Despite some hesitance to reporting CRNAs with substance use disorder, depending on the state, individuals may have certain legal responsibilities to report an impaired colleague. According to the AANA, “States may hold colleagues responsible for harm to patients if they fail to report a coworker in whom substance use disorder is suspected” (2016). A chemically impaired provider might give inappropriate doses in an effort to divert some of the narcotic resulting in inadequate analgesia for the patient (Luck and Hedrick, 2004). Impairment of a colleague in the workplace can have harmful patient safety implications. Bringing a suspected colleague to the attention of a supervisor or someone who can help is an act of caring and concern, not …show more content…
If participating in an intervention, recognize that it may take more than an allotted amount of time and allow your focus to be on the impaired colleague by eliminating diversions such as cell phones. Lastly, the intervention plan should include preparation for immediate drug testing and directly following the intervention, an accompanied transfer to a hospital treatment center. After confronting the individual, do not let the person out of sight. The impaired colleague is likely experiencing feelings of shame and helplessness and is at high risk for suicide (Roy, 2008; Bryson and Hazma, 2011; Lineberger, 2008). Only if the intervention fails and the colleague refuses evaluation, you should threaten to call the police (Bryson and Hazma, 2011). Again, the goal of an intervention is not to accuse or diagnosis, but to have the individual submit for drug testing and in-patient evaluation. Automated medication dispensing machines and reconciliation systems for controlled substances make it more difficult for anesthesia providers with SUD to obtain drugs and can alert others about suspicious behavior (Lineberger, 2008). However, conducting random drug screens on all practicing anesthesia providers can aid in identifying impaired providers earlier and conducting interventions sooner. As previously noted, behavioral changes such as mood swings and withdrawal are often seen first at home. In regards to detection of SUD in the workplace,
Drug addiction and alcoholism have a devastating effect on not only the addicts who suffers from these illnesses, but also on friends, family and workmates who interact with these addicts on a regular basis. When the addict finally succumbs to their addiction, the only way out is usually through the help of a professional and reputable inpatient addiction treatment center.
* Trained and designated care workers give controlled drugs, another trained, and designated staff should witness. (Standard 9.7 and 20.9)
There are many assessment processes that are used to identify substance abuse as well as many other disorders that are addictive. These processes include the SBIRT, AUDIT (Alcohol Use Disorders Identification Test), NIDAMED, CAGE AID (which is used frequently within the counseling foundation), AUDIT-C, and also the DAST-10 which is an assessment process used to evaluate drug abuse within the patients. These are many different processes that are currently used to identify these addictions in clients. The activity of identifying these processes can be over a period of time or can be evaluated in that same day or after the evaluation is completed.
Long term, it is much easier and cheaper to perform preventive health care than to try to manage acute and/ or chronic diseases. All at risk individuals should be given education on the dangers of developing a substance abuse problem, emphasizing that it can happen to anyone- young or old, rich or poor, etc. Health care providers need to address the supposed invincibility commonly associated with those who excessive drink alcohol or use drugs. These individuals are not quite as invincible nor do most have everything as under control as they may think. Although many may know the dangers, it is important to explain that the negative health impacts may not be noticeable right away, but the damage is still being done. Additionally, these at risk patients should work with social workers or case management to set up referrals to substance abuse cessation programs within the
Another challenge of working with substance users occurs when clients arrive intoxicated for a session. This may at times be a way of testing the counsellor, and although from the outside the client may seem impaired, being intoxicated may be their more familiar, functioning state. If the client is still able to engage, it is possible and often beneficial to continue with the session, if only in a limited way, Helen says.
Substance abuse continues to be a serious health care concern with millions of American 18 and older using illegal drugs. Substance abuse occurs across all generations, cultures, and occupations, including nursing. “About 1 in 10, or 10-15% of all nurses, may be impaired or in recovery from alcohol or drug addiction” (Thomas & Siela, 2011). When a nurse is impaired they will not be able to function at their normal capacity, and are not able to provide quality patient care. They may not be able to think as quickly, and have a delayed reaction time.
The meaning of a word portrays what it encompasses and if the phrase itself is misunderstood then defining what it’s trying to explain can be a studious task. Addiction has been defined by many and holds different meanings based on the context it’s used in. Addiction can be defined as a condition in which a person undertakes the use of substance, or engages in activities, which in turn brings pleasure, and tends to divert oneself from their day-to-day duties and responsibilities. Addiction is mostly related to drug use but it is also used to describe non-drug entities, such as gambling, and Internet addictions (Avena et al, 2008). Researchers (Herbert, J. D., Forman, E. M., 2010) have been keen on identifying the factors that lead to
Many people have turned to substance abuse or experience chemical dependency for a variety of reasons. Nurses experience chemical dependency as well. According to Kunyk (2013), “healthcare professionals, including nurses, are also potentially vulnerable to substance use disorders regardless of any special knowledge, skills or insights they might have owing to their education and professional experiences” (p. 54). This paper will define what chemical dependency is, report causes of chemical dependency in nurses, describe behaviors associated with chemical dependency, and explain what needs to be done upon reentry into the work place.
