Community Health Nurse'S Role In Cannabis Legalization

On October 17th, 2018, the Canadian government plans to legalize cannabis. In the post-secondary setting, this change is expected to have a huge impact. As my community health placement at a university, this legalization is a focus of mine for the semester. One of the first tasks I completed in my placement was putting together informational posters and placing them around campus. Within a day of posting them, I received an email stating that they needed to be removed because the government had made an announcement and the posters were not representative of this change. Although I was not at my placement this day, I did my best to assist my preceptor with removing the posters and continued the process myself when I returned to campus. While I did all I could at the time to rectify this situation, upon reflection, I have found that although this situation was unavoidable, it was a valuable learning experience for me in education and health promotion. The following reflection will discuss my role in health promotion in the university setting, particularly in the legalization of cannabis.

If you walk around a university or college campus, you will see posters all over the walls. There are posters advertising clubs and events, but also informational posters. In collaboration with the Student Life department at the university, I was tasked with creating a poster to provide information to students regarding the upcoming legalization of cannabis. Several hours were spent determining the specific wording of the poster with the underlying stance of the university being that they do not promote the use of recreational cannabis, but there are resources if you require information or assistance. After the points on the poster were edited several times between myself and my preceptor, Student Life, the university marketing team, and many other groups and persons of authority at the university, the posters were sent to print. This process in and of itself was valuable to me, as it gave me the opportunity to see the role of the community health nurse in health promotion.

In accordance with Community Health Nurses of Canada (2011), I observed the role of the community health nurse in understanding and using marketing and media to raise awareness of health issues, as well as using a client-centered approach to help the individual, family, group, community and population identify available resources. After receiving the posters, we identified areas of high traffic on campus and placed the posters there so that they could have the most impact. As I was posting them, I could already hear people around me being drawn to the posters.

The legalization of cannabis has been a subject of great interest in the media lately, and the university has been quiet about it so far. However, these posters represented the university’s stance on the legalization and included information such as that cannabis can only be smoked in your own home and that it is not permitted anywhere on university property, including residences and cars. When I received notification that the posters needed to be removed from campus, it was because the provincial government announced that cannabis could be smoked anywhere that cigarettes could be smoked. Although the law is more nuanced than this, the university decided that this statement would cause confusion with the information on the posters and that they needed to be edited. Although there was nothing that we could have done to predict this announcement from the government and how it could conflict with the information we were providing to the university community, we acted quickly to remove the posters and edit them. We are currently waiting on the new posters to be printed so that we can place them around campus. This experience is significant to my nursing praxis, because I did what I could in the situation with my current nursing knowledge, and upon reflection, I observed more clearly the role of the community health nurse in a post-secondary setting. I participated first-hand in evaluating and modifying the population health promotion program we were implementing in partnership with the university and policy makers. This is a key role of the community health nurse in meeting the standard of health promotion.

Cannabis use is a very current topic and crucial for a university and its health promotion team to address. According to the World Health Organization (WHO), cannabis is the most commonly used psychoactive substance around the world. In Europe, 8.8 million persons aged 15-24 years used cannabis in the last year. In the USA, the percentage of people in this age group using cannabis rose each year between 2002 and 2014. While the rates of cannabis use in this age group is rising, the prevalence of cannabis-use disorders is also increasing. Furthermore, remission rate for cannabis dependence is estimated at 17% each year. As cannabis-related health outcomes can be influenced by modifiable behaviors, evidence-based interventions are required to improve public health outcomes. These evidence-based recommendations set out by Fischer et al. (2017) are directly relatable to some of the points used on the posters, such as that cannabis use poses a number of health risks, just like tobacco and alcohol. It is planned that further information will be provided by the university along these recommendations.

According to Fischer et al. (2017), the risk of adverse health outcomes can be reduced by informed behavioral choices. These recommendations can be used as an educational and interventional tool. This experience greatly increased my understanding of role of the community health nurse and health promotion in a post-secondary setting. Personally, I would never consider using cannabis except for medical reasons; however, as a nurse and advocate for health promotion, you cannot have this bias. Creating the posters helped me understand that all health issues must be addressed, regardless of my personal viewpoint of them, because they could be greatly influencing other members of the university community. It is important that the university population have the resources we can provide to them in case they are seeking assistance for themselves or peers. Furthermore, this experience taught me that as a community health nurse, it is necessary to be flexible and accommodating to changing policies. It is important to work collaboratively with other members of the community, so that you can promote health effectively.

The goal of health promotion is not to tell the community how to act, but to empower them to care for themselves by providing education and resources. In my future nursing praxis, I will be sure to identify my own values and not allow them to influence my work as a nurse. The CNHC (2011) states that health promotion action includes creating supportive environments, especially in light of the changing nature of society and the impact of values and client readiness. I will also be certain to maintain fluidity in my practice and be cooperative with policy-makers and other members of the community who have influence over health promotion.

Through this reflection, I have gained insight into the work of the community health nurse and the importance of health promotion in the university. Since the legalization of cannabis is new, the impacts on public health, particularly on the Canadian university population, are still uncertain. Many areas still require more research and, for the university community, it is crucial that the community health nurse and health promotion team are available as an educational resource for the community. Even the wording on a poster can have a large impact on the community and its members’ understanding of potential health issues. If the community health nurses meet the standard of health promotion, members of the community can take control of their own behaviors to minimize their risks, and thus, have more control over their own health.