By Kristin Rothwell, associate editor
Keeping a secret is one thing, but hiding an addiction to drugs and alcohol is quite another, according to Sharon Rossi, RNC, MS.
Rossi recently spoke during the “Chemically Impaired Nurses: It’s Everybody’s Problem” session at the American Association of Critical-Care convention in Orlando, Florida, in May.
Rates of Use Varied by Specialty
- Emergency and critical care nurses are 3.5 times (38 percent) more likely to report using marijuana or cocaine than any other specialty.
- Oncology nurses have the highest (42 percent) overall substance use rates largely due to binge drinking.
- Psychiatry has higher rates (40 percent) of substance abuse.
- Administrators have higher rates of binge drinking.
- Pediatrics and women’s health have the lowest substance use rates.
Source: American Journal of Public Health, April 1998
Sharing the story of a 28-year-old PACU nurse who was found dead in a locked hospital restroom stall with several vials of drugs shortly after her shift ended in April 2002, Rossi said it is cases like this one that make it imperative that administrators, managers and fellow nurses increase their knowledge about the problems that substance abuse in health care can cause and how to identify common signs seen in nurses who abuse drugs and/or alcohol.
Though cases of chemically impaired nurses and other health care professionals generally remain private, Rossi said “We need to bring this out in the open. We have to talk about it.”
Drawing from a study published in the April 1998 issue of the American Journal of Public Health,
Rossi said the study’s authors, Alison Trinkoff, RN, Sc.D., and Carla Storr, Sc.D., found that about 32 percent of the 4,438 nurses surveyed reported drinking, smoking or using drugs.
While nurses’ use of drugs and alcohol is about the same rate as the general population, the study found that critical-care and emergency department nurses are more than three times as likely to abuse narcotics as nurses in other specialties.
Rossi said that the contributing factors for substance abuse include availability of controlled substance, frequency of administration and degree of control, pharmacological optimism [opportunities to self-medicate], work and personal stress and denial, among other factors.
Though nurses and other health care professionals may see substance abuse as a sign of failure or weakness, Rossi said nurses who shy away from broaching the subject with their colleagues directly or with a manager, are negatively impacting the safety of their patients and other staff members.
The effect on patients could mean that medications are being omitted, causing increased pain and suffering for patients and potentially causing permanent injury or death.
On the other hand, the effects of a chemically impaired nurse on staff could mean increased workloads, unit tension, decreased morale, guilt, anger, a sense of betrayal or even denial—don’t ask, don’t tell.
Rossi said it’s important that nurses be proactive by educating themselves and their staff about alcohol and substance abuse issues, how to report impairment issues to management, knowing how to fully investigate all sources to validate any suspicions and knowing how to confront the nurse colleague if he or she has a substance abuse problem.
“We’ve gotta get our heads out of the sand by learning what we can learn,” Rossi said. “Let’s not let this be taboo anymore.”
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