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

Abstract

For more than a century, the US nursing profession has been aware of substance abuse problems among its practitioners and student nurses but has generally dealt with the issue by taking disciplinary action rather than pursuing nonpunitive options.

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

“…ATD programs in the USA receive 75% more new enrollees than the discipline‐based state programs (Monroe et al., ). ATD yields more favorable outcomes overall than discipline‐based approaches, primarily because there is considerably more service uptake when it is offered to nurses in lieu of discipline (College of Registered Nurses of British Columbia [CRNBC], , Kunyk & Austin, ; Monroe & Pearson, ; ; NCSBN, ). Long‐term overall ATD treatment outcomes have also been positive, with completion and recovery rates ranging from 48% to 95% (Monroe et al., ; Smith et al., ; Trossman, ).…”

“…Problematic substance use (PSU) is a serious health issue that affects people in all walks of life, including those in the nursing profession. Prevalence estimates of nurses in North America who have problems with substance use vary widely, ranging from 6% to as high as 20% (Dunn, ; Kunyk, ; Monroe & Pearson, ; Servodidio, ). The Canadian Nurses Association (CNA) takes the position that nurses' use of substances is considered to be ‘problematic’ when the effects or aftereffects of substance use impair their work performance to the extent that expected standards of professional practice are not met (CNA, ).…”

Don’t ask don’t tell: substance abuse and addiction among nurses

“…The hypothetical scenario above illustrates the challenges faced by substance‐abusing nursing professionals. There is an ongoing initiative to promote greater dialogue about what practitioners, administrators, health care providers and students can do when they suspect someone in their profession is abusing substances, or when they may themselves be suffering from addiction (Monroe et al. 2008, 2009, Monroe 2009).…”

“…Those being educated for entry into professional practice are also in jeopardy; at present, nursing educational programmes do little to recognise and assist students suffering from addiction (Maher‐Brisen 2007, Monroe 2009). Nursing schools seldom have policies in place for appropriate referral and potential re‐entry (Monroe et al. 2009).…”

A cross-sectional study of drinking patterns, prelicensure nursing education, and professional identity formation

“…Through the process of internalizing professional values, one's professional identity becomes self-evident in the nurse's lived experience and creates the foundation for promoting the ideals of the profession (NLN, 2010 Code of Ethics (2001) further specifies that nurses have an ethical responsibility to practice unimpaired and safely. However, substance abuse is a significant problem within the profession that impairs nurses' ability to perform essential job functions and threatens both self-concept and safe practice (Lillibridge, Cox, & Cross, 2002;Kenward, 2009;Monroe & Pearson, 2009). It is estimated in the United States that perhaps 6% of nurses have a problem severe enough to impair practice (Dunn, 2005).…”