Ep 4: A Closer Look at Substance Use Disorder Nursing with Ondrea

In this episode of My Nurse Specialty, I talk with Ondrea about her work as a substance use disorder registered nurse and how she found her way into this specialty through mental health nursing. After years in different nursing roles, she discovered that working with patients receiving treatment for substance use disorders became one of the most rewarding paths in her career.

Ondrea shares what a typical day looks like in an outpatient clinic, including patient assessments, vitals, drug screenings, injections, medication-assisted treatment inductions, follow-up calls, education, and harm reduction. She also explains the importance of working within a close interdisciplinary team to support patients who often have both substance use and mental health needs.

We also talk about how nurses can enter this field, where these roles can be found, what certifications may help, and how this specialty offers room for growth into leadership, care coordination, and other mental health roles. Ondrea’s passion for this work comes through clearly as she describes the life-changing impact nurses can have in this area of care.

In This Episode, You’ll Learn

• How substance use disorder nursing blends education, treatment, and harm reduction.
• Why this work can be one of the most rewarding areas in nursing.
• How nurses can get started in this specialty and continue to grow in it.

About My Guest: Ondrea is a substance use disorder registered nurse who works in an outpatient clinic supporting patients receiving medication-assisted treatment. With 18 years of nursing experience and a background in emergency and mental health nursing, she brings both compassion and insight to this growing specialty. She is passionate about helping patients feel supported without stigma and wants more nurses to consider this rewarding path. 

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Transcript

SPEAKER_00 0:02

Welcome to Minor Specialty, a podcast for nurses who want a clearer view of what's possible in this profession. I'm Rebecca, a registered nurse, nurse career strategist, and someone who has spent decades working across different nursing roles. Nursing school teaches us podcast boards. But when it comes to careers, most of us are introduced to only a handful of specialty. It just depends on who you do have to get into school or what we're in school. And then we're expected to figure out the rest of the list. That like awareness is what confidence alignment exists. This exists. Along with the insight to help you understand what's for your career at anything. This is minor specialty, real interesting, real stories, and real capabilities. Thank you for coming onto the podcast to Minor Specialty. How are you? Yes, I'm excited to have you. Please tell everyone your name and what your specialty is.

SPEAKER_01 1:24

My name is Andrea, and I'm a substance use disorder registered nurse. So I deal with those that are dealing with substance use disorders and also receiving medication-assisted treatment in an outpatient clinic.

SPEAKER_00 1:38

Oh, wow. Okay. How did you get into this specialty?

SPEAKER_01 1:43

That's an interesting question. Thank you so much for asking because it was I fell into it. Let's put it that way. I'd been in a nurse for 18 years. And so I and I've been in multiple areas of nursing. I fell into it when I was doing some ER nursing, and I tend to gravitate, I gravitated towards the pod that had the mental health. And so I really enjoyed that. So it just came my way. I've been in mental health since 2016, and I have loved it every step of the way. But most of all, this the clinic that I'm in now in substance use disorders has just really stolen my heart. And it's been a great journey to it. And I have actually found it to be probably the most rewarding area of nursing that I've experienced.

SPEAKER_00 2:29

Wow, that's big. And I love that you didn't really plan it. You just navigated your way over to this. Like you just kept exploring like what areas were in the areas of what you were already loving then.

SPEAKER_01 2:45

Yes, correct.

SPEAKER_00 2:46

Yep. That's great. What does like a typical day look like for a nurse in this specialty?

SPEAKER_01 2:54

Um, for me, in this particular clinic that I'm in for substance use disorders, we see hundreds of people throughout the year. And so a typical day is going to start with really you come in, you get your list of your patients for the day. And then also I have pretty much every single person that comes into the clinic. We're doing drug urines, we're doing vital signs, we do injections, long-acting injections, pretty much monitoring. We have, I get to really do some, really a lot of education, a lot of harm reduction, which is really is I find very huge and very important in multiple ways. It's to keep people safe and meeting them where they're at versus trying to push them somewhere or because we have a lot of stigma around those with substance use disorders, which is something we do not want to ever have anyone feel. And then, of course, also we do lots of phone follow-ups. I'm doing inductions as well. I'm doing inductions of medication-assisted treatment, so bubonorphine inductions that could be not only just oral medications, but also the inductions of the injections as well.

SPEAKER_00 4:01

So I'm sure the patients like are really trusting you. There, it's more of an environment than they're trusting you.

