Concept Analysis: Substance Abuse In Health Care

Concept Analysis

Abuse in regards to the health care setting is not found in any dictionary, but as a beginning point for this concept analysis, a general definition of abuse is considered; “…abuse means to consume or misuse” (Cutcliffe & McKenna, 2005, p. 17). Another definition considered is by Bruggemann, Wijma & Swahnberg (2012) stating, “Abuse in health care is defined by patients’ subjective experiences of encounters with the health care system, characterized by devoid of care, where patients suffer and feel they lose their value as human beings” (p.123). The authors continue the definition, stating that abuse can be intentional or unintentional, verbal and non-verbal, and abuse can occur in both children and adults (Bruggemann, et.

In addition, these infants often receive poor prenatal care so there is an increased risk of infection (Jansson, 2015). Neonatal abstinence syndrome presents with many detrimental effects; “neurological, gastrointestinal, and respiratory signs including increased tone, a high pitched cry, poor feeding, sleep-wake abnormalities, poor weight gain, tremors and seizures.” (Dow, Ordean, Murphy-Oikonen, Pereira, Koren, Roukema, Selby, Turner, 2012). In order to enact professional caring when treating the infant with neonatal abstinence syndrome, the nurse must be educated on the pathophysiology and treatment modalities specific to this syndrome. The nurse must also possess courageousness and commitment to the infant when caring for them because a barrier to professional caring for the infant is the distress and frustration at the limitations in the process of comforting and consoling the infant (Maguire, Webb, Passmore & Cline, 2012). The nurses in a study by Murphy-Oikonen, Brownlee, Montelpare & Gerlach (2010) struggle between the desire to exhibit their critical nursing skills and techniques, and the needs to provide necessary maternal care to infants affected with

The study by Murphy-Oikonen, Brownlee, Montelpare & Gerlach (2010) identified common themes nurses reflected on being a personal struggle in the NICU. Frustration, burnout, barriers to parenting values, and awareness of community drug use were included in the study’s findings of common themes among nurses in the NICU. An example of a challenge to values in professional caring includes the nurse’s attitudes toward the family’s decisions and socioeconomic status, which can be influenced by knowledge gaps and difficulties in communication. Another challenge to professional caring includes encompassing all “medical, legal, social, and economic perspectives” (Savin, 2015, p. 21). Professionals and the larger society conflict over whether to approach the abuse issue punitively or supportively (Savin, 2015). Caring for patients with NAS “requires empathy, knowledge, and curiosity. It requires experience and stamina, which can be corrupted and exhausted,” ultimately causing burnout (Savin, 2015, p.22). Nurses may feel frustrated by the need to advocate for the helpless infants with NAS whose issues developed directly as a result of the mother’s actions, however, research by Savin (2015) indicates that nurses feel unready to care for the