Chemical dependency has been acknowledged as one of the leading health problems in the United States. In health care professionals, the number of cases of chemical dependency is one out of five to seven (Guidelines, 2009). Nurse impairment is a topic that can affect any nurse at any time. Students in nursing school need to be told about and understand that nurse impairment occurs frequently in the health care system and it can happen to anyone.
Review of Literature
Chemical dependency in the nursing profession has been recognized as one of the leading health issues in the America (Guidelines, 2009). It is estimated that around 16 percent of United States citizens suffer from addiction, but the population of nurses is estimated to be one in five or around 20 percent. The ease of access to controlled medications is thought to be one of the reasons for the increase from average Americans (Monroe, Pearson, & Kegaga, 2008). Chemical dependency is a treatable, medical illness that has distinguishable signs and symptoms (Guidelines, 2009). Substance dependency causes can be from many factors. Although, nursing can be a rewarding and enriching career, it also can be stressful and demanding. A few factors include long hours, large workloads, and overtime (Ortgiesen, 2009). The stress can cause burden and some nurses use substances such as drug and alcohol in order to try to cope (Kunyk & Austin, 2012).
When nurses with untreated, active dependency are providing care, the practice of the nurse is impaired and can negatively affect patient safety (Kunyk & Austin, 2012). If the drugs are acquired from the hospital or workplace, patients may suffer by being under-medicated. Nurses are required to address threats that occur in the del...
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... Horton-Deutsch, S., O'Haver Day, P., Gavardinas, T., Outlaw, C., Palmer, R., & Schroeder, M. (2012). Indiana State Nurses Assistance Program: Identifying Gender Differences in Substance Use Disorders. Perspectives In Psychiatric Care, 48(1), 41-46. doi:10.1111/j.1744-6163.2010.00300.x
Monroe, T., & Kenaga, H. (2011). Don't ask don't tell: substance abuse and addiction among nurses. Journal Of Clinical Nursing, 20(3/4), 504-509. doi:10.1111/j.1365-2702.2010.03518.x
Monroe, T., Pearson, F., & Kenaga, H. (2008). Procedures for handling cases of substance abuse among nurses: a comparison of disciplinary and alternative programs. Journal Of Addictions Nursing, 19(3), 156-161.
Ortgiesen, J. (2009). Report and help impaired nurses to protect patients from harm... "Substance Abuse Among Nurses" (Johnson Talbert, 2009). Clinical Journal Of Oncology Nursing, 13(3), 260
Fortinash, K. M., & Holoday Worret, P. A. (Eds.). (2012). Substance-related disorders and addictive behaviors. Psychiatric mental health nursing (5th ed., pp. 319-362). St. Louis, MO: Elsevier Mosby.
The methadone program at Rosthern Hospital is a very active and intense program. Boast over 20 patients that are regular methadone users, the involvement of the physicians, pharmacists, nurses, and addiction counselors are key (Melle, 2016). Dr. Melle is the coordinator of the methadone program at Rosthern Hospital. His roles include, patient recruitment, patient care management, follow up care, and most importantly prescription and dosage of the methadone (Melle, 2016). Pharmacist’s role in methadone treatment is providing the methadone to the hospital, as well as in Warman pharmacy they monitor and dispense some methadone to some of the patients in the methadone program. Addiction counselors are an outside resource that the staff at Rosthern hospital can utilize. There are not social workers or counselors at Rosthern, but Dr. Melle and the nurses prefer if their patients are regularly seeing an addiction counselor while in the methadone program. Finally, the nurses role in the methadone program is early treatment and monitoring of patients during detox, the continued monitoring or patients when methadone doses change, dispensing methadone and monitoring our patients in the recovery program, and observation of patient’s success during the program. Together the interprofessional team has successfully treated dozens of patients, and the methadone program address the needs of both the patients and the addiction issues that are plaguing the surrounding communities (Melle,
White, William L. Critical Incidents: Ethical Issues in Substance Abuse Prevention and Treatment. Illinois: Lighthouse Training Institute, 1993
...is causes injury or not is an example of unsafe practice. This act could also be categorized as careless or repetitive conducts that puts a patient in danger. Drug diversion is a type of drug dealing, nurses have access to many drugs and it is a part of the nurses’ responsibility to ensure those drugs go where they should, precisely document and closely supervised. Criminal conduct can happen in the work place or on personal time. If a nurse is convicted of a crime, such as Driving While Intoxicated, it could affect their ability to practice nursing. It is out of a RNs legal scope of practice to medically diagnose any patient, order a medical treatment or conduct a medical treatment that has not been ordered by a physician. It is the nurse’s duty to their patient’s to exhibit sound clinical judgment, with in their scope of practice to ensure patient safety.
