National debate helps drive continuing education topics

CE modules can help nurses respond to current events
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By Heather Stringer
EDITOR'S NOTE: Heather Stringer is a freelance writer.
“With the changing laws in this country, cannabis is no longer simply something interesting for nurses to learn about,” said Carey Clark, PhD, RN, AHN-BC, the presenter of the OnCourse Learning webinar and an associate professor of nursing at the University of Maine at Augusta. “It is now something nurses need to know about. Patients are using medicinal cannabis, and we need to educate them about how they can best use it.”

The webinar is an example of how current events influence the continuing education opportunities for nurses who are working in a field that is continually evolving. “We have covered everything from the Ebola and Zika viruses to human trafficking, child abuse reporting laws and more recently the opioid epidemic,” said Maria Morales, MSN, RN, CPAN, executive director of healthcare programs for OnCourse Learning. “The goal is to provide the information nurses need to know before they know they need it.”
In the medicinal marijuana webinar, Clark covered topics such as the wide variety of cannabis strains available and the fact that these strains include differing levels of cannabidiol (CBD) and tetrahydrocannabinol (THC), the psychoactive compound that produces the feelings of euphoria. People with multiple sclerosis, cancer and post-traumatic stress disorder are among the patients using medicinal cannabis to treat their conditions.
“One of the common myths is that more is better, but with cannabis, patients often have a better response with fewer side effects when they receive a lower dose,” said Clark, who is also president of the American Cannabis Nurses Association.

Patients also may experience different responses to the same strains. One patient may feel energized when using a specific strain, while another patient may feel anxious with the same strain and dose. “Nurses need to focus on the patient experience to find out what works best for each person,” Clark said.
The importance of learning about this topic was highlighted in July when the National Council of State Boards of Nursing published new nursing guidelines for medical marijuana. The NCSBN recommends nurses should have a general understanding of topics including the endocannabinoid system, cannabinoid receptors and the interactions between them. They also should be familiar with cannabis pharmacology and risks for certain patient groups.
The opioid epidemic also has intensified the need for continuing education as nurses encounter patients who are receiving — and potentially abusing — these drugs. In one recent CE module, nurses learned how to navigate the complexities of treating pregnant women who may be struggling with opioid use disorder.
“One of the areas where nurses can be particularly helpful is ensuring that women are adequately screened for substance use, depression, anxiety, trauma and social determinants of health,” said Daisy Goodman, DNP, MPH, APRN, CNM, who recently led a CE presentation about evidence-based care for pregnant women with opioid use disorder.
Many of these women need multiple services, such as behavioral healthcare, food and housing assistance, screening for HIV and Hepatitis C, transportation to treatment and nutrition education — and nurses can play an important role in coordinating this care, Goodman said.

During the course, Goodman also encouraged nurses to consider their own biases when working with this patient population. “Pregnant women who are using opioids encounter a lot of judgment and criticism, and we need to offer the same compassion and support to them as other patients,” she said.
In another CE module, nurses had the opportunity to learn about the differences between men and women who are struggling with substance use disorders. Women become addicted to alcohol, nicotine, and prescription and illegal drugs at lower levels and in shorter periods of time, according to Susanne Pavlovich-Danis, MSN, ARNP-C, CDE, CRRN, one of the course’s authors.
“It’s important for nurses to understand that women do not currently have or take advantage of the same opportunities for treatment that men with substance abuse do,” Pavlovich said. “Many factors keep them from seeking treatment, including life responsibilities and the need to care for children.”
Pavlovich-Danis hopes understanding the specific needs of women with substance use disorders will help nurses identify gender-specific approaches for assessing, intervening and educating women about how to overcome the barriers to becoming substance free.
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As awareness of human trafficking has increased in recent years, nurses also need more information about how to identify and report potential victims, Morales said. “It’s a challenging situation because nurses want to help victims, but they must find ways to communicate without putting victims in danger,” she said.

An OnCourse Learning webinar described the types of human trafficking, how to identify victims and the legal issues related to reporting. States such as Florida now require nurses to complete two hours of CE coursework about human trafficking, and the course must include data on topics such as social services related to rescue, food, clothing and shelter, hotlines for reporting, and assessment tools for victim identification. Although it may seem difficult to take the time to complete continuing education requirements, Morales said the feedback from participants about recent CE offerings related to current events has been overwhelmingly positive.
“When we see different events in the news, the chances are high that frontline healthcare workers have already seen it or will see it shortly,” Morales said. “If nurses can stay up to date, then they can be prepared for situations rather than just reacting.”
She foresees a demand for more information about the recreational use of cannabis now that nine states and Washington, D.C. have legalized the practice for adults 21 and older. The public will likely be turning to healthcare providers to answer their questions about everything from how the drug interacts with other medications to health risks of longer-term use, and nurses should be prepared to answer these questions, Morales said.
When 1,300 healthcare providers watched a webinar about medicinal cannabis at the end of August, the nurse presenter knew the high attendance rate was a sign of the medical community’s desire for more understanding about this controversial topic.
When we see different events in the news, the chances are high that frontline healthcare workers have already seen it or will see it shortly. If nurses can stay up to date, then they can be prepared for situations rather than just reacting.”
— Maria Morales, RN
Carey Clark, RN
Maria Morales, RN
© 2018 OnCourse Learning Corp. All rights reserved
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