SPEAKER_01 4:09

Very, and in a very close-knit, we have a great team that I work with too, with all the providers. So we have psychologists, we have psychiatrists, we have clinical pharmacists, we also have social workers that are also therapists as well. And so we really have weekly, we have weekly team meetings. We get to talk to each other throughout the day. We talk in the beginning, in the afternoon, and in the late afternoon before we change, we close the clinic. It's very different than when I was in like the medical med surge area. It's very communicative, meaning that we're very close and we work together to help take care of these patients because a lot of these patients they have lots of either comorbidities, they have multiple diagnoses. Not only do would they typically have a substance use disorder, but they also have mental health disorders on top of that. So it's a combo and really trying to really wrap around their entire team, including their medical, their primary care, their specialty, their specialists to pretty much every single person that might be in part of their care, their family, their friends, their spouses, children, every everybody. And it's really great to have that. Um, I think that a lot of people overlook probably mental health and substance use disorders in general, because it is, again, as I said, it's very rewarding. And the thing is, in this particular specialty, you get to see people get better fast, especially when they're ready and motivated. These patients get really well fast, especially with and they, you know, with their medication, with their their support of their team, their family, and just being ready and motivated, really. They can get better fast. And it is amazing. And that it is you will hear more thank yous than I can even count how many thank yous I have gotten, how much just seeing people in general just go from when they walk in the clinic of pretty much being at their lowest and really suffering and withdrawing from these substances to then uh you know, going into treatment, going through treatment, and then turning around and being these most amazing, bright individuals and coming in and saying, Thank you, you saved my life. I've gotten more of that in this specialty than I have gotten in any other specialty that I've been in.

SPEAKER_00 6:38

That's so powerful.

SPEAKER_01 6:40

It feels so good because you can absolutely see the difference and feel it all at the same time.

SPEAKER_00 6:46

Yes, how appreciative you're changing lives.

SPEAKER_01 6:50

Yes, absolutely. And you really you save them every day. You save them every day when you work in this type of clinic and this specialty. And uh it's again very rewarding, very heartwarming and humbling to be in this field.

SPEAKER_00 7:05

So are these like specialty for nurses? Are they available like in every city? Where are these located?

SPEAKER_01 7:12

Yeah, yes, they're pretty much everywhere. It depends on which area you'd like to be in. So I work in an outpatient medical facility, and you they're usually embedded in your hospitals, they're embedded in your outpatients. You have freestanding facilities like your detox, your residential programs, to your partial hospitalization programs and in and intensive outpatient programs. So they're widely spread out throughout your states. So you're gonna, so it depends on where you're looking, what you want. So if you want to be part of a really large medical system, you kind of look within that. If you want like a freestanding facility, you look for those. You can go anywhere from your community to right now, there's a lot of also programs out there that do a lot of outpatient clinics too. So they're everywhere. They're everywhere.

SPEAKER_00 8:06

So, what would you recommend to a nurse who says, that sounds amazing. I like mental health, I've been working in mental health, or maybe they're not in mental health yet, and maybe that's a good place to go. What would you recommend to a nurse to find the pathway to get into the type of specialty that you're in right now? Absolutely.

SPEAKER_01 8:26

So, what I would recommend for nurses that are interested in this is really reach out to your facility that you're in now. If they're you have mental health part of your facility now or your environment that you're in, please go to them. Start reaching out to those individuals, to either the nurses, to the psychiatrist, psychologist. That's what's another beautiful thing about this specialty is that they everyone is very approachable. It doesn't matter what's behind your name, it is one working, one big machine that works together. And without one, it doesn't work. So everyone is usually very, very helping. They want to, they want you to learn, they want you to get that education, they want to bring you in. Yes, please reach out to your teams out there. Also just look at other facilities. I've noticed that I have called other like freestanding facilities, could be a detox center to one that has all the way from detox to all the spans of those outpatient specialty of levels of care. And just talk to them. And they're usually everyone that I've talked to, lots of they're happy to help, they're happy to give you education, how you get in. So start looking and also just start looking around of what's available in your area. Start doing that search, that that job search, and start looking into it. The other thing that I do and I did do is I started educating myself. I just started doing more work in diagnosis. What do those mean? The medications. I started educating myself in mental health medications, medication assistant treatment medications. Also, I did go and I did receive my certified addictions registered nurse certification. That is hugely helpful and helps you also in your field if you want to get into mental health as well. So yeah.

SPEAKER_00 10:19

So a certification, lots of ways. Yeah. So that so what are the certifications that like I could do if I wanted to go into this? Which one?

SPEAKER_01 10:29

The one so the specific for the registered nurse for the addictions, it would be the certified addictions registered nurse. That's the certification you can do. It is you can go to there's lots of review programs. I did one through Boston Medical Center, BMC, and they actually have a virtual one, and they actually have a really great what they it's a technical assistance, and people that are nurses now can actually reach out to this to them, and they're willing to help anyone from anywhere to understand more. They actually have free classes that you can go on as well and do. I did a bunch of those, it was really fantastic. And they had a reviews, two-part review session for the certified addictions registered nurse as well.