Trinkoff, A.M, & Storr, C L. (1998). Substance use among nurses: differences between specialties. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508454/?page=1
Painter, L. M., & Dudjak, L. A. (2010). Actions, Behaviors, and Characteristics of RNs Involved in Compensable Injury. Journal of Nursing Administration, 40(12), 534-539. http://dx.doi.org/10.1097/NNA.0b013e3181fc19eb
Mangrum, L., Spence, R., & Steinley-Bumgarner, (2006). Gender Differences in Substance-Abuse Treatment Clients with Co-occurring Psychiatric and Substance-Use Disorders. Brief Treatment and Crisis Intervention, 6 (3), 255 - 267
In the recent past, nursing has come to the forefront as a popular career amongst students across the globe. The demand for nurses has kept increasing gradually over the years. In fact, the number of registered nurses does not meet the demand of the private and public health sector. This phenomenon has resulted in a situation where the available registered nurses have to work extra hours in order to meet the patients’ needs. With this in mind, the issue of nurse fatigue has come up as a common problem in nursing. According to the Canadian Nurses Association (CNA), nurse fatigue is “a feeling of tiredness” that penetrates a persons physical, mental and emotional realms limiting their ability to function normally. Fatigue does not just involve sleepiness as has been assumed before. It involves utter exhaustion that is not easily mitigated through rest. When nurses ignore the signs of fatigue, they risk the development of chronic fatigue and other health problems that may not be easily treated. Additionally, fatigue may cause nurses to lose more time at work as they may have to be away from work for several days to treat it. The issue of nurse fatigue has permeated the nursing profession to the extent of causing errors in the work performed by nurses. Fatigue causes a decrease in a nurse’s ability to make accurate decisions for themselves and their patients. It is therefore important to find ways to curb nurse fatigue such that it is no longer a problem. Nurse fatigue is a danger to the patients, organizations and to the nurses themselves and must be mitigated adequately.
The American Nurses Association (ANA) developed a foundation for which all nurses are expected to perform their basic duties in order to meet the needs of the society we serve. The ANA “has long been instrumental in the development of three foundational documents for professional nursing; its code of ethics, its scope and standards of practice, ands statement of social policy.” (ANA, 2010, p. 87) The ANA defined nursing as “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” and used to create the scope and standards of nursing practice. (ANA, 2010, p. 1) These “outline the steps that nurses must take to meet client healthcare needs.” () The nursing process, for example, is one of the things I use daily. Other examples include communicating and collaborating with my patient, their families, and my peers, and being a lifelong learner. I continually research new diagnoses, medications, and treatments for my patients. As a nurse of ...
Nurses across the globe are saving multiple lives daily. They work hard to take care of various patients with an array of different health problems. They are accountable for not only caring for the patient’s health but also being empathetic and friendly with all visitors. Exactly how many patients is a nurse responsible for keeping safe, comfortable, and alive? It is difficult to say because the nurse to patient ratio policies varies immensely across state borders.
The nursing shortage most likely does not mean a great deal to people until they are in the care of a nurse. The United States is in a severe nursing shortage with no relief in sight due to many factors compounding the problem and resulting in compromised patient care and nurse burnout. Nursing shortages have been experienced in the past by the United States and have been overcome with team effort. However, the current shortage is proving to be the most complex and great strides are being made to defeat the crisis before it becomes too difficult to change. Researchers anticipate that by 2010, the United States will need almost one million more registered nurses than will be available (Cherry & Jacob, 2005, p. 30).
However, upon securing a job, they find that things on the ground are not as they had expected them to be and this results in some of them deciding to leave the profession early. Research shows that turnovers within the nursing fraternity target person below the age of 30 (Erickson & Grove, 2011). The high turnover within the nursing fraternity results in a massive nurse shortage. This means that the nurses who decide to stay have to work for many hours resulting in exhaustion. A significant percent of nurses quitting their job sites exhaustion and discouragement as the reason that contributed to their decision. In one of the studies conducted on the issue of nurse turnover, 50% of the nurses leaving the profession argued that they felt saddened and discouraged by what they were unable to do for their patients (Erickson & Grove, 2011). When a nurse witness his/her patients suffering but cannot do anything because of the prevailing conditions he/she feels as if he/she is not realizing the reason that prompted him/her to join the nursing profession. The higher rate of nursing turnover is also affecting the quality of care nurses provide to
Substance abuse complicates almost every aspect of care for the person with a mental disorder. When drugs enter the brain, they can interrupt the work and actually change how the brain performs its jobs; these changes are what lead to compulsive drug use. Drug abuse plays a major role when concerning mental health. It is very difficult for these individuals to engage in treatment. Diagnosis for a treatment is difficult because it takes time to disengage the interacting effects of substance abuse and the mental illness. It may also be difficult for substance abusers to be accommodated at home and it may not be tolerated in the community of residents of rehabilitation programs. The author states, that they end up losing their support systems and suffer frequent relapses and hospitalizations (Agnes B. Hatfield, 1993).
Historically, the nursing profession has been actively involved in the health promotion and disease prevention among the general public. However, while caring for others, nurses often neglect their personal safety, which ultimately results in the high level of work-related injuries. Failure to timely address risk factors for nursing can have dire consequences for patient outcomes, since it is often associated with increased medication errors and patient falls, poor quality of care, and permanent disability of the nursing staff (Stokowski, 2014).
The nursing profession is constantly in a state of change becoming more complex over time. Registered nurses work to prevent disease, promote health and help patients cope. They develop and manage nursing care plans, instruct proper outpatient care, and help improve and maintain health within their community. They are educators of health governed by state laws. Registered nurses can work in many different settings which determine their daily job duties. Depending on their level of training a RN could work with geriatrics, in intensive care units, as an educator, as clinical study observers, a midwife, oncology, or palliative care. Hospital nurses make up the majority of the RN group. They work as staff nurses who carryout medical regimens and provide bedside care. Most registered nurses work in well-lighted comfortable facilities, work nights, weekends, and holidays, and spend a considerable amount of time on their feet. They have to be available at a moment’s notice. Nursing also has its hazards all employees of care facilities are at risk for infectious disease, radiation poisoning, back injuries, shocks from electrical equipment, and hazards posed by compressed gas. Nurses are the link between doctors and patients.