Nurses and midwives do complex, challenging, unpredictable and vital work. We often don’t acknowledge that our work exposes us and makes us vulnerable to physical and mental health issues, including problems related to substance use.
“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” — Rachel Naomi Remen
Problems related to substance use are a health issue. The factors that cause a person to develop problems related to substances are complex and varied, as are the problems themselves. Some people might find themselves using alcohol or drugs more plentifully or more often than they’re comfortable with, while others may come to realise they are physically or emotionally dependent. All experiences are valid and someone doesn’t need to have a very serious problem before they can benefit from reaching out for assistance — and, on the other hand, it’s never too late to get help even if the problem has become very serious.
Nurses and midwives report varied experiences of developing problems related to substance use. It is extremely common for people who are struggling with substance use to have experienced trauma at some point in their lives — in fact, 1 in 2 patients in addiction treatment have symptoms of PTSD. The vicarious trauma many nurses and midwives experience in the workplace — often over decades — may make them more vulnerable to problems related to substances.
Other common risk factors for nurses and midwives who struggle with drinking or drug use include (but are not limited to):
- childhood and or adolescent trauma
- vicarious stress
- chronic stress
- chronic pain
- mental illness and self-medication
- post-traumatic stress disorder
- moral distress
- compassion fatigue and
- shift work.
Nurses and midwives with problematic substance use concerns deserve sensitive, compassionate, and considered support — yet many report feeling isolated, unsupported, and fearful. Many feel they can never reveal the problem to employers, peers, friends and loved ones due to stigma. We’re here to offer confidential, non-judgmental support 24/7 — give us a call on 1800 667 877.
In this edition you will find a range of blogs, resources, and podcasts to help you understand problems related to substance use, whether you are experiencing them yourself, supporting someone specific, or want to better understand the problem and how it affects people in our industry. Remember that 1 in 5 Australians will experience an alcohol, drug or gambling disorder in their lifetime, so it’s likely that more people around you are struggling than you might ever guess.
Nurse & Midwife Support is operated by Turning Point, Australia’s leading national addiction treatment, education, and research centre. The nurses and midwives who answer your calls work alongside the drug and alcohol counsellors of Turning Point’s telehealth services such as Counselling Online and Gambling Help Online. In fact, many of the members of our team actually used to work on that team, and we are so grateful for the experience and expertise they bring to Nurse & Midwife Support.
Turning Point seeks to transform the way society provides treatment, specialist care and support for those affected by addiction. For Turning Point, issues of stigma, significant delays in help-seeking, knowledge gaps across the health workforce, a fragmented service system, and a siloed response to addiction are key areas that must see improvement. They offer research, treatment, education and training programs designed to improve access and effectiveness of treatment to people who are struggling with all forms of addiction.
In 2020, Turning Point partnered with SBS and Blackfella Films to create the documentary series Addicted Australia, which followed 10 Australians with serious drug, alcohol and gambling problems through a holistic, tailored and extended treatment program that models the kind of treatment that Turning Point believes is the future of recovery. This documentary offers valuable insight into the daily lives of people struggling with substance dependency.
To inform the newsletter content priorities I met with two experienced drug and alcohol nurses: Jackie Shaw and Cally Berryman who work at Nurse & Midwife Support. I asked Jackie and Cally what they really wanted us to share with our readers. They were unanimous that it is essential to encourage support, compassion, empathy and care when hearing the issues from those experiencing problems related to substance use, and that it is crucial that managers have the knowledge and skills to support nurses, midwives or students who disclose an issue.
As a service, we have benefited enormously from Cally and Jackie’s expertise in this area, and we are so grateful. In fact, Cally’s work was integral to the creation of Nurse & Midwife Support. She wrote a PhD thesis Nurses’ drug and alcohol use and dependence: creating understanding, which investigated drug and alcohol use among Victorian nurses. Cally’s research findings and the vision of several nurses led to the formation of the Victorian Nurses Health Program in 2006, now known as the Nursing and Midwifery Health Program Victoria. The experience of the NMHPV and advice and expertise of Cally were instrumental in informing the establishment of Nurse & Midwife Support.
Tessa Moriarty: Extending a hand of care: Supporting managers to support nurses and midwives dealing with substance issues
Experienced mental health nurse Tessa Moriarty writes about the complexity of problems related to substance use for nurses and midwives, and how managers can support team members struggling with this issue.
The team from Counselling Online, the free national online drug and alcohol counselling service, share some signs that might indicate it’s time to make a change, what harm looks like, and how you can get started.
Hobbies and pasttimes are a powerful tool to counter problems related to substance use. Nurse & Midwife Support’s Celeste Pinney writes about finding healthy outlets as an alternative to drinking and drug use.
We talk to Adam Searby, president of Drug and Alcohol Nurses of Australasia (DANA) about how nurses and midwives can seek support if they are experiencing problems related to drugs and alcohol.
