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Substance abuse in nurses and patient safety bartleby
Substance abuse in nursing essays
Controversies of substance abuse use within the nursing field
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A career in nursing can be the most rewarding occupation most people can think of. It truly takes a unique person with a strong sense of discipline, diligence, responsibility, and a love for mankind to take on such a role. While nursing for most is very rewarding, it is also an occupation that can very easily overwhelm employees and requires most of the time more so then none, a great tolerance to stress. For some when the stress becomes overwhelming, It may lead to addiction, especially in the medical profession where prescription drugs are readily on hand. The addicted/under the influence nurse affects many people including their colleagues. Most importantly, under the influence nurses pose a serious risk to their patients. There is a major …show more content…
controversy in the medical field because not all states in the U.S. handle these matters in the same way. Some policies use a disciplinary method in regards to substance abuse, others remove the nurse from practice and give them a chance at rehabilitation, a chance to save their licenses, and for their problem to remain confidential. Adopting a nationwide policy to address substance abuse among nurses will ease the role of the professional nurse dealing with this controversy. The sooner this situation can be addressed and reconciled in the most productive and effective way, the sooner nurses can achieve delivery of the best quality of care possible to their patients. It is estimated that 10 percent of Americans will have a substance abuse issue in their lifetime by the National Institute on Drug Abuse.
It has also been estimated by the American Nurses Association that the rate of drug dependent nurses is also 10 percent (Copp, 2009). This statistic is horrifying but realistic. The decisions that nurses make are at times a matter of life and death, and it is imperative that nurse and healthcare providers are attentive and alert to what they are doing at all times with no exceptions. All the combined stressors that may often come with this profession, along with the other stresses of personal life may lead a person to feel as though they will do what they have to so they can make it. Sadly for some this can lead to disappear and addiction. In the healthcare setting where medication is widely accepted as a cure to ailments and is readily accessible, nurses are at high risk to develop substance issues (Talbert, 2009). Although the incidence of addiction among nurses is about the same as the general population, there is a higher rate of prescription-type medication abuse as opposed to street drugs. Nurses may administer medications on a daily basis, thus may feel more comfortable self-medicating. There is also a higher risk for drug issues to develop among specific nursing specialties including psychiatry, oncology and anesthesiology. This may be due the stresses and emotional hardships nurses in these fields face. They also have access to …show more content…
narcotics on a day-to-day basis and see the benefit the patient receives (Copp, 2009). One of the most important roles of a registered nurse is to assure the patient is getting the safest and most appropriate care possible.
If a nurse is providing care while under the influence they are failing to fulfill this role. There is also a legal and moral responsibility of all nurses to report suspicions of abuse because the number one role of the nurse when dealing with an impaired colleague is to protect the patient (DeClerk, 2008). There may not be many signs or symptoms in the beginning, however as it progresses, it becomes more clear that something may not be right. When a nurse cannot perform the basic essential of their job functions due to chemical dependency, they can be defined as impaired (Talbert, 2009). Because it is such a controversial topic, substance abuse among nurses is a taboo subject, which makes this issue under-reported and under-mentioned in the nursing field (Monroe & Kenaga, 2010). According to the DEA, nurses tend to avoid getting involved with co-workers who they may suspect have a substance issue. There is also a stigma associated with potentially being labeled as a “whistleblower”. When relationships develop in the workplace, nurses may be less likely to report this type of abuse, however it is also the role of the registered nurse to ensure patients are receiving safe care, and in the case of substance abuse this means reporting (Talbert, 2009). There is a very low incidence of self-reporting, because there is a great sense of guilt
and fear for everything they could potentially lose by exposing themselves (Copp, 2009). There are two potential methods agencies use when dealing with nurses who have a substance abuse issue. Most states in the U.S. support alternative to discipline programs (Monroe & Kenaga, 2010). These types of programs offer assistance to the addicted nurse, placing them in treatment programs and giving them a second chance to keep their license and return to work (Talbert, 2009). The idea for this alternative method developed in the early 1980s and remains supported by the American Nurses Association to this day. Its philosophy seeks to advocate for nurses by supporting the chance of rehabilitation rather than punish them (Monroe & Kenaga, 2010). According to the ANA, addiction is a treatable disease (Copp, 2009). Alternative programs also seek to protect public health by removing the nurse under the influence from practice within weeks as opposed to a few years it could possibly take to remove an under the influence nurse from practice using disciplinary methods. States that support these alternate programs believe that nurses