Beyond "Meeting Them Where They Are At" : How Nursing Students Conceptualize Harm Reduction In Their Practice With People Who Use Drugs
Bibliographic record
Abstract
This thesis presents findings from a qualitative study that explored how final year nursing students conceptualized harm reduction as a part of their practice with people who use drugs. The research was conducted using a critical social theory lens informed by the work of Habermas (1972; 1984). Data were collected in semi-structured interviews with 11 undergraduate nursing students from a western Canadian university. Data analysis was undertaken using the thematic analysis method developed by Braun and Clarke (2006). Three themes and nine sub-themes demonstrate the complex influences involved in the conceptualization of harm reduction among the participants. Participants expressed that harm reduction was congruent with nursing practice and that conceptually, harm reduction was inherent to their understanding of the profession. While participants seemed to have integrated the concept of harm reduction with their practice, their diverse experiences and identities influenced their perspectives. Contextually, these perspectives caused continued tensions for participants as they navigated questions about drug use stigma, the nature of drug use, the scope of the nurse, and the real-world application of their nursing education. These interconnected influences occurred against a backdrop of critical societal and systemic issues. Participants were negotiating oppressive systems and systemic norms, which affected their perspectives towards harm reduction and the care of people who use drugs. Participants enthusiastically perceived nurses as capable advocates and agents of change, yet they focused on individual contributions and abilities rather than collective efforts and progress. This study’s findings, reflected in four recommendations, contribute to the evidence required for educators to critically explore and prioritize educational approaches that support HR as nursing practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.031 | 0.025 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.018 | 0.051 |
| Scholarly communication | 0.017 | 0.016 |
| Open science | 0.004 | 0.016 |
| Research integrity | 0.005 | 0.011 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".