PS377 Unit 7 Peer Crisis Response Paper Example

A Bedside at 3 A.M. and the Sentence That Changed the Plan: A PS377 Unit 7 Crisis Response Paper

[Student Name]

Purdue University Global

PS377: Models of Peer Recovery

Unit 7 Crisis Response Paper

[Instructor Name]

[Date]

The writer, the center, the hospital, the participant and every detail are composite and illustrative; the articles cited are real.

The Call

Our Louisville recovery community center sends peer specialists to two emergency departments when a patient who has survived an overdose agrees to see one. At 3:00 a.m. on a Sunday in February, I was on call with my supervisor as backup. A nurse called about Jordan, twenty-two, who had been revived with naloxone by his roommate and brought in by ambulance. He had used what he thought was a pressed oxycodone pill.

When I arrived, Jordan was awake, embarrassed and shaking. I introduced myself as someone in recovery who had once been in a bed like his. I asked if he wanted to talk; he did.

Peer Outreach After Overdose

Waye et al. (2019) described the implementation of two peer recovery outreach programs for overdose prevention in Rhode Island, one based in hospital emergency departments and one reaching people in the community. Peers met overdose survivors and others at high risk, offered support and naloxone, and connected them to treatment, recovery supports and harm reduction services. The authors reported that peers engaged large numbers of people at a moment when many were open to help, and they discussed the practical lessons of building such programs, including hospital partnerships and follow-up after discharge.

The emergency department visit is a narrow window. Within hours, a patient may leave and return to the same supply that nearly killed him.

The Sentence

About twenty minutes into our talk, Jordan said quietly, "Honestly, maybe next time it's better for everybody if I just stay under."

I did not try to assess how serious he was, and I did not promise to keep it between us. I said, "Thank you for telling me. That matters, and I want to make sure you get the right help with it. I'm going to ask the doctor to come back in, and I'll stay with you." I went to the nurse's station and told the attending physician exactly what Jordan had said. The physician and the hospital's behavioral health clinician came within minutes and completed a suicide risk assessment.

Hearing that sentence was not my cue to counsel; it was my cue to get the clinician and stay.

Safety Planning

The clinician learned that the thought had come and gone over the past month without any plan or intent, and she worked with him on a safety plan before discharge. Stanley and Brown (2012) developed the Safety Planning Intervention as a brief, collaborative way to reduce suicide risk. Its written steps run in order: spotting one's own warning signs, trying coping steps alone, going to people or places that take one's mind off things, reaching out to trusted people for help, contacting professionals and crisis lines, and removing or locking up the means of self-harm.

Jordan's plan, written in his own words with the clinician, listed his warning signs ("staying in my room all day," "not answering my mom"), his coping steps (music, a run), his roommate and his mother as contacts, the national crisis line, and the center. For lethal means, he agreed to give his remaining pills to his roommate and to keep the naloxone kit I gave him by his bed.

My role in the safety plan was supportive. I was present when the clinician wrote it, at Jordan's request, and I agreed to be one of the contacts listed under people to call during the day.

The Overdose Itself

Separate from suicide risk, Jordan had survived an overdose on a counterfeit pill, probably containing fentanyl. I gave him and his roommate naloxone kits and showed them how to use them, explained that pills bought outside a pharmacy can contain fentanyl, and offered a same-week appointment for buprenorphine at a partner clinic. He accepted the appointment, and his roommate wrote the clinic's address on the back of his discharge papers.

Follow-Up

Eddie et al. (2019) found that peer recovery support is often most valuable at transitions, such as leaving a hospital, when people otherwise lose contact with care.

Waye and colleagues emphasized that follow-up after the emergency department matters. I called Jordan the next afternoon and twice more that week, met him at the clinic for his first buprenorphine appointment and connected him with a young adults' recovery group. He kept his safety plan in his phone, pinned as the first note so he could find it fast. Two weeks later, he told me he had used his warning signs list once, on a bad night, and called his mother.

What Jordan Needed First

Before any talk of treatment, Jordan needed to feel less ashamed. He kept apologizing to the nurses and said his mother would "never look at me the same." I told him, briefly, that my mother had sat by a hospital bed for me once and that we are close now. I did not tell more of my story than that; the point was to show him that an overdose does not end a family's love, not to make the conversation about me. He asked whether I still talked to my mother. I said every Sunday. He was quiet for a minute and then asked if I could be there when he called her. I stood in the hallway outside his curtain while he made the call, and he waved me back in afterward. His mother drove in from Elizabethtown before dawn.

Supervision

After the shift, I debriefed with my supervisor. Crisis calls can stir up a peer's own memories; my first overdose was at nineteen. Talking it through the next morning, and taking the following night off call, is part of how peers stay well enough to do this work.

The Line Between Peer and Clinician

Crisis work tests the boundaries of the peer role. Peers can offer presence, lived experience, naloxone and connection. They do not conduct suicide risk assessments, make clinical judgments about safety or keep disclosures of suicide risk confidential. When someone's life may be at risk, the peer's job is to involve the people trained to assess it, and then to stay.

Conclusion

Jordan's overdose brought a peer specialist to his bedside, and his sentence about not waking up turned the visit into a clinical matter. Waye and colleagues' account of peer outreach after overdose explains the value of being there, and Stanley and Brown's safety planning gave Jordan a written plan in his own words. The peer's role was to listen, alert the clinician, support the plan and follow up.

References

Eddie, D., Hoffman, L., Vilsaint, C., Abry, A., Bergman, B., Hoeppner, B., Weinstein, C., & Kelly, J. F. (2019). Lived experience in new models of care for substance use disorder: A systematic review of peer recovery support services and recovery coaching. Frontiers in Psychology, 10, Article 1052. https://doi.org/10.3389/fpsyg.2019.01052

Stanley, B., & Brown, G. K. (2012). Safety planning intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256-264. https://doi.org/10.1016/j.cbpra.2011.01.001

Waye, K. M., Goyer, J., Dettor, D., Mahoney, L., Samuels, E. A., Yedinak, J. L., & Marshall, B. D. L. (2019). Implementing peer recovery services for overdose prevention in Rhode Island: An examination of two outreach-based approaches. Addictive Behaviors, 89, 85-91. https://doi.org/10.1016/j.addbeh.2018.09.027