NMHPV Podcast: Conversations that Connect Episode 1: Keys to a nurse or midwife thriving in recovery from their alcohol or other drug (AOD) addiction (a personal story)
Heather Pickard is a nurse who is now the CEO of the Self-Help Addiction Resource Centre (SHARC). She is 27 years in recovery and shares the story of her journey to offer hope to others. Heather shares her thoughts on the risks for nurses and midwives in relation to developing problems related to substances, the reasons nurses and midwives may not seek support, the importance of self-care and how to access support. Heather tells us that nurses and midwives are often loaded with shame and stigma when experiencing problems how that can impede their access to support. However, key to Heather’s recovery was another nurse who recognised her problem and provided support and care. It is the nursing and midwifery community that can be our greatest support. Throughout this podcast, Heather provides hope that recovery is possible. Heather reminds us that to live our best life we need to be ‘humans being’, not just ‘humans doing’! Check out the episode.
Heather also assisted us as we prepared this newsletter, and we could not be more grateful for her input!
SHARC have collaborated with NMHPV and the ANMF Vic branch to establish residential rehabilitation services for nurses and midwives with problematic substance use via Oxford Houses. This is an open-ended program that provides secure, supportive, and affordable homes for people recovering from alcohol and other drugs. Oxford Houses is three-quarter-way living, where residents are responsible for strengthening their own recovery and accountable for managing the affairs of their home within the Oxford Houses guidelines.
Find out more about the program here.
Drug and Alcohol Nurses of Australasia (DANA) position statement: Problematic substance use by nurses and midwives
DANA recently updated their position statement: Problematic substance use by nurses and midwives. The statement acknowledges the importance of protecting the public, the profession, and the individual in relation to problematic substance use, and describes the responsibilities of individuals, colleagues, employers, the profession, and government in managing this issue. Read the statement.
While there is now greater understanding of the issues influencing and impacting nurses and midwives with substance dependency and problems related to substance use, there is also limited research to explain the reasons and complexities of this issue.
Our podcast guest Adam Searby is conducting research to provide insights on whether a relationship exists between nurses’ work settings, work stress and their alcohol consumption: Alcohol Consumption in Australian Nurses & Midwives: An Action-Design Study.
The research is investigating the prevalence of ‘at-risk’ drinking among Australia nurses and midwives. The study aims to understand the drinking habits of Australian nurses and midwives and will test existing technology-based interventions for at-risk drinking, typically delivered via mobile apps, to establish if they would prove effective among nurses and midwives.
The survey is not currently accepting new participants.
Research on the origin and development of problems with substances
Here is some research on various aspects of the genesis of problems related to substances
- Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population
- Chronic Stress, Drug Use, and Vulnerability to Addiction
- Substance Use and Mental Illness Among Nurses: Workplace Warning Signs and Barriers to Seeking Assistance
- Shift-Work-Play: understanding the positive and negative experiences of male and female shift workers to inform opportunities for intervention to improve health and wellbeing
- Secure Your Mask First: The Importance of Self-Care
COVID-19 and substance use
Chronic Stress is a risk factor for developing substance dependency. The COVID-19 pandemic has stressed, challenged, and exhausted nurses and midwives and we continue to feel the impact.
Research examining ambulance attendances for alcohol-related harms during COVID-19 restrictions in Victoria found that attendances to homes increased by 9 percent in 2020, with those from more socioeconomic advantaged areas showing the largest percentage change. Read about the research.
Counselling and referral
- Nurse & Midwife Support 1800 667 877
Please be aware that there are many treatment and rehabilitation services available that are not evidence-based and can be expensive. If you or someone you know is considering entering a treatment program, it’s a good idea to get a referral from a trustworthy source. Counselling Online and the Alcohol and Drug Information Service in your state have been government-funded to offer this information. Get in touch with Nurse & Midwife Support or one of the services below for more information.
Research and information
Self-help and peer support resources
- Counselling Online Peer Support Forums
- SMART Recovery Meetings
- Self Help Addiction Resource Centre (SHARC) 1300 660 068
- Alcoholics Anonymous Australia
- Narcotics Anonymous Australia
- Hello Sunday Morning
- CAHMA (ACT)
- NUAA (NSW)
- NTAHC (NT)
- QuIHN (QLD)
- Clean Needle Program (SA)
- Needle and Syringe Programs (TAS)
- Harm Reduction Victoria
- Harm Reduction WA
Resources for family, friends and other significant others
- Family Drug Help (via SHARC) 1300 660 068
- Counselling Online Friends and Family Forums
- Al-Anon Family Groups
- Nar-Anon Family Groups
If you know of further research or resources relevant to this topic we would love to hear from you! Pass them on to firstname.lastname@example.org.
If you are impacted by problematic substance use, please access support — it’s never too early, and it’s never too late. Give us a call on 1800 667 877. Your health matters!
Mark Aitken RN
Stakeholder Engagement Manager
Nurse & Midwife Support