When nurse practitioners (NPs) find themselves grappling with a substance use disorder (a.k.a., chemical dependency, addiction to alcohol and/or drugs), their problem is not solely an individual one. That is, the inevitably detrimental and health-damaging consequences of addiction do not simply affect them alone. Why? Because an NP being impaired at work can cause harm, even death, to those who are in their care. Certainly, the odds decrease rapidly of their being able to perform the necessary tasks for and give proper care to their patients.
Put another way, impaired NPs are “impaired” in their ability to fulfill their professional duties and act in accordance with the set standards and established guidelines of the medical field.
This is actually a multi-faceted problem, which those who work with, are supervising and/or charged with monitoring the quality of performance of NPs need to address. The major elements of this quandary include:
- Addicted NPs often divert prescribed drugs—for their own use—that are intended for their patients, thereby jeopardizing the desired health outcomes (and well-being) for these patients. According to a study by Pilgrim, et al., these impaired NPs ultimately “become liabilities in their respective facilities and organizations.”[1]
- The majority of the existing codes of conduct in the medical profession mandate all healthcare workers to report or identify co-workers who may be diverting or stealing prescription drugs from their patients or the facility where they work. Unfortunately, following through with this requirement is associated with both a social stigma and rejection from one’s peers. (Note: Requiring healthcare professionals to report co-workers who might be struggling with a substance use disorder “is a practice that can trigger various workplace challenges. Nurses who are labeled ‘whistleblowers’ will be unable to practice independently or effectively due to isolation.”)[2]
- Since being an NP requires one to use high-level skills and competencies to deliver essential medical care to their patients, when an NP is impaired, he/she will be unable to provide the necessary high-quality support.[3]
Needless to say, immediate action needs to take place to safeguard the patients in the care of any impaired NP. Concerned co-workers, supervising physicians and hospital/medical center directors, policymakers and healthcare leaders must all take action, including implement effective measures that have the potential to enable all affected NPs to swiftly get into treatment.
Fortunately, this challenge has inspired nursing associations and medical institutions to introduce measures for empowering and meeting the needs of NPs (and other healthcare professionals) struggling with substance use disorders. Per a study by Monroe, et al., more progressive attitudes have “considered evidence-based and leadership approaches that will ensure that both disciplinary and assistive programs work synergistically to empower more (NPs) who are facing the problem of addiction. The most important thing is for all stakeholders to acknowledge the nature of this predicament and pursue programs that provide sustainable support to every at-risk practitioner.”[4]
Since there is currently a shortage of NPs in the field, it is imperative that all related medical institutions implement the appropriate rehabilitation, empowerment and aftercare systems that will support the retention of more NPs. According to research by Fowler, “The use of data-driven measures will make it possible for different agencies and institutions to understand how addiction among nurses (and NPs) is a major ethical issue. The acquired information will empower them to understand the most appropriate tactics for supporting the affected practitioners and ensuring that they achieve both their personal and career aims.”[5]
[1] Pilgrim, J. L., Dorward, R., & Drummer, O. H. “Drug-caused deaths in Australian medical practitioners and health-care professionals.” Addiction. 2016.
[2] Ibid.
[3] McHugh, M., Papastrat, K., & Ashton, K. C. “Assisting the drug addicted nurse: Information for the legal nurse consultant.” Journal of Legal Nurse Consulting. 2011.
[4] Monroe, T., Pearson, F. & Kenaga, H. “Procedures for handling cases of substance abuse among nurses: A comparison of disciplinary and alternative programs.” Journal of Addictions Nursing. 2008.
[5] Fowler, M. D. M. Guide to the code of ethics for nurses with interpretive statements (2nd ed.). Silver Springs, MD: American Nurses Association. 2015.
