I was recently honored to be able to talk with Dr. Joanne Schwartz, current president of the Foundations of Addictions Nursing. I had the opportunity to meet Dr. Schwartz at a recent Board meeting and was so impressed with her background. She is a nursing educator, nurse practitioner, and leader. I asked her if she would be willing to share her career path and describe her focus on addictions nursing.

For 8 years, my career was initially focused on psychiatric nursing in the care of patients with acute and chronic mental illness across the life span. In the mid-1990s, I transitioned into academic nursing education, initially working as a part-time clinical instructor at Holy Family University and then assuming a full-time academic position at Drexel University in the summer of 1997. At Drexel University, my roles have been varied: teaching at the undergraduate and graduate levels both in-class and online, chairing the accelerated BSN program from 2006 to 2013, and eventually transitioning into the nurse practitioner program in psychiatric nursing once I completed my post-master's psychiatric nurse practitioner certificate program in December of 2016.

Tell me about your path and motivation for becoming a nurse practitioner with a focus on psychiatry and addictions.

I initially obtained my Master of Science in Nursing as an Adult Primary Care Nurse Practitioner in 1995 from the University of Pennsylvania but then pursued a Post-Master's Certificate in Psychiatric Mental Health Nurse Practitioner Track in 2016. I had an interest in addictions since I had a brother who was in recovery beginning in his mid-20s. I encountered firsthand the enormous impact of an addiction on a family member as well as the entire family system. My interest in working in addictions really stemmed from my interest to do some work in this area in order to support individuals and families who were experiencing the same thing. Consequently, this Post-Master's Certificate program was very meaningful to me. My interest in addictions really took off with this. I had challenged my brother about his relationship with alcohol prior to his getting sober and then, once sober, supported him during his recovery. He said my ongoing support of him helped him make that personal epiphany that his relationship with alcohol was both not normal and problematic. I did not shy away from telling him this-I did not protect him from this reality. We developed a close bond over this once he was in recovery. I believe that the decision to become a psychiatric NP and my interest and work in addictions were very much because of his life.

Thanks so much for sharing your personal journey. As difficult as that must have been, it certainly has contributed to your path and many accomplishments in helping others. Do you mind telling us about some of these accomplishments?

Besides my NP credentials, I obtained a PhD from Villanova University in 2011. During this time, I was chair of the accelerated BSN program. My dissertation studied professional outcomes and career satisfaction in accelerated nursing graduates. More recently, my professional focus has been on teaching psychiatric nursing at the graduate level and developing my clinical practice. I became a CARN-AP in 2017. I think this is a very important credential in advancing the specialty knowledge of addictions nursing. Last year, I was inducted as a fellow in the Academy of Addictions Nursing and was elected President of the Foundations of Addiction Nursing. I feel that in these roles I can do my small piece in advancing addictions nursing as well as global knowledge about addictions. I also try to live my commitment to addictions nursing in my clinical work. I strive to be compassionate and supportive in working with patients with addictions. I want to educate individuals with substance use problems as well as their families. For example, many times in dealing with a family member with an addiction, it can be tempting to reject that person for having an addiction. I think you can value people who have an addiction without enabling them. You affirm the person but reject the addiction. My addictions work has also deeply impacted my work as an academician. Some students may have personal problems with addictions. They may approach me to see how to deal with family members who are struggling. We talk about the challenges affecting them and strategize how to address them. My work with addictions nursing really has influenced all spheres of my professional work.

For the past 14 months, I have been working weekly in an eating disorders recovery center while continuing my work as a faculty member. It is a wonderful marriage between clinical practice and education. I can teach psychiatric theory in the classroom and connect with people who are struggling with mental health issues-including addictions-in the real world. Regular clinical practice also allows me to maintain my certification as a nurse practitioner as well as stay current on best practices.

You have been in nursing education for 22 years and have achieved an NLN Educator certification as well. Can you talk a little about what has this role has been like for you and what some of these rewards have been?

One of the greatest rewards in nursing education is the realization that you can have an impact on people for many years. I recently met a former student in the supermarket, of all places. When the student approached me, she told me I taught her and thanked me profusely. She reminded me of a story I told in class. Apparently, my story telling was very important to her. In teaching, one has the potential to connect with people, but with that comes a tremendous responsibility. I sometimes think back wondering if what I said to someone was received in the way it was intended. Words can live on in both good and bad ways. Teaching is a powerful role, and it is important to remember that students are growing and sometimes quite vulnerable.

What do you see as a major challenge in educating students about addictions today?

I think the major challenge in educating students is developing compassion for individuals with addictions. Story telling is a great way of creating an opportunity to reflect about the need for compassion in providing care. I have so many stories about individuals with substance use problems. They want to get sober, and yet it is so difficult. I remember hearing the story of one woman with an addiction who was in a research experiment. If she provided a clean urine at the end of the day, she received a nominal fee. I think it was $10. She was anguished that she could stay sober for a daily reward of $10 but not for her two children. The pain and anguish of family members of individuals with addictions is another example-everyone in the family struggles when someone is struggling with an addiction. It is important to share these stories of struggles to help with understanding and, ultimately, develop compassion.

In thinking about this, what strategies have you used though to help build compassion?

Story telling-I sometimes share stories about my own family as appropriate. We have such an opportunity to touch people's lives-to share the human experience-to touch a cord within another person.

Stigma is such an important issue in talking about compassion. What are your thoughts about how to deal with this? What has you experience been in working with students in addressing this understanding?

You are right. Stigma is an important issue. Many individuals see addictions as a character flaw. I am not sure the etiology really matters. More importantly, their patients are struggling and suffering. An important question is how we can support patients regardless of our view about the etiology of addictions. I remember observing a patient repeatedly asking another clinician for medication. The clinician, who was in recovery, saw this as drug seeking and confronted the patient rather firmly. The approach worked in helping the patient be more aware of her own behavior-she stopped immediately. This clinician's approach was very different from my own, but it made me realize that many approaches can be effective. It is an example of the art of nursing-you try to identify what the patient needs at the moment based on your own knowledge.

When we think of the challenges of addressing substance use in our society on a broad level, the opioid epidemic, for example, what challenges do you think we have?

Addictions are pervasive in society and need to be managed in all nursing specialties-even if we as health professionals are uncomfortable. I think that, as a profession, we have an ethical obligation to assess and treat addictions, particularly given the current opioid crisis. Healthcare professionals need continuing education about addictions. For those of us with additional knowledge and skills in addictions, we have an obligation to share that knowledge. It is impossible to provide comprehensive nursing care without properly addressing addictions.

As a closing point, I noticed that, besides being a nursing educator, you also seem to be an ongoing student. Can you tell us about the degree that you are currently working on? What motivated you to pursue this?

I am currently working on a master's degree in addiction counseling. I am hoping to expand on my theoretical knowledge as well as my understanding of how to effectively work with patients with addiction issues. It is an interdisciplinary degree and includes many professionals with a wide variety of backgrounds. It gives me the opportunity to interact with people outside nursing and appreciate their perspectives. It makes me more aware and appreciative of the benefits of different theoretical and clinical approaches to the care of individuals with a substance use problem.