In helping people battle substance misuse, Paul Thompson has learnt it’s not just the patients who need educating
Recently a hospital drama on television featured a nurse and doctor arguing over the care of a drug addict who had missed his clinic appointment and was begging for help in the emergency department. The nurses ignored him and the hospital’s chief executive barked at him, while the doctor calmly prescribed him methodone.
This situation is all too common in many healthcare settings - but not The Royal Liverpool and Broadgreen Hospital, where Paul Thompson is a clinical nurse specialist for substance misuse. He was a finalist in this year’s Nursing Times and HSJ Patient Safety Awards for his outstanding work taking care of patients with addiction, supported by a committed chief executive.
After qualifying in 1991, working at a nursing home and then in orthopaedics, it was a brief spell in Saudi Arabia that inspired him to consider substance misuse.
“I had an accident diving from a diving board into a 5ft deep pool. I’m 6ft 2,” Mr Thompson says. “I broke my neck and was given pethedin. It’s strong and has addictive qualities; I had it in a safe, controlled environment so I didn’t develop an addiction but it made me see how easy it is for people to become addicted when they don’t have that and there is a catalyst to make them addicted.”
After returning to the UK he was later sought out by the Royal’s substance misuse nurse to replace her when she left. “She saw I had a lot of sympathy for addicted patients,” he said. “I didn’t know a lot, but I did some research and went for it.” He got the job in October 2008.
“I may have approached it with trepidation, but it is a privilege to have a job I love and be able to help those who need it desperately,” he says.
“My remit is to see every single patient affected by drug addiction or substance misuse who comes through our doors, to signpost them to support services, to talk and help.
“The main drugs I see patients using are marijuana, heroin, cocaine and anabolic steroids. On Mondays and Tuesdays I see lots of patients, usually aged 18-25, who have taken cocaine at the weekend and come in with cardiac problems. The rest of the week is more of a mix. I probably see fewer heroin addicts now than a few years back because mortality is high and it’s no longer the drug of choice.
“I spend a lot of time with link nurses, such as COPD nurses, because heroin addicts have breathing issues, or specialist IV access nurses as some people don’t have good enough veins for injections.
“My job is part counselling, part pointing [patients] to the right support services outside of the hospital or to nurses who can help inside. I provide advice for patients, but also for staff,” he says.
Staff attitudes to these patients led Mr Thompson to start his own project, working with the adult safeguarding lead to educate all staff about substance misuse. Of the trust’s 5,200 employees, 2,500 have already done the training.
Mr Thompson believes it is vital as not everyone shares his view that all patients deserve empathy and high standards of care; however, their beliefs are borne of misunderstanding or fear over a previous encounter with drug addicts.
“We can improve addicts’ lives and health, and stop them using dirty drugs. Even if they’re hostile or aggressive we, as health professionals, have to learn how to treat them and get them the care they deserve.
“When I start a training session I ask the staff if they have any feelings about drug users. Once I did this and a woman shouted derogatory comments. I carried on; by the end of the session she apologised and asked where she could get more training.”
Mr Thompson believes sharing people’s stories dissolves anger - and ignorance. “I saw a heroin user who had clearly been an attractive young man, but whose face had been ravaged by drugs. I asked him why he had got into using and he said his mother pimped him out to a local paedophile when he was 10 to fund her drug habit. That makes you realise people don’t have choices and we shouldn’t ever judge or just think they can stop. They can’t.”