Substance Abuse

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Non-punitive support key to tackling issue among nurses

An estimated 10 percent to 20 percent of nurses and nursing students may have substance abuse and addiction problems.  The key to tackling this difficult issue – and protecting public safety – is support and treatment rather than punishment, according to a recent paper in Journal of Clinical Nursing, developed by VUSN’s Todd Monroe and University of Tennessee’s Heidi Kenaga.

“Doctors and nurses are only human and face the same problems as everyone else, which can include chemical dependency,” said Todd Monroe, PhD, post-doctoral fellow at the Vanderbilt University School of Nursing. “Since they work in a highly stressful environment with easy access to powerful drugs, they are exposed to an increased risk of substance abuse, misuse and abuse.”

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

They believe that 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 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.

Monroe and Heidi Kenaga, PhD, from The University of Tennessee Health Science Center came up with the key points for successful ATD programs:

1)Promote open communication by discussing substance abuse in health care and nursing education settings.
2)Encourage an atmosphere where people feel they can report problems confidentially.
3)Provide information about the signs and symptoms of impairment.
4)Conduct mock interventions to help people feel less fearful or uncomfortable about approaching a colleague about suspected chemical dependency.
5)Invite ATD experts to speak to hospital or school administrators.
6)Participate in scholarly forums about addiction among health care providers.

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