Kiona Hayes, MSN, APRN, FNP-C, GRACE Program Case Manager at Woman’s Hospital in Baton Rouge talks about the GRACE program and how they help women stay clean for their babies.
Interview conducted by Ivanhoe Broadcast News in October 2019.
Why do you do what you do?
HAYES: I’m quite passionate about what I do. I actually started working on the high risk unit here at Woman’s Hospital, which is a unit for high risk pregnancies and high risk postpartum deliveries. So we would get the patients who had opioid use disorder on our floor because they’re considered high risk. I actually didn’t know that I was passionate about working with these moms until other social workers and other nurses kind of pointed it out – you’re really good with these patients. I learned more about it, got more education, did more research, and I realized, wow, this isa need, and I like to give where I’m needed. I’ve become really passionate about it. I love my patients. They teach me so much about myself and so much about them. So it’s been great to work with the program.
When did you start working at Woman’s
HAYES: I started working at Woman’s in November 2015, and that’s when I was working on the high risk unit. And then I moved over with GRACE in April of 2018.
In the past four years, have you noticed this becoming more and more of an issue?
HAYES: Absolutely. And I think a lot of it has to do with so much in the community about opioid use disorder now is just being more supportive because there’s been a lot of stigma associated with it. So before, patients wouldn’t disclose and they would come to the hospital after the pregnancy was over when they’re ready to deliver because they didn’t feel they had the support. So now, with the program being here, I think patients are voicing that they need the help and seeking the help. But that also has a lot to do with changes the hospital is making with a lot of the OB offices – making sure that we’re screening the way we should. And I don’t mean just drug screening, I mean verbal screening – universal screening to help these patients be able to identify, that they have an issue that they need help with.
People now understand the opioid crisis and we’re trying to catch up with what’s happening.
HAYES: Yes.
What kind of changes are you seeing just in the mindset of hospitals and medical providers?
HAYES: I think, in relation to medicine and science, we’re finally understanding that addiction is a disease of the brain, and being able to relate that to actual disease – it makes it easier for us to understand how to treat these patients and not realizing it’s a lack of will or an issue with them just having – oh, I just want to use. I want to be “high” – them understanding, this is an actual disease that is treatable, I think, has moved milestones because it did for me. Before, when I worked with these patients, I treated all patients the same. But understanding their addiction and that disease made it really easy for me to take care of them and follow guidelines and treatment for them.
Tell me a little bit more about Courtney.
HAYES: Yes. We met Courtney last winter or late fall. She came into the hospital. I think she had, a hand abscess and she disclosed that she had been having issues using. And so they referred her to us – one of the inpatient social workers did. So we made first contact with her while she was inpatient here at the hospital. And she was just really open and honest and said, I need help. I want to parent my child. I just really need to do what I need to do in order to do what’s best for me and my baby. So since then, she’s been highly engaged with the program. She’s been a great peer for others that she’s met in her treatment provider. We were able to get her referred, and she’s been engaged with them as well since the beginning of her pregnancy – the first trimester. She did everything she’s supposed to do. She went to all of her OB appointments. She checked in with us whenever she needed. She was receptive to the education. A big part of care for babies who are diagnosed with neonatal abstinence syndrome or NOWS – which is neonatal opioid withdrawal syndrome – is breastfeeding and doing skin-to-skin and really keeping the baby swaddled and things like that. She did that with flying colors. She had no issues at delivery and she was actually able to take her baby home, which says a lot. Just because she stayed committed and she stayed engaged, and a big part of working in your recovery is staying connected, and she’s done that. So we’re super super proud of her.
When you think of her and her baby, picturing them in your mind, just what’s your first gut reaction?
HAYES: Wow. Like, amazing. She was 11 – 12 weeks when we met her. She would show us all her ultrasound pictures and everything. So actually being able to see her grow with the baby, and then the baby’s here and she’s at home and she’s healthy. I mean, that’s why we do this. So it warms my heart. It’s amazing to be able to see this and this just makes my job so easy and rewarding just to watch that. All of them aren’t as successful as Courtney is, but they’re all successful in their own way. And justwalking into our door to begin with says a lot about who they are and how resilient andstrong they are. And she’s a perfect example of that.
What do you think makes the GRACE program unique from what other people are doing to fight the opioid crisis?
HAYES: We’re based on harm reduction, which basically means just strategies to keep people alive. A lot of people associate harm reduction withsafe needle exchange or using Narcan. But it’s way beyond that. It’s meeting the patients where they are and allowing them to have this open door policy. So I have some patients that sign into the program, and then they go away for a while, but then they come back and we greet them with open arms. And I think that allows us to be successful. So just zero judgment zone – I think that helps them to feel comfortable and open and be honest. And we just have mutual respect. So I think just having that open door policy and just being based on that harm reduction helps them to feel safe here – it’s like a safe zone.
I really hope that the program grows. We see a big need still for providers of buprenorphine. Methadone is a little different because it has to be at government facilities, but buprenorphine – any medical doctor or nurse practitioner – any type of provider could get – if they have a DEA, they can get the x waiver. So it’s really easy to do. You just take a course and then you apply for it. But a lot of people are still afraid of what that means and what that looks like. So allowing us to be able to actually prescribe and provide the actual medication, I think, would be great, but also just having more support from the community with referrals, making sure they know that this is a resource. Right now it’s free Allowing patients the freedom, to be referred to us and not being afraid to do that, I think, will help the program grow as well. But we’ve had great support from the hospital. I don’t want to say that we haven’t, we’ve had great support from the hospital, but there is definitely room for growth.
Is there anything you’d like to add that I didn’t ask?
HAYES: Just the stigma surrounding opioid use, especially in pregnancy – understanding that addiction is a disease of the brain and it takes consistent treatment and work. And instead of looking down or talking bad or not trying to understand the patients that are dealing with this disorder, but helping them seek the help that they need and realizing that GRACE is here for that support. We want to do this to help others. We don’t want anyone to feel that they can’t call us. And we want to be support for the community as well, not just for the patients. We want everyone to have the education and resources that they need. So just understanding what addiction is in general, I think, will change a lot of things.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
If you would like more information, please contact:
Caroline Isemann
504-909-8359
Sign up for a free weekly e-mail on Medical Breakthroughs called First to Know by clicking here
