Dispelling 6 Common Myths About Impaired Nurses
Given addiction to alcohol or drugs (a.k.a., substance use disorder) afflicts people of all ages, races and from all walks of life and occupations, it should come as no surprise that it can occur in nurses, too. Past research indicates 10-15% of all nurses may be impaired by alcohol or drug addiction.[1]
The most pressing problem with impaired nurses stems from the fact that substance use disrupts their ability to provide safe, appropriate care for their patients. And while the American Medical Association considers addiction a disease, an impaired nurse remains responsible for her or his actions while on the job.
Since most states hold nurses legally responsible to report to management any potential substance abuse problem observed in a co-worker, they should be aware of the signs and symptoms of substance abuse.
To help recognize a nurse who might be impaired by alcohol or drugs, or to identify instances of medication diversion, it would be helpful to understand some of the myths and truths about addiction and substance abuse.
Myth #1: Impaired nurses are easy to recognize.
Truth: There are specific signs and symptoms of a nurse who is abusing or addicted to alcohol or drugs, but she or he may be hiding such and/or taking precautions to avoid being detected.
Myth #2: Impaired nurses have a long history of drug or alcohol abuse.
Truth: While many impaired nurses have a long-standing history of alcohol or drug abuse, a recent stressful life event such as a divorce, accident or prolonged illness can lead to drug abuse as a coping mechanism.
Myth #3: Impaired nurses only get addicted to street drugs.
Truth: Those nurses who are found to be impaired often abuse prescription medications—typically diverted from those intended for patients at the workplace—instead of or as well as alcohol or street drugs. And while the nurse’s substance use habit may start by simply taking a patient’s medication for a headache or back pain or to cope during a stressful shift, the dependency can escalate quickly. And as stated above, addiction to alcohol can be as harmful as illegal drug use.
Myth #4: Impaired nurses can never really recover. Once an addict, always an addict.
Truth: Nurses who seek treatment have been shown to be able to make a successful recovery in the majority of cases (approximately 70%).[2] Treatment can be effective in reducing substance use and improve health, social, and occupational well-being. Many organizations offer alternative treatment programs instead of drastic action such as termination.
Myth #5: Addiction to alcohol or drugs is voluntary. If they really wanted to, impaired nurses could just quit drinking or using.
Truth: Drug addiction is widely recognized as a disease, an obsessive-compulsive disorder affecting the afflicted person’s brain and behavior. It may be the result of heredity (including, but not limited to a family history of addiction), an emotionally, physically or sexually abusive or traumatic family situation, poor choices, loss of important support systems, enabling behavior, unstable lifestyle, seeking an adrenaline rush to fill an inner void, or other factors.
Myth #6: Nurses with a chemical dependency on alcohol or drugs only need treatment for a couple of weeks to get straightened out.
Truth: Short-term treatment programs (less than 21 days) are generally not sufficient to help a nurse get established on the road to recovery.[3] Getting the necessary support to “kick the habit,” develop a clear understanding of the nature of both addiction and recovery, and form an effective set of behavioral and attitudinal tools and practices takes time and requires the commitment of each nurse seeking recovery from addiction. Equally important is the follow-up support and supervision: the former for developing a recovery network for ongoing psychological and emotional support; and the latter to ensure a nurse stays sober and in line with his or her recovery and career-resumption goals. Nurses who remain in treatment for at least a year are twice as likely to be drug-free.[4]
Impaired nurses can make a complete recovery if given support and opportunity and they have a desire to recover. Currently 37 states offer some form of a substance abuse treatment program to direct nurses to treatment, monitor their re-entry to work, and continue their license according to the National Council of State Boards of Nursing.
The American Nurses Association (ANA) is a strong supporter of alternative or peer assistance programs that monitor and support safe rehabilitation and the eventual return to the professional workforce.
[1] Baldisseri M. “Impaired healthcare professionals.” Crit Care Med. 2007.
[2] McLellan, A.T, et al. “Five-year outcomes in a cohort study of physicians treated for substance use disorders in the United States.” British Medical Journal. 2008.
[3] Saver C. “Substance abuse in the OR: Saving lives through treatment, prevention.” OR Manager. 2008
[4] Shaw M.F., et al. “Physicians and nurses with substance abuse disorders.” Journal of Advanced Nursing. 2004.
