An approach to staff development for the delivery of care to drug addicted patients

The authors believe that the rehabilitation of drug addicted patients requires specialized and highly skilled nursing care and that quality care is insured only by planning and developing a well functioning, cohesive staff. As a result of three years of experience in working with both patients and staff in a research treatment setting, four key areas of planning for staff development have been identified: recruitment and selection of staff based on established criteria; orientation and training utilizing a self paced approach; definition of the role of staff based on a philosophy of care; and program evaluation by both patients and staff as an ongoing process. Criteria used to determine effectiveness of the delivery of care include retention of patients, level of aggressive behavior on the unit, frequency of illicit drug use, staff morale, and professional satisfaction. It has been observed that success in recruitment and selection of staff can be potentiated by utilizing an interview tool developed to review individual areas of interest as well as psychologic and social adjustment. Final selection of staff is the responsiblity of the clinical nursing supervisor and is made with the aid of a personnel representative, the individual interview, references, and feedback from the group interview with staff. Orientation is the first step in an ongoing training process and is carefully planned with the new staff member so that a self paced plan of setting objectives is established. Examples of content include: theories on addiction, psychopharmacology, treatment modalities, and interpersonal process theory. The role of the staff focuses responsibility for rehabilitation on the patient as staff function in the role of facilitators in encouraging patients to explore life style change. Evaluation must be an ongoing process, gathering data from patients as well as from staff.