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