On the meaning of "drug seeking".

The term "drug seeking" is frequently used but poorly defined. By soliciting nurses' comments and suggestions, a survey was developed to identify behaviors that may cause nurses to refer to a patient as drug seeking, to identify what nurses think the term "drug seeking" means, to explore how nurses regard the use of the term "drug seeking" in health care, and to identify differences between general nurses, emergency nurses, and pain management nurses with regard to these items. Behaviors that would cause the majority of all three nurse groups to refer to a patient as drug seeking were as follows: going to different emergency departments to get opioids, telling inconsistent stories about pain or medical history, or asking for a refill because the prescription was lost or stolen. When the term "drug seeking" is used, all three groups of nurses agreed that it was very likely to mean the patient was addicted to opioids, the patient was abusing pain medicine, or the patient was manipulative. One-half or more for each nurse group said they used the term "drug seeking" in talking about patients, but less than 10% said they used it in charting. After completing the survey, approximately one half or more of nurses in each group were less inclined to use the term. The use of stigmatizing terms in clinical practice is addressed with suggestions for alternative approaches to patient behavior related to requesting opioids for pain relief.

Evaluation of the End-of-Life Nursing Education Consortium undergraduate faculty training program.

BACKGROUND: Previous research has demonstrated that nursing education has not prepared nurses to provide optimum end-of-life (EOL) care; and yet, care of patients at the EOL is contingent on adequate preparation of nurses. To date, there has not been a unified or organized effort to broadly address the preparation of nurses in EOL care. OBJECTIVE: The purpose of the End-of-Life Nursing Education Consortium (ELNEC), a Robert Wood Johnson Foundation funded project (2000-2004), was to develop and implement a comprehensive national effort to improve EOL care by nurses through a joint collaboration between the American Association of Colleges of Nursing (AACN) and the City of Hope Cancer Center. DESIGN AND SETTING: Based on the AACN Peaceful Death document, the ELNEC curriculum focuses on nine EOL core areas. This project is a synthesis of research and knowledge in EOL care and is intended to assist clinical nurses with implementing scientifically based care in practice. Eight national training courses followed the development of the core training curriculum to enhance EOL expertise in faculty in undergraduate nursing programs (five courses) as well as in continuing education programs (three courses). Development of the ELNEC program included detailed teaching materials to integrate EOL content into existing nursing curricula and clinical teaching and extensive follow up evaluation. RESULTS: The data revealed significant outcomes in the report of implementation in the nursing curriculum including an increase in the amount of content, perceived effectiveness of new graduates, and of faculty expertise in EOL care, and a broad dissemination of all modules geographically. CONCLUSION: This national organized effort is a major step toward preparing nurses in EOL care to improve care of the dying.