who are willing to seek help should be able to remain confidential. If a nurse refuses to be rehabilitated, disciplinary measures will have to be taken (Monroe & Kenaga, 2010). The role of the nurse is to protect the patient by reporting nurses who are under the influence and impaired, however a secondary role should be to seek help for a colleague as nurses do for a patient. It is important to note that the workplace is usually the last place addiction surfaces, meaning the issue is probably much more severe than it appears (DeClerk, 2008). While 45 state nursing boards support the use of alternative to discipline programs, not all have a confidential treatment program for nurses with substance abuse issues. Iowa and Missouri have considered the idea, however have yet to put them into practice. Arkansas, Alaska, Georgia and Mississippi have no such programs. Meaning that when a nurse is reported for abusing any type of drug in these states, If they are or not seeking help, they will be reported to the Office of the Inspector General. This will exclude them from being eligible for liability and health insurance. With more severe consequences, it becomes more difficult for nurses to seek help which causes them to become more hesitant to report the issue of concern. There is concern about termination and punishment from the board, which could potentially worsen ones addiction issues by creating more stress for the individual (Monroe & Kenaga, 2010). Many facilities may also fire employees caught with substance issues instead of directly dealing with the issue, meaning that individual can get another position somewhere else, continuing to put patient safety at risk (Copp, 2009). The nursing profession is all about caring and educating not only for the patient, but also anyone who needs assistance and it is important for everyone to understand that those who are suffering with addiction have an illness, which requires treatment and evaluation.
Prescription and pharmaceutical drug abuse is beginning to expand as a social issue within the United States because of the variety of drugs, their growing availability, and the social acceptance and peer pressure to uses them. Many in the workforce are suffering and failing at getting better due to the desperation driving their addiction.
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,
Lilley, L. L., Rainforth, S., & Snider, J. (2013). Pharmacology and the Nursing Process (7th Ed.)
...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.
Substance abuse among health care professionals is an issue that is continually gaining more attention due to the harmful affects it can have individuals as well as the patients. Substance abuse can greatly hinder the ability to provide quality care and if left unchecked could lead to serious implications within the health care facility. There are a significant amount of nurses and health care providers that deal with substance abuse problems. At one point, it was estimated, that 2-3%, of all nurses were addicted to drugs (Trinkoff, & Storr, 1998). To encourage nurses to seek help, the Texas Peer Assistance Program for Nurses was created. This program gives employers, LVNs and RNs the ability to seek help, education, guidance, and support in dealing with substance abuse and mental health illnesses. In this paper, we will examine the ethical perspectives that these programs foster and the ethical responsibilities of the patient, nurse, and coworkers as determined by the Texas Board of Nursing and the Nurse Practice Acts.
In this career about there are approximately an average of 2600000 people employed. There is many duties in this field but the main achievement in this field is to maintain a stable and healthy life towards a patient. This is not always going to be a success one day you might have to deal with an unexpected health issue that can no longer be cured. You may pass by this situation quite frequently that doesn’t mean you’re a bad nurse.
Recent literature reports that there is a nursing shortage and it is continually increasing. Data released by the American Association of Colleges of Nursing (2011) projects that the shortage, would increase to 260,000 by the year 2025. AACN (2011) also reported that 13% of newly registered nurses changed jobs and 37% were ready to change within a year. A study conducted reports that there is a correlation between higher nursing workloads and nurse burnout, retention rates, job dissatisfaction and adverse patient outcomes (Vahey & Aiken, 2004). Among the nurses surveyed in the study, over 40% stated that they were suffering from burnout while 1 in 5 nurses intended
One of the most serious issues in nursing, that can affect a nurses career is nursing burn- out. According to the article “Where have all the nurses gone”, current nurses that are practicing, report high rates of job dissatisfaction (which is part of burn out) and 1 of 5 nurses may quit nursing in the next 5 years (Dworkin, 2002). Burnout is associated with nurses not coming in to work, not feeling satisfied when doing their job, high turnover rates and a lack of commitment to the work (Katisfaraki, 2013). If a nurse becomes burned- out, they may not take care of their patients as well and could make mistakes with medication administration. A study performed in the United States by Dr. Jeannie Cimiottti, shows that hospitals with high burn-out rates among nurses have higher levels UTI’s, and surgical infections (World, 2012). Nursing burnout not only affects the nurse, but it also affects the patient, the nurses’ colleagues, and the nurses’ family; nursing burn out often leads to emotional exhaustion and depression, that can effect relations and communication between the nurse effected and the person they are communicating with. This paper will cover what burn-out is, who is susceptible to burn out, and treatment and prevent nursing burn out.
