Nurses from across the country will be gathering in Vancouver at the Canadian Nurses Association Biennial Convention this week. As part of the occasion Insite and the Dr Peter Centre are each hosting special sessions on June 17th, providing opportunities for knowledge exchange on harm reduction policies and nursing practice.
Canadian nurses recognize that substance use, both legal and illegal, is an enduring feature of human existence and that abstinence is not always a realistic goal. As such, nurses focus on reducing adverse consequences and building non-judgmental, supportive relationships for the health and safety of individuals, families and communities.
There is a risk that the image of nurse-supervised injection is limited to a nurse hovering over a client while the injection takes place and nothing more occurs. I want to dispel this image.
The nurses of Insite have articulated their framework of nursing practice. Nursing care is client-centred with the focus on relationship building, maintaining dignity and respect, and creating an environment of cultural safety and empowerment. Primary nursing care at Insite includes safer injection education, needle-syringe exchange, first aid, wound care, overdose management, addiction treatment, reproductive health services and communicable disease prevention. These services are delivered as comprehensive harm reduction and health promotion programming nested in partnerships with the health and social service systems and community agencies.
In 2011 the Canadian Nurses Association released a discussion paper on Harm reduction and currently illegal drugs: implications for nursing policy, practice, education and research, which was endorsed by the Canadian Association of Nurses in AIDS Care. The values of harm reduction are consistent with the values guiding professional ethical nursing practice articulated in CNA’s Code of Ethics for Registered Nurses for the provision of safe, ethical, competent and compassionate nursing care; for the promotion of health and well-being; for the promotion of and respect for informed decision-making; for the preservation of dignity in which care is provided on the basis of need; and for the promotion of justice.
Considering this it really shouldn’t come as a surprise that Canadian nurses support harm reduction services. The origins of outreach nursing have been attributed to the Grey Nuns, founded by Marguerite d’Youville in Montreal, who by the mid 1700’s, were known for their care to the destitute. Inequity of access to health care and the basic determinants of health has led to “street nursing” practices in many urban centres.
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In Vancouver, after World War II nurses led a major effort to reach marginalized people who would not attend hospitals for the treatment of sexually transmitted diseases. In 1988 the BC Centre for Disease Control established the AIDS Prevention Street Nurse Program with a focus on needle and syringe exchange. With the epidemics of overdose deaths and the dramatic outbreak of HIV that Vancouver experienced in the 1990’s, the street nurses were some of the first to advocate for bringing injecting from the alleys into the safety of a supervised injection health service.
Just over one year ago, professional associations – Canadian Nurses Association, Registered Nurses Association of Ontario and Association of Registered Nurses of British Columbia and BC Nurses Union each acted as intervenors in support of Insite at the Supreme Court of Canada. Nurses across Canada cheered when the Supreme Court ruled in favour of Insite remaining open.
Look for nurses to be leaders in advocating for the expansion of supervised injection services locally, nationally and globally!
