Modeling Attitudinal Antecedents of Nurses’ Decisions to Report Impaired Colleagues

Abstract

Nurses whose professional functioning is impaired due to substance abuse represent a threat to the health and safety of patients, other health care staff, and themselves. The major means for identifying impaired nurses is nonimpaired coworkers. Yet, only 37% of nurses who have had experiences working with impaired colleagues reported them to supervisors. A cross-sectional correlational research design, employing structural equation modeling, was used to explicate the relationships among the latent attitudinal constructs: permissiveness, morality, treatment efficacy regarding substance abuse, and punitive attitudes toward impaired nurses. The influences of these attitudes on perceived severity of impairment in fictitious coworkers and subsequent intentions to report these coworkers to nursing supervisors were modeled in a sample of 126 nurses. Permissiveness and positive attitude toward treatment were significantly related to intentions to report nurses. Moralistic attitude was not related to intention. Moralistic attitude was, however, strongly associated with a punitive attitude toward impaired nurses.

A critical review of knowledge on nurses with problematic substance use: The need to move from individual blame to awareness of structural factors

“…Although obligated by their professional associations to report peers whose practices are impaired by PSU (ANA, ; Canadian Nurses Association [CNA], ), nurses are often reluctant to do so for several reasons. These include fear of reprisals; perceptions that they are being disloyal to friends; being unsure of what to say or do; and a general lack of knowledge of the signs of PSU and of the supports and treatment programs available to their colleagues (Beckstead, ; Breslin, ; Grover & Floyd, ; Kunyk, ; Malloch, ; Monroe et al., ; Pullen & Green, ).…”

Dealing with professional misconduct by colleagues in home care: a nationwide survey among nursing staff

“…In the case of impairment, a healthcare worker’s cognitive, interpersonal or psychomotor abilities are seriously impaired due to individual conditions that interact with the environment (e.g. substance abuse, aggressive behaviour, mental illness or physical disability) [ 4 , 5 ]. Impairment is frequently accompanied by incompetence [ 3 ].…”

Childhood Exposure to Religions With High Prevalence of Members Who Discourage Homosexuality Is Associated With Adult HIV Risk Behaviors and HIV Infection in Black Men Who Have Sex With Men

“…A low, nonsignificant chi-square is desirable as it indicates a low plausibility that there are significant differences between the hypothesized and observed models. Root mean square error of approximation of less than .08 is considered a reasonable approximate fit and low likelihood of model misspecification (Beckstead, 2002; Browne & Cudeck, 1993). The weighted root mean square residual (WRMR) was also used as an indicator of the overall fit of the model.…”