I AM A ...
Transforming the prospects of vulnerable clients motivates Chelita De La Haye each day in her work as a nurse prescriber . She tells us about her role at Delphi Medical Consultants Ltd , a community drug service in Blackpool , Lancashire
I
qualified as an RGN in 2008 , then started working as a young person ’ s substance misuse nurse – my first job as a qualified nurse . Initially my role was commissioned by the local PCT in conjunction with the local authority . Over the years it has developed , including qualifying as a non-medical prescriber ( NMP ) in 2012 and now predominantly prescribing in the adult drug treatment service , with lead responsibility for young people . I also provide prescribing cover for the adult and young ADDER projects .
I knew that I wanted to work in the health and social care sector from a young age . My father had been an ambulance driver and this was something that I aspired to . I decided to gain some experience and started working as a healthcare assistant on a nurse-led unit . While in this role , I completed my NVQ level 2 in care and was lucky enough to be offered a secondment to complete my nursing qualification .
During my training I carried out some bank shifts with the national chlamydia screening team working with young people under the age of 25 . At the same time I volunteered with a local drug treatment project on the Dance Drug Safety Project , providing harm reduction advice in the night-time economy . I found engaging with both young people and individuals who misuse substances rewarding .
The post of young person ’ s substance misuse nurse was a new role which combined the two fields that I was interested in – and thankfully I was successful in securing the position . While in post I have been able to complete the Drug and Alcohol National Occupational Standards training , non-medical prescribing V300 , a foundation degree in managing drug and alcohol misuse , a degree in health and social care practice ( substance misuse ) and the RCGP management of drug misuse ( level 1 ) and alcohol management in primary care ( level 1 ).
A typical day at work involves carrying out prescriber review assessments with clients . The purpose of these is to establish if the prescribed opiate substitute is effective and the client has managed cessation of illicit substances . The review covers other areas of the client ’ s wellbeing and lifestyle which may have an impact on their progress , and then prescribing decisions regarding dose increases , supervision and dispensing pattern can be determined . The process also contributes to the client ’ s care plan and outlines any actions required , such as liver function tests , ECG , BBV screening and vaccinations . These reviews take place either face to face or remotely via telephone .
I also conduct discussion time with key workers to look at any issues or concerns as they arise . Other parts of my job role include administration of prolonged-release injections of buprenorphine , vaccinations , batch signing , detox / reduction planning , alcohol detoxifications and provision of symptomatic relief . Through the ADDER project I work with some of the most chaotic individuals offering fast
access to , and support to remain in , treatment . I work as part of a wider multi-disciplinary team to provide the most effective care available .
The majority of individuals who are in addiction will have experienced some prejudice and feelings of worthlessness during their life . To be able to support them from a place of vulnerability to being abstinent from substances and exiting treatment is the most rewarding part of my job .
Having a safe environment is fundamental to making positive change . Sub-standard housing and access to affordable accommodation is an ongoing issue – however this is not an issue that solely affects this cohort of individuals . Although the current housing situation is a wider societal issue requiring attention , ideally I would like to change the amount of social housing available to clients I work with .
It is a privilege to be able to work with people who have struggles
‘ I knew that I wanted to work in the health and social care sector from a young age . My father had been an ambulance driver and this was something that I aspired to .’
and difficulties in their lives and to be part of the process that provides them with the hope and motivation to change . Although there may be challenges along the way , if you are honest , compassionate , empathic and non-judgemental then working with substance misusers is the career for you . DDN
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