Interpersonal challenges as a constraint on care: the experience of nurses' care of patients who use illicit drugs.

Men and women who use illicit drugs have a heavy reliance on health care in emergency departments and acute care wards. Nurses' care however, is known to be constrained by inadequate drug education and policy and practice standards. This paper describes an additional constraint on care, namely, patients' behaviour. The findings are part of a broader mixed-methods study of nurses' therapeutic attitude to this patient group. The themes of violence, manipulation and irresponsibility emerged from the data analysis of written reports provided by a sub-sample (N = 311) of the main study sample. Recommendations are made for assisting nurses to reconceptualise their role with this patient group, and importantly, for an increase in violence management education and organisational role support, safety and security measures. Finally, further research in the field is recommended so that a comprehensive analysis of the difficulties faced by nurses and patients can be made.