Impaired Nurse

The populations of interest are the staff nurses who work on the Addiction Medicine adult inpatient unit treating patients with drug and alcohol misuse disorders and the adult patients on this unit undergoing treatment for drug and alcohol misuse disorders.

Over the years, substance abuse in the United States has become a persistent issue affecting many individuals. In 2008, it was estimated that 17.8 million Americans over the age of 18 where substance dependent (Epstein, Burns, & Conlon, 2010). Many of these individuals being affected are nurses. Ponech (2000) stated that "approximately 10% of the nursing population has alcohol or drug abuse problems, and 6% has problems serious enough to interfere with their ability to practice" (as cited in Talbert, 2009, p.17). Studies show that nurses have a 50% higher rate of substance abuse compared to the rest of the public (Epstein et al., 2010). Among the many factors that contribute to the nurse’s issue of substance abuse,

The North Carolina Board of Nursing has specific criteria for any nurse that is identified as being under the influence. They offer a voluntary program for nurses who have impaired judgement and competency as a result of chemical influence. The Alternative Program, or AP, focuses on ensuring public health and safety by monitoring impaired nurses, return the nurse to a safe state of practicing, achieve early intervention of chemical dependency, and give nurses the opportunity to seek recovery in a non-published, non-punitive and therapeutic environment (Alternative). To enter into the program, the nurse must apply directly to the NCBON and agree not to work until cleared by the board. Eligibility for re-entering into the work force is a minimum of three months after initial treatment

Jackie was one of the growing numbers of nurses who are impaired because of addiction. Sullivan (1994) cited that “nurses who abuse substances not only place themselves at risk for physical, emotional, and professional harm, but also create hazards for the institutions in which they work as well as the public” (p. 20). To deal with the issue posed by an impaired nurse, “nursing leaders must consider legal, regulatory, ethical, humanistic, and practical considerations in

First, the identification of a licensed chemical dependency counselor would suffice at the moment. A licensed chemical dependency counselor are counselors that specialize in identifying and treating addictive behaviors that are maladaptive, altered from cognitive imbalance, and from physiological discrepancies, or frequent intoxication to achieve homeostasis or functionality to some extent. In other words, licensed chemical dependency counselors establish and implement treatments to help people cure their addictions from substances which they are chemically dependent on. Second, the nature of chemical dependency is to be acknowledged. The nature of chemical dependency is not very well understood by human population. Many people see addictions as diseases, immoral behaviors or sins, as maladaptive behaviors, and some may view such substance dependence as out of control behaviors as well. However, chemical or substance dependency is a mental issue. The mind tells the body that it needs a certain substance to function, it is a craving that is difficult for the body to ignore, and the body cannot function until such a need is met. The change in behaviors, mood and conscious motivates the mind further to continue finding ways to meet this need. Therefore, there is not only an addiction, but a chemical dependency issue as well. It is strong and difficult to defeat. It is strong enough that it may cause some people to conduct criminal activities or infringe upon the rights and

As the article The Impaired Nurse stated, “Impaired nurses can become dysfunctional in their ability to provide safe, appropriate patient care” (Thomas, C.M., & Siela, D. 2011). As we learned in class the four ethical principles include; beneficence which is the act of doing the most good, non-malfeasance which is the act of doing the least amount of harm, autonomy which focuses on allowing each individual to make their own decisions and justice which focuses on being fair to all involved. Nurses who are abusing substance typically can’t follow these for ethical principles to the best of their ability because they are too focused on themselves. As mentioned in the article Substance Abuse among Nurses, nurses who are abusing substances are not able to complete tasks and function as a typical nurse would (Talbert, J. J. 2009). These types of nurses are not able to apply the four ethical principles to their everyday work environment because they are too focused on the substances they need. These nurses would not be able to function and apply to principle of doing the most good because they will not be doing the best if on substances. As mentioned in both articles, these nurses will spend a good amount of time in the bathrooms hiding and using, take medications from patients, and forget tasks that need complete. Beneficence and non-malfeasance in my opinion could not apply to nurses who are abusing substances because they are not caring for their patients as

In first talking about substance use, abuse and addiction as it relates to the Nursing profession it is necessary to understand the aspect of addiction. Drug use is a broad idea that refers to the use of any chemical substance rather legal or illegal. This topic includes prescription drugs, street drugs, herbal supplements, and the like. The term Drug abuse is defined as “the use of a substance or substances in such a way that it leads to measurable personal, interpersonal, or social consequences” (Faupel, C., E., Horowitz, A., M., & Weaver, G., S., 2010, p.20). Drug addiction is then regarded as “a compulsive use of chemicals (drugs or alcohol) and the inability to stop using them despite all the problems caused by their use” (National

