Harm Reduction Model
What are two harm reduction strategies nurses might use, and give an example from practice?
Alcohol programs, safe injection sites
Reflecting on your own biases about substance use - share how this can impact care.
Personal knowing: helps avoid judgement, builds therapeutic relationships.
Name one action under the “Communicator” role with a client in contemplation. Give an example.
Active listening: using open ended questions to explore fears about dying.
Pam fears dying but isn’t ready for rehab. What stage is this? How would you support her?
Contemplation: support safer choices, educate without pressuring.
A client in withdrawal says, “I’m shaking and feel anxious.” What’s your priority? Why?
A. Encourage the client to take deep breaths and wait it out
B. Notify the healthcare provider and assess for CIWA protocol
C. Refer the client to addiction counselling services
D. Explain the consequences of continued alcohol use
Correct Answer: B
Rationale: The priority is patient safety - shaking and anxiety may indicate withdrawal complications. CIWA is the standard protocol for alcohol withdrawal monitoring and treatment. The other options either delay care or focus on long-term goals.
Harm reduction accepts that not all clients are ready for what outcome? Why is this important
Abstinence, respects autonomy, clients remain engaged
How does aesthetic knowing help nurses build trust with clients like Pam? Share an example from practice.
Understanding Pam’s fear of dying creates empathy, informs trauma-informed care
How can nurses act as advocates for harm reduction clients like Pam? Share a strategy.
Speak against stigma, promote access to low-barrier services (such as mobile clinics).
How can nurses support clients in precontemplation without pushing them away?
Provide education on risks, focus on rapport-building, avoid confrontation.
What ethical principles guide harm reduction care for stigmatized populations? Give examples.
A. Beneficence, autonomy, justice
B. Veracity, fidelity, nonmaleficence
C. Confidentiality, paternalism, altruism
D. Advocacy, self-discipline, utilitarianism
Correct Answer: A
Rationale: Beneficence (doing good), autonomy (respecting choice), and justice (fair access) are core to harm reduction. These guide nurses in offering care without judgment, respecting clients’ rights, and reducing barriers caused by stigma.
How does harm reduction challenge traditional abstinence-focused models in nursing care?
Shifts focus from abstinence to reducing harm, celebrate small successes
Which way of knowing emphasizes evidence based models like harm reduction? Why does this matter?
Empirical knowing: ensures care is research informed and effective
Why is collaboration with other disciplines crucial in Pam’s case? Give one example.
Holistic care: social worker for housing, physician for withdrawal management
What’s the goal of nursing care of someone in the preparation stage? Share a possible intervention.
Support planning small steps - referral to withdrawal management program
While caring for a client who is experiencing alcohol withdrawal, what actions should the nurse take? (Select all that apply.)
A. Monitor neurological status on a routine basis.
B. Administer medications by IV route only.
C. Pad the side rails and place suction equipment at the bedside.
D. Orient the client to the environment and person with each contact.
E. Administer antiseizure drugs and sedatives to relieve symptoms during withdrawal.
Correct Answers: A, C, D, E
Rationale: These actions align with withdrawal safety and symptom management. IV route is not required unless clinically indicated.
Why is a non-judgemental approach key in harm reduction? Share an example where judgement might harm care.
Encourages engagement, judgement might lead to avoidance of care - PAM avoiding ER
Why is ethical knowing vital when working with clients like Pam? Discuss and give a situation where this applies.
Supports fairness and dignity - advocating for equitable pain management despite substance use history.
Which competency is demonstrated when a nurse uses trauma-informed care to support autonomy? How?
Clinician: considers trauma history, involves Pam in decision making about her care
Why is it important to recognize relapse as part of the stages of change? Give an example from practice.
Relapse is normal. Avoid blame and re-engage clients (offer support after a drinking episode).
A client in precontemplation refuses help. How should the nurse respond to maintain trust?
A. Reiterate the need to enter treatment or face natural consequences
B. Respect their decision, stay supportive, and leave the door open for future help
C. Offer a detox pamphlet and step away
D. Document the refusal and move on to another client
Correct Answer: B
Rationale: In precontemplation, the focus is building trust and readiness. Maintaining support without pressure respects autonomy and lays the groundwork for engagement. The other answers either pressure, abandon, or minimize the client’s readiness.