Nursing Week 2024: Interview with Cara Westgate

1. Why did you become a nurse, and what drove you to specialize in addictions care?

I have always been a fixer, I always put others before myself. I grew up with a mom who was an amazing nurse and I think that’s where my passion for nursing came from. To be honest I never wanted to work in mental health or addictions coming out of school, I always thought I wanted to work in the hospital. When I was in college they barely touched on addictions or mental health. One of my very first preceptors taught me to ignore one of my patients in the hospital because she was ” just drug seeking”. The world teaches us that people who use substances are scary, which is not the case at all. A friend of mine got me a part time job at the clinic in Brockville and because I was only casual at the hospital at the time, I took it because it was guaranteed two days a week, but I was unsure, I didn’t know if I could work with “those people”. That all stems from lack of education which is still a problem today. I have worked here for going on 13 years now and I can’t imagine doing anything else. My patients are like my family, they are some of the best people I have ever met who have more compassion than most. 

2. Can you share a memory from your time working at one of our treatment centres, in which you were able to make a real difference in a patient/client’s recovery?

I don’t like the word recovery or success because that can look different for everyone. I have felt worthless at times not being able to fix their problems. I am a nurse, nurses are supposed to fix right?

Sometimes it’s not about fixing but rather just listening, talking, or making them smile, that makes the biggest difference in their lives. It took me a long time to realize that my definition of recovery or success couldn’t be more wrong. Something we see as small might be the biggest thing to our patients, maybe that step forward was something they have never been able to accomplish before, maybe it needs to happen over and over before it sticks, or maybe it will never stick but its a positive in their lives for a change and that’s okay. 

I administered Naloxone and gave CPR to a young man that was overdosing outside of our clinic. When I got to him he was not breathing, he was blue and had no radial pulse, I wasn’t sure I would get him back. After multiple Naloxone and chest compressions he took a gasp of air and the blue slowly left his face. While working on him all I kept saying was “come on bud, wake up, wake up” over and over. Thank god he woke up, not everyone wakes up. The next day that young man walked in to my clinic to thank me over and over for saving his life and apologized for putting me in that position. The way he said it was like he thought he didn’t deserve to be saved which made me sick. I reassured him that I would do it a million times over. I often think about if that was my son in his position and picture him laying there on the cement, I would hope that someone would help him and not walk by thinking “who cares, it’s just another drug addict”. That person laying there is a person just like you and me and you don’t know their story.

3. What do you find to be the most challenging and rewarding aspects of working in addiction treatment? What keeps you motivated through the challenges?

Being an addictions nurse is tough man, I have lost so many patients to this ugly monster. I have cried myself to sleep thinking about how we as a society have failed these people and we should have done more to save them.

I believe addiction nursing is one of the hardest versions of nursing. You don’t only deal with a very vulnerable population of patients but you deal with a very judgmental, stigmatized world that doesn’t accept “drug addicts”. I used to argue with people, including friends and family about how addiction is real and is not a choice. I no longer do that, I am just one person and I know I can’t change the worlds mind,  but what I can do is try and educate people more if they will listen.

It takes a strong person to be an addictions nurse. You have to accept that you can’t fix everything, you can’t discharge your patient home in a few days, this is a lifelong battle that you feel like you are fighting with them.

I will continue to fight with them because they are worth it. Because for once they feel like they have someone who cares, someone in their corner. My few “hard” days at work, doesn’t even compare to their hard days everyday.

4. What is your approach to building strong relationships with people in your care, and why is it so important to do so?

I think the main thing is not making it about us. We are bred to believe things should be black and white and with the population we work with there is a whole lot of grey area. Why do we get to tell them what they can and can’t do, we don’t live their lives, we don’t know what trauma they have had to live through. 

I can’t even tell you how many patients of mine have said it would be so much easier if they were just dead. That makes my heart and stomach drop every time I hear those words. How are their lives that bad that the thought of them dying gives them such relief? We just live in our bubbles and carry on with our “normal” lives and continue to judge what society makes us believe is bad or unacceptable. I listen to my patients, they are all different and I continue to help them with whatever their definition of ‘recovery’ looks like. This is so important because not every situation is the same and a lot of our patients only have us in their corner fighting with them. 

5. Why should nurses choose to work in addictions care? What is your favourite part of the job?

There are days I feel defeated, like we are fighting a losing battle. I have experienced more loss in the past year than in my entire nursing career. Giving Naloxone and CPR shouldn’t be a normal day at work, but this is reality and I will continue to fight this battle because my patients mean the world to me and they are worth it. A close family member told me in a joking manner, “well you’re not a real nurse you just hand out Meth to drug addicts”. At first I became really angry, I was in fight mode, all I wanted to do was prove them wrong and try to defend myself as a nurse but then came to realize very quickly that there is no point in arguing with someone who knows nothing about addiction and what we do and who isn’t willing to listen and learn. Why am I not a real nurse? Just because I work with people who use drugs? Are these people not worth helping? I knew in that moment that arguing and yelling would not solve anything and I just needed to continue doing what I do to help my patients and continue to try educating those who will listen. Making sure that my patients know they can count on me to be vulnerable with, cry with, smile with or just hold their hand when they don’t want to talk is the best part of my job. Some of these people have gone through things I cant imagine going through. I believe the population we work with needs us the most. Addiction nursing can be hard, but it’s worth it.

Thank you, Cara, for everything you do for our patients. Happy National Nursing Week!