John Kriticos

Date of Award


Degree Name

Master of Health Sciences and Physiotherapy

First Supervisor

Dr Amanda Timler

Second Supervisor

Professor Jim Codde

Third Supervisor

Dr Greg Gordon


Background: Methamphetamine (MA) use in Australia has stabilized over the last 22 years, however changing routes of administration and increased purity of the drug has led to greater rates of physical dependency and higher rates of cardiovascular, neurological, and mental health complications. Challenges managing MA related presentations have been reported in Australian Emergency Departments (ED’s), with limited research considering nurses’ experience treating individual(s) who use MA (IWUM) and require prolonged mental health care. Purpose: The aim of this study was to understand nurses’ experiences who care for IWUM in a West Australian hospital’s inpatient mental health service. Methods: Interpretive phenomenological analysis was the chosen methodology for this study. Purposive sampling and one-on-one interviews were conducted with 10 nurses to explore their experiences providing mental health care for IWUM. Results: Three superordinate themes emerged to describe the nurses’ experiences of caring for IWUM across different inpatient mental health services. These included; “Hit by the Storm” [presentations in Mental Health Observation Area (MHOA/ED)] “Working in the Rain” [Authorized Mental Health Unit (AMHU)], and “After the Storm” (discharge and community support services). The nurses highlighted the most acute phase of care was the initial presentation to ED, as IWUM often arrived intoxicated by the drug. The risk management strategies used by the nurses interviewed to manage aggressive behaviour in ED were notably Intravenous (IV) sedation, restraint, and security. Most IWUM who recovered quickly and showed signs of compliance were either discharged directly from ED or monitored in MHOA then discharged within 72 hours. A small proportion of IWUM who experienced drug induced psychotic symptoms were admitted to AMHU, where many nurses felt they had less access to medical resources, relied on their colleagues, security, and the Alcohol and Other Drug (AOD) community liaison team for support to safely manage these patients. Training to provide specialized care for IWUM, discharge planning and community follow up were areas viewed as inadequate or needing improvement. The high rate of continued MA use and representations also raised stigma among nurses caring for IWUM. Conclusion: Nurses associated the highest levels of acuity with their experiences caring for patients intoxicated by MA in ED/MHOA and reporting a perceived reduction of acuity when working with the small cohort of IWUM who were admitted to the AMHU. Nurses acknowledged overcoming stigmatising behaviours, required specialised MA training and education, and valued the support received from AOD nurses when caring for IWUM.