SPEAKER_00 11:13

So all of that makes your resume stronger, not really required to go in a position. You can do that maybe even after you get a position, but it does make your resume stronger and more. It sure does for someone that's absolutely. And are they under different names? Because when you do a search, there's probably a couple that you could find that is similar, like you have detox nurse and addiction nurse. Do they actually nurse?

SPEAKER_01 11:41

It falls under all of them. It covers the C A R N is really the area of addiction, okay, of everything. So that's the one that you would focus. That's the only one that I know of that I have seen that's out there for this specialty. So when you want to get that certification, yes. Obviously, there's certifications in mental health as well, like mental health nursing. So you can also do that too. And that also makes you stronger too in your resume. ANCC has those. So if you go on, take a peek at that, it'll help guide you there.

SPEAKER_00 12:13

Okay, wonderful. Thank you for sharing. This is all great information for a nurse who wants to go in that area, especially lately. I've been hearing a lot of nurses that are very interested in the mental health field. But I always like to ask, you know, what in that field you can grow from? Because you can go into any area of nursing, and then what are the leadership opportunities within that so that you can stay and grow and keep that energy going and what you're loving, doing something different. What are there other opportunities within from what you're doing right now that you could able to pivot to?

SPEAKER_01 12:53

So right now I've actually started to pivot to other things as well already. I actually already am doing mental health discharge case management care coordination on top of that, onto consult management. But there's also hopefully to pivot towards leadership as well, being one because there is manager of mental health nursing as well. You can move there, directors to also CNOs, all the way up there. It's amazing what how much this can actually bring. It doesn't matter if you've just been in mental health, does not stop you from any type of higher achieving higher leadership positions as well. And it rounds you out very well. And especially when you're learning a lot in this, too. You're learning a lot of tools to help you grow, your patients grow, and your coworkers grow. And it just adds on and on. So it's amazing how many tools you can have, especially in mental health. Communication is really great. Communication tools and skills. And that's another thing about this is that you learn a lot of communication skills as well in this field.

SPEAKER_00 14:04

Yes, I would think that's very important. Yeah. And is ADN okay, or do you recommend getting a bachelor's? What do you see in this field?

SPEAKER_01 14:13

Yeah, in this field, I see all levels of nursing, ADNs, I see bachelor's, masters. So it's really, and of course, we also see nurses' aides, especially in like MSAs, like secretaries, all in this specific specialty that are specific to mental health, you do see all the levels. And of course, obviously, usually bachelors are gonna really help you out to a certain extent as well, depending on what the facility is looking for, really. It depends on the facility sometimes, if what level of education they're looking for.

SPEAKER_00 14:51

Okay.

SPEAKER_01 14:52

Yeah.

SPEAKER_00 14:52

Is there anything else you want to share or anything you'd like to say to a nurse who's wanting to go this route?

SPEAKER_01 15:01

Oh, I would say embrace it. It is a it is a wonderful field. It is an exciting field, it is a growing field, and there is no stopping it. It's only growing more and more. Lots of job security, first of all. But the opportunities are endless. And so I would absolutely recommend the field, and it can take you a long way.

SPEAKER_00 15:28

Yeah, I mean, definitely so needed in the nursing area of expertise and wealth and to be in there. And we learn so many skills and being able to take those skills and bring it into the specialty.

SPEAKER_01 15:41

That's absolutely good.

SPEAKER_00 15:43

A good thing. Absolutely. Yes.

SPEAKER_01 15:46

I just wish everybody the best in their journey in nursing because I know that I have absolutely loved mine. It took me a little bit to find my niche, but once I found it, it was absolutely the best thing I could have ever said yes to. And so, in in mental health, but specifically substance use disorders, has been a blessing and has given me a lot of also just warmth and also being very thankful for being a nurse in this field because so many people need it. And we are so needing so many more of these nurses in this field. So please come on over. And if anybody still would, and if anybody would like to also reach out to me, they're happy to do so. But I'm happy to talk to them to give them a little bit more information.

SPEAKER_00 16:36

Thank you so much. You're welcome. I'm so excited to have you on today, and thank you again so much. Thank you for listening to my nurse specialty. I hope what you heard today gave you real insight into this specialty and helped you see what's possible for your nursing path. If you're watching this on YouTube, please subscribe. And if you're listening on audio, follow the show so you don't miss what's next. If you know a nurse or even a student nurse who's learning about their next steps, tell them about the show or send them this episode. And tell me, what specialty should we feature next? If you're a nurse in a unique specialty that you'd love to share, apply to be a guest on my website. I'm Coach Rebecca. Until next time, keep exploring.