Nurses with Addiction

Nursing is one of the most stressful careers in healthcare. Long hours of direct patient care take its toll emotionally and physically. While the profession is rewarding for most, the constant stress can become a catalyst for all kinds of self damaging behaviors. The American Nurses' Association estimates between ten and twenty percent of nurses will abuse drugs within the workplace at some point during his/her career (ANA, 2002). This percentage is similar to that of substance abusers within the general population. Due to the ease of access to narcotics on the job, it can be difficult to recognize a problem in the early stages. Only once the nurse’s activities have been suspected due to medication shortage or job performance problems can intervention be made. Professionals with addiction not only risk harming themselves and their career, but put their patients at an increased unnecessary risk of malpractice. Unfortunately in November 2009, four nurses in a local hospital were found to be stealing Morphine, Fentanyl, Dilaudid, and other narcotics during their shifts. All four nurses had been employed in various departments and were operating independently of each other. Each nurse was apprehended after being observed for strange behaviors and unauthorized Pixus medication station discrepancies. According to Dunn, psychiatric and oncology nurses have the highest likelihood for drug abuse due to the constant stress and emotional pressures associated with their careers (Dunn, 2005). The lowest instance of abuse occurs in Women’s Health and Pediatric nursing (NIH, 2003). It is unclear whether this rate is due to the nurse’s coping capabilities in such areas, or the lack of narcotics available on these types of care units. Aside from disobeying the loyalty of the workplace, these nurses have violated the Nursing Code of Ethics in relation to themselves, the hospital, and the patients. Within the Nursing Code of Ethics (ANA, 2001) nurses vow to: †¢Safeguard the client and the public when health care and safety are affected by the incompetent, unethical or illegal practice of any person. †¢Participate in the profession's effort to establish and maintain conditions of employment conducive to high quality nursing care. Maintain primary concern for the patient, whether an individual, family, group, or community Fortunately, there have been no reports thus far of malpractice or injuries with any of the patients under the direct care of these four individuals. Grave circumstances may have occurred if the situation had not been discovered promptly. When serious issues occur, Risk Management must work feverishly to investigate all the patient’s records to determine if any errors occurred regard ing their care. Risk Management also has the responsibility of investigating the claims against the nurses to prove or disprove validity. Only after the investigations are concluded can the Risk Management team work to repair the reputation of the hospital and its employees. As a result of this incident, workplace respect, reputation, and ethics have been violated at the expense of drug addiction. Nurses and other healthcare professionals have a responsibility to the patient’s and the workplace to uphold a standard of care that will not jeopardize the position of the hospital, its staff, the patients or the community. When serious issues occur, patients become judgmental of all providers and institutions. The profession and the organization’s reputation have suffered because of this incident. Being a healthcare provider myself, I do not understand how a nurse could not find any other coping mechanisms besides drug abuse. Although I am not a nurse, I deal with the same daily issues associated with direct patient care. As a professional, you are required to deal with situations outside of your beliefs and find avenues to vent your frustration, grief and stress without harming the patients, yourself, or the relationship between the two. I have not come across any colleagues that take a different ethical viewpoint than me regarding this situation. We all know that stealing medications from patients for personal use is wrong professional ly, personally and legally. Perhaps our lack of understanding is due to the inability to relate to those with drug addiction. All coworkers within an organization need to be educated to recognize potential issues of narcotic abuse within the workplace. Since healthcare professionals are able to hide some signs of abuse such as work absences, it may be more difficult to recognize a problem in the early stages. Some physical signs to be aware of include: irritability, forgetfulness, isolation, and decreased levels of motivation. Issues in personal life may also increase the chances of drug abuse, such as: stress, family problems, a previous history of mental illness, and a history of prior abuse (any type). Potential issues must be reported to the Nurse Manager as soon as possible. In order for the organization to protect the safety of its personnel and patients, ethical standards of practice must been routinely stressed within the workplace. Many institutions conduct annual competencies, in-services, and /or reviews to ensure employee commitment to maintaining and promoting an ethical work environment. Conclusion Drug abuse among workers will occur in any organization despite all efforts taken by coworkers, management and the organization as a whole. Drug abuse becomes a severe ethical issue once the life of another human being is jeopardized. Those in the healthcare field have a responsibility to maintain a standard of care to patients regardless of any personal issues occurring in his/her own life. When drug abuse occurs in a hospital setting, the potential for disaster increases dramatically. Not only is the safety of patients and coworkers compromised, so is the reputation of the hospital and the profession. All healthcare employees must be monitored by their employer to ensure workplace drug abuse is prevented, detected and extinguished before irreversible damage occurs. References: American Nurses Association (2001). Code of ethics for nurses. Retrieved from http://www. nursingworld. org/about/01action. htm. on December 11,2009. Dunn, D. (2005). Substance abuse among Nurses-defining the issue. Association of operating room nurses. (82) 592-596. Retrieved from Proquest December 10, 2009. National Institute of Health (2003). Retrieved from www. drugabuse. gov/infofacts/costs. html on December 10, 2009.