Educational visit to Betty Ford Center an eye-opener for Nursing Professor
Leanne Busby believed she had the knowledge about substance abuse she needed as director of Vanderbilt University School of Nursing's Family Nurse Practitioner program.
But Busby, assistant professor of Nursing at VUSN, teaches future nurses with a little more firsthand knowledge these days, following a week-long "immersion training experience" for health care professionals conducted last summer at the renowned Betty Ford Center, in Rancho Mirage, Calif.
Her experiences there have led Busby to incorporate more about the recognition and prevention of substance abuse into her lectures and she now believes she listens more closely to her patients.
"I was taught how to recognize risk factors and symptoms of substance abuse in patients, but I had never spent any detailed time working in this area. The Professional in Residence Program at the Betty Ford Center was an uplifting and educational experience. I gained significant knowledge and skill which will impact my professional role of educator and practitioner."
Busby and Caroline Post Cone, a psychiatric and mental health instructor at VUSN, were two of six health care professionals from across the country selected to participate in the "immersion experience" as a Professional in Residence in the Family Program at Betty Ford Center. Through their participation in a Faculty Development and Substance Abuse Prevention grant, these two Vanderbilt faculty members were assigned to two different small groups of family members and "significant others" of inpatients at the Betty Ford Center.
Spending every day listening to the experiences of the eight family members in her group was an emotionally exhausting but educational experience, Busby said.
"I experienced many emotions every day I was there, from feeling the anguish of the family members to experiencing their joy as small steps were made in the family member's move toward success in dealing with their disease," Busby said. "What I had learned in my education took on a new meaning by the examples that were given there. I felt for the first time that I could really conceptualize the disease of alcoholism."
Inpatients at the Betty Ford Center normally participate in a 28-day treatment program. During the third week, family members and significant others are strongly encouraged to participate in the family counseling.
Busby and the other health care professionals were cautioned against any one-on-one counseling with family members. That was to be left to the center's full-time counselors, all of whom have either been substance abusers themselves, or who have family members with substance abuse problems. The six visiting health care professionals were allowed to participate in the feedback portion of the daily group sessions.
"From my earliest days in nursing I was taught to maintain a professional demeanor, especially when counseling patients," Busby said. "But I found myself needing Kleenex as we went around the room hearing family members share their personal stories. On the first day, before we even got a quarter of the way around the room, the emotion of the week was clearly evident."
The groups were varied. There were husbands, wives, sisters, sons and daughters. There were three boys under 16 whose fathers or mothers were in treatment.
The daily counseling sessions were followed by a Thursday encounter where the inpatient and the family member confronted each other, face to face, as the rest of the members in the small group listened. A counselor facilitated the session.
One of the most poignant moments of the week came during one of the family group's spiritual sessions, Busby said. A nun, who led the group, asked how the participants felt when they saw their family member incapacitated by alcohol or drugs.
One voice, that of a 14-year-old boy, responded, "not surprised."
"I don't know why that was such an enlightening event for me, but that child had been very quiet all week, and when he was the first to respond his anguish was evident."
During the face-to-face confrontations, as an outsider looking in, there appeared to be obvious answers to the family member's and patient's problems, Busby said.
"But to them, simple answers just aren't there."
Busby said that she was surprised to realize that of 200 inpatients, very few demonstrated obvious physical symptoms of substance abuse.
"If you saw them on the street, you would never think they had a problem. Most of these patients looked just like you and me. This raised my awareness that people can have significant problems impacting their health and the health of their families that are not always obvious.
"This experience convinced me that it is absolutely necessary to introduce more substance abuse recognition and prevention material into the academic component of nurse practitioner education."