How to Manage Nurses With Substance Abuse Problems

Addiction to drugs and alcohol can be particularly harmful when the people involved are health care professionals. With their knowledge of and easy access to drugs, nurses are susceptible to turning to these substances to deal with stress. Other factors can include exposure to death and suffering, excessive overtime or musculoskeletal pain. Nurses might have difficulty admitting to their addictions out of fear of losing their licenses and their livelihood. There are resources for addicted nurses to not only get into recovery but to become better nurses. Dealing with substance abuse can help nurses better protect themselves and their patients.

Instructions

Action Plan

• 1

  Learn the signs of abuse among health care workers. A study published in the American Journal of Public Health states that ER nurses, nurses who work night or rotating shifts and nurses who work in critical care areas are the most likely to turn to drugs for relief. Telltale signs of drug abuse among nurses are behaviors such as showing up early or leaving late consistently, and arriving at work on non-scheduled days. Other signs include a consistent need to "waste" medication and frequent discrepancies in the documentation of medications. Misappropriating medications from the workplace is called "diversion" of medications, and evidence such as pharmacy records can corroborate abuse.

• 2

  Take reports of suspected abuse seriously and put an administrative plan into action at once. The most common approach is to immediately remove the suspected nurse from the floor and to start an investigation to determine the accuracy of the report. If the nurse admits to use, many health care facilities are now taking an approach involving treatment rather than punishment.

• 3

  Develop a program that nurses can participate in which involves supervision while they are in the early stages of recovery. For example, a nurse in Oregon who admits to any type of substance abuse is allowed to keep her license. The nurse can continue to practice if she voluntarily participates in the Oregon Health Professionals Services Program (HPSP), run by the Oregon Department of Human Services. This is a program that restricts the health professional's practicing duties while allowing her to continue working in her profession.

• 4

  Monitor any nursing staff within the guidelines of the program that is developed. In the state of Oregon, health care professionals are either self-referred or board-referred to the HPSP. A nursing manager can monitor any employees in a program similar to this to ensure that they are compliant with any toxicology or interview requirements. Strict compliance is mandatory for most programs. After a pre-determined amount of time the nurse can apply for an unrestricted license at a hearing.