Glenwood’s Valley View Hospital utilizing more opioid alternatives
Valley View’s Emergency Department Administrative Director Laurale Cross has served on the front lines of the opioid epidemic for decades.
“It’s near and dear to my heart from all the years working in the newborn intensive care unit, because I saw the end effect of addicted mothers,” Cross said of her time working as a neonatal nurse practitioner.
“And those babies, it’s heartbreaking to watch them in withdrawal,” she said. “It frequently takes about three weeks in the hospital to get them off of those opioids.”
Rounding out her career in a leadership role, Cross described how doctors and especially nurses in Valley View’s emergency room (ER) work closely with patients to determine the feasibility of what are known as alternative to opioids (ALTOs) as it relates to their medical condition.
According to Cross, at the time of patient discharge, Valley View in the second half of 2017 wrote 603 prescriptions for Class II drugs. During the second half of 2018, the Glenwood Springs hospital sent out 482 such prescriptions.
Class II drugs primarily consist of narcotics, or opioids.
“You can crunch numbers a million different ways but no matter how you crunch it that’s a big decrease,” Cross said of the department’s opioid prescription reduction.
Cross emphasized the integral role nurses play as it relates to explaining to patients their options concerning ALTOs when they end up in the Valley View ER.
“The most powerful way to promote those alternative drugs is really nursing,” Cross said of the educational and data components relating to ALTOs. “Nurses spend, probably, the most time with patients.”
Additionally, Cross described how doctors, often younger ones, have become increasingly versed in their expertise of ALTOs.
“What we are seeing now in new doctors coming out of training is they are really trained toward using some of the alternatives more,” Cross said. “Where, if you’ve been around a long time … it wasn’t even an option.”
Regardless of the health care provider’s age, Cross felt very lucky to work in a setting where doctors were open to adopting change and trying new medical advancements.
“We are really seeing a reduction in the number of patients going out the door that are taking those [opioid prescriptions] home with them,” Cross said.
Make no mistake, though, a patient’s success with ALTOs should not diminish the usefulness of opioids in certain cases when prescribed and administered by a doctor, she added.
“I have to be very clear, there are patients who absolutely need opioids,” Cross emphasized. “We are not trying to not give [opioids] to the people that really need them.”
At Valley View, doctors identify whether or not an ALTO would suffice in place of an opioid, she said. If not, and the patient does in fact need opioids, then the amount prescribed becomes the next pertinent question.
“We are just trying to sort out who really needs [opioids], or would an alternative work,” Cross said. If the alternative doesn’t work, then the question is how much to prescribe.
“You don’t give so many [opioids] that they are going to just sit in the medicine cabinet,” Cross said.