February 24, 2011

Support needed to help nurses tackle substance abuse

Support and treatment, not punishment, are needed to help the 10 to 20 percent of U.S. nurses and nursing students who may have problems with substance abuse and addiction.

Image of pain pills (iStock Photo) (iStock)

An estimated 10 percent to 20 percent of nurses and nursing students in the United States may have substance abuse, misuse, dependency or addiction problems.

Todd Monroe
Todd Monroe (Vanderbilt)

The key to tackling this difficult issue — and protecting public safety — is support and treatment rather than punishment, according to a recent paper in the Journal of Clinical Nursing by Todd Monroe, a post-doctoral fellow at Vanderbilt University School of Nursing, and colleagues at the University of Tennessee.

“Doctors and nurses are only human and face the same problems as everyone else, which can include chemical dependency,” said Monroe.

Researchers have recommended six key points that could be built into alternative-to-discipline strategies after reviewing the latest research and professional guidance from the United States, Canada, New Zealand, Australia and the United Kingdom.

Benefits of alternative-to-discipline

The researchers said ATD programs provide greater patient safety, as they enable managers to remove nurses from the work environment quickly, unlike traditional disciplinary procedures that can take months, if not years. ATD programs also provide non-judgmental support and treatment that encourage nurses to seek help and improve their chances of staying in the profession.

“Health care professionals are expected to show compassion when caring for patients who are alcohol and/or drug dependent and they should extend the same compassion to colleagues struggling with chemical dependency, which is an illness,” said Monroe.

Research suggests that ATD programs help many nurses recover from addiction, reduce the chance of dismissal and return nurses to work under strict monitoring guidelines, with random substance checks, support and meetings with managers and regulators.

ATD programs can also lead to a 75 percent reduction in practical problems, like obtaining liability health insurance after disciplinary action, and they usually help nurses to re-enter the workforce.

“Poor or ineffective policies that mandate punitive action are more likely to endanger the public, as they make it more difficult for impaired nurses or students to seek help,” said Monroe.

Monroe teamed with Heidi Kenaga, from The University of Tennessee Health Science Center, to come up with the key points that they believe should be incorporated into ATD programs developed by regulators, educators and health care facilities. Among them:

  • Promote open communication by discussing substance abuse in health care and nursing education settings.
  • Encourage an atmosphere where people feel they can report problems confidentially.
  • Provide information about the signs and symptoms of impairment.
  • Conduct mock interventions to help people feel less fearful or uncomfortable about approaching a colleague about suspected chemical dependency.

The Nurse Wellness Program of Work/Life Connections-EAP at Vanderbilt offers a confidential assessment, referrals, and brief counseling for a variety of concerns including addictions, depression, grief or relationships problems. For a confidential appointment call 936-1327.