The Historical Context of Addiction in the Nursing Profession: 1850–1982

Abstract

Intertwined in the history of substance abuse in the United States is the history of addiction in the nursing profession. This historical research explores the context of addiction in the nursing profession with reference to social, medical, political, and legal events from 1850 until the American Nurses' Association officially acknowledged addiction in the nursing profession in 1982 with guidelines for the impaired nurse. Prior to these guidelines colleagues looked the other way hoping the nurse would solve the problem by herself or if not, just leave. If caught, punitive action was taken. Nurses lost their licenses, their source of income (meaning no resources for rehabilitation treatment), and often went to jail.

Procedures for Handling Cases of Substance Abuse Among Nurses: A Comparison of Disciplinary and Alternative Programs

“…In the early 1980s, 48 states began investigating, though not implementing, some type of alternative-to-discipline program for nurses who were chemically dependent (Fletcher, 2001). In 1982, the American Nurses Association (ANA) offered further support for these initiatives in its position paper recommending that treatment be tried before disciplinary action was taken (Heise, 2003). In 2002, the ANA adopted the following resolution reinforcing its commitment to alternative-to-discipline programs and encouraging each state to adopt non-punitive strategies to address the disease of chemical dependency among its membership:…”

Treating Nurses and Student Nurses with Chemical Dependency: Revising Policy in the United States for the 21st Century

“…Despite efforts by the American Association of Colleges of Nursing (AACN) (1994) and the National Student Nurses Association (NSNA) (2002), most nursing programs continue to use zero-tolerance policies in the 21st century (Fletcher 2001;Heise 2003). Such policies rely on "deterrence theory," that is the use of punishment to control behavior (Haack and Yocom 2003).…”

“…In 1980, the National Nurses Society on Addictions (NNSA), which would later become the International Nurses Society on Addictions (IntNSA), began to address the issue of substance abuse among practitioners (Heise 2003). In 1982 and then again in 1984, the American Association of Nurses (ANA) in conjunction with NNSA passed resolutions promoting treatment before disciplinary action was taken (Fletcher 2001;Heise 2003;Quinlan 2003).…”

“…In 1982 and then again in 1984, the American Association of Nurses (ANA) in conjunction with NNSA passed resolutions promoting treatment before disciplinary action was taken (Fletcher 2001;Heise 2003;Quinlan 2003). In 2002, the ANA adopted a resolution supporting the establishment of alternatives-to-discipline programs in all jurisdictions.…”

“…Since the beginning of the 20th century, the profession has been aware of substance abuse and addiction among its members (Heise 2003). For the next 80 years, nurses so afflicted were viewed as morally weak and not fit to practice.…”