Surveys of Canadian frontline nurses, today, show that issues with intense workload, while ensuring safe patient care are the most significant challenges they face at work on a daily basis (Berry & Curry, 2012). Research shows that a heavy nursing workload adversely affects both the patient and nurse. For example, many Registered Nurses (RN) are experiencing ethical distress because they are not able to
Nurses are the ones whom trust is placed to care for the sick, but with the growing population of chemically impaired nurses, patient care is in danger. Factors that are contributing to substance abuse among nurses need to be further explored to combat the issue and provide better quality care for patients.
The rate of death due to prescription drug abuse in the U.S. has escalated 313 percent over the past decade. According to the Congressional Quarterly Transcription’s article "Rep. Joe Pitt Holds a Hearing on Prescription Drug Abuse," opioid prescription drugs were involved in 16,650 overdose-caused deaths in 2010, accounting for more deaths than from overdoses of heroin and cocaine. Prescribed drugs or painkillers sometimes "condemn a patient to lifelong addiction," according to Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention. This problem not only affects the lives of those who overdose but it affects the communities as well due to the convenience of being able to find these items in drug stores and such. Not to mention the fact that the doctors who prescribe these opioids often tend to misuse them as well. Abusing these prescribed drugs can “destroy dreams and abort great destinies," and end the possibility of the abuser to have a positive impact in the community.
Factors such as, heavy workloads, stress, job dissatisfaction, frequent medical errors, and intention of leaving the job are all common for nurses to experience, especially during the nursing shortage crisis. Not only do the nurses suffer during a shortage, but the patients ' health outcomes suffer even more. For instance, there are higher rates of infectious diseases and adverse patient outcomes, such as urinary tract infections (UTIs), upper gastrointestinal bleeding, shock, pneumonia, prolonged hospital stays, failure to rescue, and mortality. As a result, this leads to higher re-admission rates for patients. Furthermore, high patient-to-nurse ratios cause heavy workloads due to an inadequate supply of nurses, an increased demand for nurses, a reduction in staffing and an increase in overtime, and a shortened length of stay for patients. Without the heavy workloads that nurses have to endure on a daily basis, there would more time for nurses to communicate more effectively with physicians, insurance companies, and patients and their families. Those heavy workloads are the result of hospitals reducing the nursing staff and implementing mandatory overtime policies just to meet unexpectedly high demands. Unfortunately, the nursing shortage has affected nurses ' mental and physical health. For example, the most common health concerns for nurses include cardiovascular health, occupational injuries and illnesses, and emotional and physical exhaustion. Therefore, safe-staffing ratios/levels have to become the main
Drug administration forms a major part of the clinical nurse’s role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (O'Shea 1999). So as a student nurse this has become my duty and something that I need to practice and become competent in carrying it out. Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (NMC 2008). Accountability also goes for students, if at any point I felt I was not competent enough to dispensing a certain drug it would be my responsibility in speaking up and let the registered nurses know, so that I could shadow them and have the opportunity to learn help me in future practice and administration.
Firstly, nurses are expected to practice evidence-based health care hence a mastery of information about the essential and safe dose of drugs for a patient is very important for a nurse. Consequently, it could be the determinant between the life and the death of the patient. Pharmacology is a discipline which is mandatory for the nurse to excel in to be efficient in discharging his/her duties. Understanding which drug to use, the right dosage, the expected side effects which may occur and the contra-indications of the various drugs are key in the preservation of
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.