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substance abuse in the nursing profession
substance abuse in the nursing profession
substance abuse in the nursing profession
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Introduction
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, accessibility to drugs in the work environment has played a significant role. Substance abuse among nurses is an arising issue in need of attention, it is alarming to know that patient safety and care is in danger when a chemically impaired nurse is in the workplace.
Thesis
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.
Analysis
There are several contributing factors to substance abuse among nurses such as family, and stress. Nurses who have family members with emotional problems and inability to cope, alcoholism, and drug use, have been linked to a higher risk of substance abuse (Talbert, 2009). Coming from a family that relies on substances tempts the nurse to be chemically dependent when experiencing high job demands. "Stress in the workpl...
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Substance abuse in the field of nursing has become a serious problem. Every day exposure to drugs in addition to other factors have contributed to the issue of substance abuse among nurses and the impact on patient care. Some may still be unaware of the substance abuse problem nurses struggle with, and they don't realize until they see the consequences on overall patient outcomes and work productivity. Learning to recognize the chemically impaired nurse has allowed the health care field to expand its awareness and begin to take action on this issue. “To ensure productivity, safety, and quality of care, most hospitals have instituted drug-free workplace programs...that identify prohibited behaviors and the consequences of violating the policy” (Epstein et al., 2010, p. 515). In hope of change to this issue, further action continues to be a work in progress.
You did an awesome work, I heard. We have monthly meetings, where we talk about the latest news in the nursing world, policy and procedure, quality improvement and many more issues. What I really enjoy about the meeting is that everyone can address his/her concerns without feeling afraid and intimidated. The meeting led by a registered nurse who is familiar with our day to day situation at work.
The interprofessional team model is a group comprised of various healthcare disciplines working together towards common goals to meet the needs of the patient population. The World Health Organization (WHO) defines interprofessional collaboration in healthcare as occurring “when multiple health workers from different professional backgrounds provide comprehensive services by working with patients, their families, and communities to deliver the highest quality of care across settings” (WHO, 2010, p.13). In my final practicum at I have experienced interprofessional collaboration, while involved with the methadone program at Rosthern Hospital. Nurses have an important role in the methadone program, and the involvement of nurses in the program
Lilley, L. L., Rainforth, S., & Snider, J. (2013). Pharmacology and the Nursing Process (7th Ed.)
The evidenced based problem that was identified for this research assignment, was that nurses were causing multiple medication errors in a clinical and practice setting. According to the authors Wolf, Hicks, and Serembus (2006), a medication error is defined as any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. It is very important for experienced nurses and nursing professors to identify medication errors to prevent them from harming the patient. Some of the errors that were identified were not reported because registered nurses didn’t want their peers to think they were irresponsible (Unver, Tastan, & Akbayrak, 2012). Nurse shaming did not help increase positive outcomes of reporting errors among nursing students and registered nurses (Harding & Petrick, 2008). When medication errors were reported they were not being reported properly, and the consequences for improper reporting were not taken seriously.
There is a shortage of all health care professions throughout the United States. One shortage in particular that society should be very concerned about is the shortage of Registered Nurses. Registered Nurses make up the single largest healthcare profession in the United States. A registered nurse is a vital healthcare professional that has earned a two or four year degree and has the upper-most responsibility in providing direct patient care and staff management in a hospital or other treatment facilities (Registered Nurse (RN) Degree and Career Overview., 2009). This shortage issue is imperative because RN's affect everyone sometime in their lifetime. Nurses serve groups, families and individuals to foster health and prevent disease.
Furthermore, short staffing affects the quality direct care each patient receives. The National Coordinating Council for Medication Error Reporting and Prevention (2012) states an estimated 98,000 individuals die every year from medical errors in the United States. One out of many significant tasks nurses do within their scope of practice is medication administration. Research shows a relationship between short staffing on medication errors: the longer the hours nurses work, the higher the chances of medication errors (Garnett, 2008). (include definition of medication error) Administering medications requires knowledge of patient rights, pharmacological information on the drug, adverse effects, proper dosage calculations, and hospital protocols. When nurses are assigned more patients, they are pressured to give due medications on time. Sometimes due to hunger or fatigue, nurses give the wrong medication to the wrong patient (Frith, Anderson, Tseng, & Fong, 2012).
