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Substance Abuse

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Substance abuse among Nurses:
Impact on Nurses and their patients

Anam Afaq
Nursing 110-E
Dr. Millenbach
Drug and alcohol abuse is a serious health and social problem in the United States. Many people in the general population are unaware of how widespread drug addiction has become. Even fewer are aware of the number of healthcare professionals such as nurses that misuse drug and alcohol. The number of substance abuse nurses is believed to parallel the drug abuse in a general population (Talbert, 2009). Substance abuse among nurses is a problem that not only threatens the delivery of quality care to patients but also the impacts the professional standards of nursing.
The healthcare profession is one of the most important professions in the world and nurses are the most trusted professionals in the world. According to the American Nurses Association (ANA), “Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.” When I read this definition, the words “protection”, “prevention” and “advocacy” stand out to me the most. The registered nurses are the premier advocates for safety and quality of patient care and health and safety of other health care professionals and co-workers. How will the nurses that have problems with substance abuse continue to protect, prevent and advocate? Should these nurses be punished or given other solutions to help them fight this problem?
Approximately 10% of the nursing population has substance abuse problems, and 6% of the 10% has problems that are serious enough to interfere in their daily practice (Ponech, 2000). The ANA states that 6%-8% of nurses misuse alcohol and drugs to the extent that their ability to practice and their professional judgment is impaired (Talbert, 2009), which poses a great risk to the patients, other health care professionals and their license to practice. According to the ANA, the nurse who practices substance abuse is unable to meet the requirements of the code of ethics and the standards of practice. A nurse’s judgment is impaired when the nurse loses the ability to perform essential job functions due to chemical dependency on drugs or alcohol (Talbert, 2009).
Addiction in the healthcare profession has been recognized for over hundred years. While the most consistent research reports incident rates of 10%-15%, some studies propose that this could be as high as 20% (Nauert, 2011). It has also been suggested that registered nurses have 50% higher rate of substance abuse than the general public and 1 in 7 nurses remain at risk for a drug or alcohol addiction. So what causes substance abuse among nurses?
As a population, nurses tend to be highly caring individuals who have devoted their lives to taking care of others. A variety of factors lead to substance abuse among nurses, such as family history, increased role strain due to high expectations at work, disrupted life-style due to long and inconsistent work hours, and easier access to prescription medications (Shaw, 2004). Family background of drug or alcohol abuse, emotional impairment or emotional abuse can lead to nurses at greater risk for using or abusing substances (Talbert, 2009). Unfortunately, nurses who abuse drugs and/or alcohol seem to come from families that have had experienced significant emotional turmoil, resulting in low self-esteem and falling into unhealthy caretaking roles of other troubled family members (such as taking care of alcoholic parents).
Environmental factors such as stress in the workplace may start an active addiction or even exacerbate it. The healthcare environment is unique because it can create a conducive environment to addiction for the professionals. The availability and ready access to medications has also been related to substance abuse among nurses. Medications are seen by all healthcare professionals as a way to cure illness and because nurses are educated on most drugs, they feel that they have the expertise to self-medicate. Nurses, who are also known as “workaholics”, deal with an increase workload with staffing changes, rotating shifts, working overtime and floating to different departments. Substance abuse may be a way for nurses to cope with the stress from home and work.
Substance abuse is a serious problem in the healthcare environment and can be detrimental to patients. It is important for nurses to report this for a number of reasons. The main reason and most important reason is patient safety. Patients are entitled to proper and “sober” care by nurses. Nurses who are under the influence of drugs or alcohol may make mistakes that are life threatening or even fatal to the patient. Another reason is that the abuser needs help and treatment to save his or her life. It is crucial for nurses to not turn a blind eye and address the problem. Some nurses working with colleagues that have a problem with substance abuse have trouble reporting other nurses because of the fear of being labeled the “whistle-blower” and creating problems in the work environment (Talbert, 200).
If I had suspicion of a colleague providing poor client care due to substance abuse, it would be my legal and ethical obligation to take some action and report the colleague.

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