Chemical Dependency among Nurses
Most people in the general population are unaware of how widespread drug addiction has become. Even fewer are aware of the number of healthcare professionals that are addicts. This paper will discuss the impact of substance abuse on the nursing profession; the various behaviors that are suggestive of an impaired coworker; an understanding of the professional responsibility to report impaired coworkers; and an understanding of the legal, ethical, and safety implications of substance abuse as well as the policies in place to help the affected individual.
According to the American Nurses Association, an impaired nurse is unable to meet the requirements of the code of ethics and standards of practice of the profession. The nurses professional judgment becomes “impaired” when their inability to perform the essential functions of his or her practice with reasonable skill or safety because of chemical dependency on drugs or alcohol. Not only do these nurses create a potential threat to their clients, but they have also neglected to care for themselves. It has been suggested that registered nurses have a 50% higher rate of substance abuse than the general public, and 1 in 7 nurses remains at risk for addiction. The data out there suggests that approximately 5% of registered nurses are alcoholics and 3% are dependent on drugs (Dittman, 2008). Another source estimates that among registered nurses, 10% may have a drug or alcohol problem (Talbert, 2009). Drug use varies among nursing specialties: emergency department nurses are 3.5 times more likely than nurses in pediatrics, general practice, and women’s health to abuse substances, and oncology and administrative nurses are twice as likely to binge drink (Young, 2008). It is clearly evident that substance abuse exists within the profession, and that more than likely we will have some connection, either directly or indirectly so it becomes important to understand the various risk factors associated with substance abuse. There is also documented evidence that offspring of alcoholic parents are more likely to grow up and become alcoholics themselves (Dunn, 2005). This combination of genetics, environment, and psychological factors plays an important role in the disease process of addition. Of interest is that people in the helping professions, particularly nurses, have significantly higher incidences of alcoholism in their families of origin (Fisk & Devoto, 1990). Stress in the workplace provides another explanation for why some nurses abuse substances. Increased workloads, decreased staffing, double shifts, mandatory overtime, rotating shifts, and floating to unfamiliar units all contribute to feelings of alienation, fatigue, and, ultimately, stress. The numbers tell us that we will most likely be working alongside an impaired coworker, so how will we know and what should we do? It is important that we familiarize ourselves with typical behaviors of substance abuse and recognize that many of them are general and nonspecific, however when analyzed overtime the picture may become a bit more clearer. The more common behaviors include changes in work habits, absence from work, consistent tardiness, and inappropriate behavior or conflicts with colleagues, staff members, patients, and patients’ families. It is common to see inconsistent job performance as the individual’s ability to function declines. The individual begins to forget the detail and will have more charting errors and omissions than usual. He or she will exhibit changes in personal hygiene, demonstrate dramatic mood swings, inappropriate behavior, personality changes, anger, cynicism, and social and professional isolation (Baldisseri, 2007). Aside from the personality changes, other signs to watch for include increased absenteeism, frequent disappearances from the department or unit, excessive amounts of time spent in medication rooms or near medication carts, work performance that...
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