Training nurses to manage ice users should be a priority in dealing with the jump in methamphetamine-related patients.

Nurses should be trained to identify and manage methamphetamine psychosis, the most challenging aspect of the frontline management of ice use, the NSWNMA has recommended.

The union makes the recommendation – one of several on violence and workforce issues – in a submission to the NSW Special Commission of Inquiry into ice.

The NSWNMA submission says ice users are a greater risk of becoming violent when they are experiencing psychosis, or drinking heavily.

It says almost one-quarter of regular methamphetamine users will suffer from a symptom of psychosis in a given year.

The union recommends that NSW Health develop guidelines to help frontline health workers manage ice users.

It says there are no national guidelines despite the National Ice Taskforce recommending them in 2015.

Training in the prevention and management of violence “must be provided as a matter of priority, to all staff, including regional areas in NSW where staff are least likely to have access to training, security or sufficient staff to allow for a duress response in an emergency,” it says.

The national taskforce reported a five-fold increase in the number of hospitalisations related to methamphetamine use between 2009 and 2014.

Specialist drug treatments provided for methamphetamines almost tripled.

The union says it is therefore essential that nurses and other frontline workers in AOD services be trained to effectively manage and care for people who use ice.

High levels of stigma and discrimination

The same training is needed for emergency departments, community health settings, acute care wards and mental health services, it says.

“It is crucial that all staff working with people who use ice (or other substances) understand the complexities of drug dependency.

“It is widely documented that people who use drugs (including ice) experience high rates of stigma and discrimination when accessing health services.

“This impacts on their willingness to access health care services, and ultimately is detrimental for both the individual and the broader community.”

The NSWNMA urges that all AOD treatment services be staffed by “appropriately qualified and regulated professionals.”

It recommends funding be allocated to expand Clinical Nurse Educator (CNE) and Nurse Practitioner (NP) positions in the AOD sector.

“Nurses working in AOD services need to have access to education and mentoring.

“Increasing the number of AOD CNEs would provide an opportunity for increased education of staff in AOD services.

“Furthermore, creation of additional CNE positions – as well as NP positions – would assist with retention of senior nurses working in the AOD sector.”

The submission points out that regional areas worst affected by methamphetamine use are the areas least likely to have access to training, sufficient staff, or security to manage potentially violent incidents.

“It is crucial that rural and remote health services are adequately funded so they can effectively manage patients using ice,” it warns.

“There needs to be a real transparent commitment from management at all levels to ensure the psychological health of AOD nurses is protected.

“Clear leadership with robust governance processes is required at all levels of management. This includes nursing leadership, with consistent state-wide processes and models of care that will help drive the required culture change at all levels.”

The submission says AOD services urgently need nurse-to-patient ratios and appropriate skill mix.

Read or download the NSWNMA Submission at: https://www.nswnma.asn.au/submission-to-the-special-commission-of-inquiry-into-the-drug-ice/