Cannabis Nurse Explains How To Educate & Empower Patients
If you’ve ever been curious about what you need to know as a nurse working with medical cannabis, a nurse prescribing medical marijuana, or are just open to learning more information about it, Nurse Alice has the expert for you.
In a recent Ask Nurse Alice podcast, she sat down with Ashley Wynn Grimes, RN, founder of Cannabis Nursing Solutions, LLC, Executive Director of Cannabis Patient Advocacy Association, author of children's books, Asa’s Medicine and Stigmatized (to be released later this year), and a recognized Healthcare Leader of 2021 by the Baltimore Business Journal. Grimes and Nurse Alice discussed everything from how exactly medical cannabis works in the body to how nurses can help educate patients on using medical cannabis to breaking down the terminology of the product.
This content used under license from "Ask Nurse Alice."
What’s in a Name?
Grimes, a 14-year veteran of the nursing profession, noted that she has had many different jobs within nursing from the bedside to leadership to corporate, but eventually made the move into the medical cannabis industry.
One of the first things that she and Nurse Alice discussed was how exactly nurses should refer to medical cannabis, because terminology matters. Fortunately, Grimes cleared that up and confirmed that “cannabis” is the term that should be used by healthcare professionals.
“A lot of the terminology that we're familiar with has a more stigmatized history and may come from a derogatory place,” she explained. “So as a healthcare provider, we use the term cannabis because it comes from the original term for the plant itself, the cannabis sativa plant. We should be sticking with that term so we don't miscommunicate inadvertently or offend.”
However, she also went on to add that if you’re in a social context and you want to talk about a blunt, a joint, marijuana, or whatever term is socially acceptable, you should do that.
“There's no shame in that either because there's a lot of community-based culture around cannabis in and of itself,” she noted. So sometimes it is important to communicate based on what the culture is receptive to as well. And being aware of that as a healthcare professional and being culturally competent is super important.”
Nurse Alice agreed with Grimes, pointing out that terminology matters in many facets of healthcare, such as in some cultures that refer to having diabetes as “the sugars.” Tailoring language to meet the needs of our patients is important.
Why Patients Turn to Cannabis
Next, the two nurses discussed why exactly patients turn to medical cannabis. Grimes explained that a common theme for patients trying medical cannabis is when they have exhausted all solutions in the traditional medical system. “Some people spend years with their chronic diseases, trying to figure this thing out,” she said. “So when they get to the point of cannabis, it's usually based in pain.”
The other two primary areas she sees patients trying medical cannabis are to relieve symptoms of anxiety and in pediatric populations, for treatment of seizures.
Grimes also pointed out that especially when it comes to chronic diseases, managing symptoms can be incredibly challenging, because symptoms tend to feed into each other and it’s hard to break the cycle. For instance, someone with cancer may be in too much pain to eat, but if they can’t eat, they will lose strength and the pain may then increase. Or someone with anxiety may have trouble sleeping, but if they don’t get quality sleep, it will only increase their anxiety levels, so it becomes a vicious cycle.
She described medical cannabis not as a “curing phenomenon” for a lot of people, but as a means of symptom relief.
“It’s not going to get rid of the cancer,” she explained. But can you go for a walk? Enjoy the sunlight? Enjoy your family while you're suffering from this disease?”
Medical Cannabis: The Laws
Grimes explained that cannabis is legal in all 50 states thanks to something called the Farm Bill, which allows cannabis products with up to .03% THC in them. (THC, if you’re wondering, has the psychoactive effect and is the part of the plant associated with “getting high,” while CBD is a different compound that doesn’t have the same impact.)
When it comes to actually accessing medical cannabis, Grimes explained that every state has different laws, but in general, the process follows a few steps: a patient has to get registered and see a doctor who will confirm that the patient has a qualifying condition. Once those parts have been taken care of, the patient will visit a dispensary on their own to actually pick up the medical cannabis.
She admitted that it can be “a lot” for a patient to go through, especially if there are financial concerns present or if they just aren’t feeling well, which is the whole reason for seeking out medical cannabis in the first place. Even more challenging, she adds that, for the most part, the doctor doesn’t follow or oversee what happens after the patient gets the cannabis, so the patient is largely on their own to figure out what happens next.
“Some doctors know what they're doing,” she noted. “And then there are others who really don't know much about it. They know that this is the qualifying condition; they know that you can take it but they don't know how to educate them on the cannabinoid profiles and the terpene profiles and the different methods of consumption, etc. So there is a gap there.”
It’s in that gap that Grimes believes nurses can step in to help with patient education. “I feel like nurses definitely should come in because that's what we do regularly; we fill in that gap from the doctor to implementation and execution,” she continued “So I feel like right now nurses don't have a huge role in the process of getting access to the medication. And I think that's where we fit in.”
To help nurses do just that, Grimes offers a 5-hour evidence-based training course for nurses (bonus: you’ll get 5 CEUs for it!) that covers the history, genetics, and endocannabinoid system. “You'll learn everything you need to know to be able to implement [it] into your practice,” she said. “That's why I do what I do—to be able to give people access to the information that they need.”
Medical Cannabis: How it Works
While you should, of course, take Grimes’ course, she also discussed some of the basics of how medical cannabis works for those of us unfamiliar with it. Here are the basics:
A cannabinoid profile refers to the unique characteristics of the cannabis product chosen, including its ingredients and how those ingredients affect the body. This includes:
- The cannabinoids. Grimes explained that this includes both TCH and CBD, but there are over 100 different kinds of cannabinoids.
- Terpenes. Next, terpenes are what give cannabis its unique smell, but it also affects symptomatology. For instance, a terpene with limonene may have mood-boosting effects on the body.
- Method of consumption. How you put cannabis in your body, from vaping to topical, affects how it works in the body. Specifically, it refers to how long it stays in the body, how fast it circulates through the body, and how long before it reaches onset duration. For instance, smoking = quick onset, shorter duration; consuming = longer period until onset and a longer duration period.
All of these things together—along with the patient’s own unique sensitivity and how they react to the cannabis–will determine how the patient responds to the cannibals. “There is no science to it,” she explained, pointing out that it’s not like a set milligram of a blood pressure medication that can be increased or decreased.
Instead, each time cannabis is used, it’s tailored to that patient— “some people are just really sensitive to THC,” she noted. “It's really about the comfort level of the patient, what we're trying to do with that patient and then how they physiologically respond to the cannabinoid in the body.”
You can learn more about Grimes, take her course, or explore the coaching options she offers on her website.
