaker 3: you have it. If you don't, you don't, give you
Speaker 3: a little bit of dias five miligrams Q idea and
Speaker 3: if you want it you can have it. If you don't,
Speaker 3: don't with a bit of PRN stuff there if you
Speaker 3: need it.
Speaker 1: And I said, that's up to you whether you take
Speaker 1: it or not.
Speaker 3: And I said, look, if you do have any cannabis withdrawals,
Speaker 3: we can symptomatically treat it with these medications. And just
Speaker 3: fed that back to the team. But I was sort
Speaker 3: of gone, these are sort of the common things that
Speaker 3: I see these days, and people don't know what to
Speaker 3: do if patients got drug and alcohol. But our care
Speaker 3: in healthcare has become though silid.
Speaker 1: No one wants to step out.
Speaker 3: And that's why I love being a nurse practitioner because
Speaker 3: I do a bit of primary healthcare. I do a
Speaker 3: little bit of min A patient's got an anxiety disorder,
Speaker 3: I'm not going to be scared to get Oh you've
Speaker 3: got a socially anxiety, Le's give you an any depression
Speaker 3: you're willing to try it, yep, let's go bang, start it. Thanks,
Speaker 3: we'll get your reviewed in seven days to see them.
Speaker 3: We'll up your days and we'll play with that and
Speaker 3: get your settle and then we'll get you back to
Speaker 3: your GP.
Speaker 1: Well, you know, we'll start it.
Speaker 3: We'll get you back to the GP and he can
Speaker 3: manage it up and ty trade you up.
Speaker 1: It's all those things. But what I'm finding there with
Speaker 1: patients is they don't.
Speaker 3: Especially drug and heal call patients because of past history whatever.
Speaker 3: There's limitations on access to general practice and stuff. So
Speaker 3: even in my things, I manage some patients general practice
Speaker 3: stuff or we're trying to secure a new GPS.
Speaker 2: Yeah, it's an issue. Thank you so much. I know
Speaker 2: how busy you are, and I know you know you
Speaker 2: move some things around to have a chat with me today.
Speaker 2: Thank you. I really appreciate it. And if people require
Speaker 2: any further information or guidance, we can put some information up.
Speaker 3: I always get candidates nurse practitioners always wanting to catch
Speaker 3: up with me or something like that about different things
Speaker 3: or questions and stuff we're getting in the area.
Speaker 1: So definitely haven help. And look, all I'll say is
Speaker 1: for nurses.
Speaker 3: If you have a drug and alcohol is you, I'd
Speaker 3: probably stee you more towards private practicing areas only because
Speaker 3: it is less likely to be preferred to Afria in
Speaker 3: the first instance. They'll probably want to support you and
Speaker 3: address that for that particular reason.