Treatment guidelines from the Substance Abuse and Mental Health Services Administration indicate that treatment should include age-appropriate group therapy, and teach skills to rebuild social support networks (Trevisan, 2008). Staff need to be experienced in working with the elderly and use a slower pace and age-appropriate content. Respect with an atmosphere of support and change rather than confrontation should be created in the therapeutic setting. Three medications have been approved for treatment of alcohol problems; however, there are few pharmacological treatment studies of alcohol dependence in older adults and no know studies of other drugs of abuse (Trevisan, 2008). These three medications include Disulfiram, Naltrexone, and Acamprosate (Trevisan, 2008).
Addiction treatment is a complex and paradoxical issue. Despite the fact that most of the medical and academic institutions define addiction as a chronic brain disease, it is too often treated on an acute basis. Chronic conditions are defined by the World Health Organization (WHO) as requiring ongoing management over a period of years or decades and cover a wide range of health problems. The goals of chronic care are not to cure, but to enhance functional status, minimize distressing symptoms, prolong life through secondary prevention and enhance quality of life.
Government research indicates that at least 100,000 doctors have an addiction to drugs or alcohol. There have been enough documented cases of doctors performing surgeries while under the influence that it has drawn national attention and the country is now asking "Should we mandatory drug test our practitioners?". Although the exact numbers are unknown, studies indicate that the percentage of physicians who use controlled substances is said to mirror that of the general population at about ten percent; however the numbers are estimated to be higher for surgeons and doctors who prescribe narcotics because of the ease of access to these controlled substances. Exactly how many surgeons perform while under the influence of mind-altering substance remains unknown; however even a one percent population poses critical issues for the profession. The most obvious is patient safety; the chances of loss of limb, loss of function and death are increased when critical thinking and surgical skills are clouded by the effects of controlled substances. Next, trust in medicine and healthcare as a whole is diminished when such activities occur.
The employee will be given an opportunity to explain his/her condition, such as reaction to a prescribed drug, fatigue, lack of sleep, exposure to noxious fumes, reaction to over-the-counter medication or illness. If, after this explanation, the jobsite supervisor or designated manager continue to have reasonable suspicion that the employee under the influence of an alcoholic beverage, non-prescribed controlled substance, then, the employee may be ordered to immediately submit to a drug and alcohol screen. Each employee will read and execute a consent form prior to any test being administered. This test shall be performed at an approved clinic. The individual will be immediately accompanied to the clinic by a company representative.
According to the Merriam-Webster dictionary; “Substance abuse is the excessive use of a substance without medical justification”. Addiction is not a lack of will power or moral weakness, but is a progressive, chronic, and fatal brain disease that not only destroys a person mentally, physically, emotionally, and spiritually, but also disrupts families, businesses, and society at large. Substance abuse is reported to be the most severe occupational safety issue associated with the practice of anesthesiology, with an incidence as high as 1% per year of training (Tetzlaff , Collins , Brown, Leak, Pollock & Popa, 2008). Anesthesiologists are reported to be more susceptible to substance abuse than other medical professionals (Garcia-Guasch. Roige, & Padro, 2012).´ Since it is not plausible to identify them before they become addicted, it is necessary to learn to recognize the signs and symptoms of addiction when they eventually become manifest so as to preserve the safety of not only co-workers or colleagues, but the patients they care for. Early identification of substance-abusing anesthesia providers is very crucial. Depending on the half-life of the abused agent, tolerance and dependence can develop and can rapidly escalate out of control to the point of discovery (Bryson & Silverstein, 2008). According to the AANA 2012 Peer Assistance and Wellness Committee, the typical time frame for discovery is 1
In Counseling for Alcohol and Drug Abuse, the need to use different techniques is an integral part of the process. Working with an individual that is either entering into recovery or actively in recovery, the clinician must take their time with introducing the 12 Steps. The individual may not be open to the 12 Step philosophies at the onset. Addiction is very complex and actively affects the person on a daily basis; therefore, it is so important to start from the beginning of counseling to create a structured program.
For any professional working in the substance abuse treatment field, they will very likely come across situations and be presented with dilemmas relating to personal beliefs, judgments, and values. Drug or substance use and abuse have been a controversial and heated topic around the world for centuries. Drug abuse, in a way, is a facet of human culture that has been present for a great deal of human history in general. Every culture handles the issue of drug abuse differently. The history of how a society views persons with addictions is intermeshed with emotion, misperceptions, and prejudice that directly affects the care of drug abusers. This is a kind of awareness that drug users and those who provide drug treatment or rehabilitation should have. They may be susceptible to treating patients different because of their own personal views or because of the culturally normative views of that particular society. Just like teenagers may be automatically considered dangerous or irresponsible, it is fairly normative in a health care setting for a patient to be perceived negatively just because that person is a known drug user. Because of the highly charged emotional nature of the substance abuse treatment field, providers should possess the tools to explore ethical dilemmas objectively. By doing so, and by examining their own reactions to the situation, providers can proceed with the most ethical course of action. Ethical practice is