The American Nurses Association (ANA) has the Code of Ethics which holds Nurses to the codes or provisions of these documents. I summarized Provision 1 of the ANA 's Code of Ethics. I give a scenario where this provision is broken by the nursing staff and consequences of doing so. Provision 1: Provision 1 reads as follows “The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems” (American Nurses Association 2001). Provision 1 is divided into five subdivisions. Provision 1.1 is titled “Respect for human dignity"(ANA 2001). The nurse always needs to place value on their patient as a unique individual. Provision 1.2 is titled “Relationships to patients” (ANA 2001). As a nurse you need to leave all prejudice, personal beliefs, and convictions out of the care of your patient. The patient’s self-worth and value is not defined by their religious choice, culture, lifestyle, hygiene, financial status, sex, and race. The nurse needs to form or follow an individual treatment plan that fits your patient’s personal preferences, religious beliefs, and requests. Provision 1.3 reads as follows “The nature of health problems” (ANA 2001). A nurse is not to judge or look down upon a patient by their "The disease, disability, or functional status “(ANA 2001).The nurse needs

In today 's world, many health care organizations encounter the most critical problem, such as chemically impaired nursing practice, on a daily basis. All areas of the nursing profession are affected by a chemical dependency and the cost associated with this problem is a great concern for the health care organizations. According to Church (2000), “nurse impairment affects the safety of the public, the nurse’s well being and the profession as a whole” (p. 2). The delivery of care provided by the chemically impaired nurse lowers the standards and the prestige of the whole profession, creates serious liability for the employer, lowers productivity, increases the turnover rate, decreases staff members morale, and increases the risk for medication error (Wennerstrom and Rhooda, 1996). People’s lives, function and lifestyle can be dramatically changed due to a medication error caused by a chemically impaired nurse (Cook, 2014). The chief nurse executive (CNE) is frequently confronted with the problem of impaired nurse, furthermore, the CNE is responsible for the policy and decision making involving this issue (Hughes, 1995). The purpose of this paper is to examine nurse executives response to allegations of a chemically impaired nurse.

This includes reporting violence, abuse or neglect towards clients by other nurses and extends to reporting conduct involving third parties, including family members and other healthcare providers

It is no secret that the United States is currently experiencing a shortage of nurses . “The U.S. Department of Labor, Bureau of Labor Statistics ( 2009 ) estimated that more than one million new and replacement nurses will be needed by 2018 to meet the increased demands of the health care workforce” (). The stressful conditions under which nurses work, due in part to the nursing shortage, are among the risk factors that contribute to nurses’ abuse of illicit drugs and alcohol. Nurses are unique in that they work in an environment where they not only have access to controlled substances, but also are exposed to critically ill patients, traumatic situations, death and dying, the stress of which can increase the risk of substance abuse. (Epstein, Burns, & Conlon, 2010). Unfortunately, it is the patient that suffers the most.

According to American Nurses Association (ANA), (2010) “the nurse promotes, advocates for and strives to protect the heath, safety and right of the patient” (p. 6). Nursing responsibilities should be acted at the highest standard and must be based on legal and ethical obligations.

Impairment delays the central nervous system by depressing it (CDC, 2016). When the brain is unable to function appropriately, negligence is a possible outcome. Negligence is a huge liability to the nurse and the facility. Marquis & Huston (2015) speak of the joint liability. Patients can hold the hospital and the nurse both legally responsible. The nurse has an obligation to provide competent care to the patient.

A good nurse is aware and knowledgeable of ethics in the field of medicine and strives to provide quality care to avoid negligence. Experienced nurses always remain well informed of changing trends and laws relating to health and safety and regulations of the Board and customs through continued education. Nurses should be prepared to defend themselves. If they know how to avoid mistakes and avoid litigation, they are almost home free. “It is believed that health

The responsibility of regulating nursing practice that ensures public safety, health and welfare and accountability to the public for proper governance falls on the State Boards of Nursing (BONs). Substance abuse is the most common disease that affects healthcare workers (Darbro, 2009). The disease of substance abuse disorder is preventable (Darbro, 2009). The intent of this paper is to discuss the ethical issues of nurses with substance abuse disorder, stigma of addiction, challenges that nurses with substance abuse problems face to include acceptance of the disease, treatment, rehabilitation and monitoring, the incidence of addiction among nurses, how to recognize an impaired colleague, nurses’ attitudes about addiction within the profession and the ethical issues that the nurse, employer and society face when dealing with a nurse who is an addict. It was in the 1980s that professional nursing organizations recommended alternative to discipline (ATD) programs to help rehabilitate nurses (Sigma Theta Tau, 2014). In the past 20 years 46 states have gone with this approach as opposed to traditional discipline (Trussman, 2003). In most cases, these ATD programs provide nurses with intense monitoring for 5 years to aid in their recovery so they may return to work and provide safe patient care to the