Beyond “Meeting Them Where They Are At”: How nursing students conceptualize harm reduction in their practice with people who use drugs

Abstract

Background and objective: All nurses encounter people who use drugs in their practice and their conceptualization of harm reduction can have a significant impact on health outcomes for this population. It is not known how nursing students conceptualize harm reduction within their practice, and what influences their development, perspective, and support of the concept. In this study, we explore how final year nursing students have conceptualized harm reduction as a part of their practice with people who use drugs.

Methods: Purposive sampling was used to recruit 11 nursing students for face-to-face interviews. The study was informed by a critical social theory lens and data were analyzed using thematic analysis.

Results: Three themes and nine sub-themes were identified. Participants believed that harm reduction was congruent with nursing practice. Contextually, participants navigated personal beliefs and experiences to understand harm reduction and nursing care for people who use drugs. Participants also negotiated systems and power dynamics, which formed a critical backdrop against which participants discussed beliefs related to harm reduction and care for people who use drugs.

Conclusions and implications: Successful conceptualization of harm reduction involves more than cognitive learning. Four recommendations are offered for educators to explore and prioritize educational approaches that support harm reduction as nursing practice to enable better care for people who use drugs.