A nurse is required to exercise appropriate clinical judgment and respond safely and quickly in order to effectively care for a patient. Substance abuse among nurses is an issue that compromises the delivery of quality care and professional standards of nursing. Many nurses are not recognized as having a problem until a patient has been endangered (Clark and Farnsworth, 2006). It has been estimated that 10-...
The purpose of this paper is to determine the level of substance abuse in the elderly community. There is concern that as the population ages in the United States, there will be a significant increase in the number of older adults being treated for substance abuse problems. This paper seeks to understand the issues and concerns that are consequently involved with substance abuse among the elderly.
Nurses are pivotal in hospital efforts to improve quality because they are in the best position to affect the care patients receive during their hospitalization. Data collection and analysis is the core of quality improvement assisting in understanding how the system work, identifying potential areas in need for improvement, monitoring the effectiveness of change and outcome. Nurses are also the eyes and ears of the hospital to positively influence patient outcome. For example, nurses are the ones catching medication errors, falls, and identifying barriers to delivering care. In this nurse’s facility, in order to minimize patient falls the hospital implemented a falls risk assessment tool called, “The Humpty Dumpty Scale” upon admission
The consequences of substance abuse as a practicing nurse are endless. According to the Alabama Board of Nursing Administrative Code, the Board will take disciplinary action toward a nurse who is proven to be negligent from the use of alcohol or has been proven to be addicted to any habit-forming drug (2017). Either of these criteria render the nurse unsafe and or unreliable to practice as a nurse (Alabama Board of Nursing, 2017). Depending on the extent of the offense, the Board may discipline the transgressor in several ways including reprimand, fine, and suspending or revoking their license (Alabama Board of Nursing, 2017). Any nurse facing these charges also must endure the embarrassment of having their name permanently put on the Disciplinary Action Reports page of the Alabama Board of Nursing website for all of the public to review (Alabama Board of Nursing, 2017). Thus, if said nurse loses his or her job in the process, future employers will access this database for hires, leaving the nurse to be scrutinized by any possible employer. Not only do nurses risk their own credibility, they also risk the lives of their patients when under the influence. A study recorded by Cares shows that substance abuse rates were highest among nurses working in specialty fields (2016). The nurses working in the fields such as adult critical care and
Still today, nurse staffing is a crucial health policy issue. Since the 1980s, the nursing profession has taken on more prominence in America with a large focus on research studies. In fact, U.S. Public Law 99-158, Health Research Extension Act of 1985, authorized the National Center for Nursing Research (NCNR) at National Institutes of Health (NIH) (Health Research Extension Act of 1985, 1985). With U.S. Public Law 103-43, NIH Revitalization Act of 1993, the NCNR was formally changed to the National Institute of Nursing Research (NINR) (NIH Revitalization Act of 1993, 1993). The NINR started constructing purposeful research projects, which produced a positive correlation between the number of staff and quality of care. However, the 1996 Institute of Medicine (IOM) report expressed, at that time, no significance between nurse staffing and clients’ outcomes in acute-care hospitals (Institute of Medicine Staff, Davis, Sloan, & Wunderlich, 1996, p. 9).
At my agency there are times when client’s come to receive their meds and some of the people handing out the med are recovering addicts and I just believe that a nurse would be better because not just anyone is supposed to hand out medications.
Patient’s safety will be compromised because increase of patient to nurse ratio will lead to mistakes in delivering quality care. In 2007, the Agency for Healthcare Research and Quality (AHRQ) conducted a metanalysis and found that “shortage of registered nurses, in combination with increased workload, poses a potential threat to the quality of care… increases in registered nurse staffing was associated with a reduction in hospital-related mortality and failure to rescue as well as reduced length of stay.” Intense workload, stress, and dissatisfaction in one’s profession can lead to health problems. Researchers found that maintaining and improving a healthy work environment will facilitate safety, quality healthcare and promote a desirable professional avenue.
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.
Trounce, J. (2000) Clinical pharmacology for nurses: the role of the nurse in drug administration. 16th Ed. London: Churchill Livingstone.