Craig looks very unhappy, very unwell. He is a regular at the NSP. Most days he comes in, as cheerful as a box of birds, grabs a five-pack and takes off.
Instead of disappearing out the door, this day Craig heaves himself into a chair with a big sigh. He’s not his normal self. There’s also the glimmer of sweat on his cheek.
Craig says he’s feeling rotten. Josh, who has served behind the counter in the NSP more than a year now, asks Craig if he has a “bug”. No, says Craig, he hasn’t been able to pick up from his usual guy. He snorts derisively that the girl upstairs from where he lives offered to take his money and go to her guy: “But I know what would happen there once she’s got the money. You just don’t give anyone money for drugs unless you’re there on the spot.”
He adds that it may all be for the best because he’s no longer able to find veins and thinks it may be time to take a break.
“I’ve just gotta get through the next couple of days,” he says forlornly.
For Josh behind the counter, Craig’s dope-sick stop for a breather is a small victory. Most clients dash in and out because they have gear which is burning a hole in their pocket and they still have to get somewhere to mix up.
It is definitely not always a time for socialising and the canny NSP worker knows this. On the whole, clients are not coming in to shoot the breeze and are not normally in the slightest bit comfortable discussing their activities.
In fact that momentary interaction between NSP worker and client can go bad in microseconds for all sorts of reasons. Challenging body language, an overly inquisitive tone in the voice, a tinge of impatience or frustration on the part of the worker – or just plain rudeness – can ruin any chance of establishing rapport and setting the scene for assisting the client. It can also discourage them from returning to the NSP and push them into harmful activities such as sharing or reusing needles.
But on this day, Craig knows Josh well enough to not be dashing anywhere. He is obviously comfortable enough to come in and sit down. The fact he has entrusted Josh with details about his health is also a good sign and the comment about maybe taking a break from using is a semi-open invitation to a discussion about his options.
For Josh it may be early days assisting Craig towards a different lifestyle.
“I know that Craig has been a long-term regular here so I don’t expect miracles from him as far as giving up is concerned. Baby steps is all you can take. I really appreciate, though, that he trusts me enough to sit and talk.”
Having a chat
People who use NSPs are not there to socialise, but a friendly working relationship can be established over time.
- Always be courteous, friendly and polite. As simple as it sounds, a simple “how are things?” can be enough to break the ice. (See article on page 10)
- Establishing trust may take many visits by the client, it can rarely be achieved overnight.
- Treat people with respect, remembering we have a duty to acknowledge their human dignity.
- Clients cannot be made to feel they are being coerced into any conversation, especially one about a referral.
- Any referral must be prioritised by the client. If they don’t have ownership they will not persist with any treatment.
– Royal Abbott