A recent article posted on the website, RegisteredNursing.org, paints a clear picture of “how things have changed” regarding the way nurses with substance use issues are currently handled; i.e., with more understanding, support and options for getting treatment and (when ready) resuming their nursing career – that is, in contrast to how, even just 40 years ago, when “nurses were relieved of duty and/or had their nursing license revoked with little recourse or treatment options when found to have a substance abuse disorder.”[1]
Substance use disorders (a.k.a., chemical dependency or addiction) can be found afflicting people from all backgrounds, education levels, socioeconomic statuses and professions. Studies indicate those in the professional healthcare field—nurses included—have a rate of substance abuse similar to the rest of the population, between 10-15%.[2]
However, unlike most other professions, medical doctors and nurses have the responsibility of caring for the health, well-being and safety of their patients. And to do this, it’s necessary they use their knowledge, skill and expertise at all times when addressing their patients’ needs.
Unfortunately, the nature of the disease of addiction is such that it robs the person of their ability to make sound decisions and think critically when under the influence of the drug. This results in countless medical “accidents,” mistakes that put their patients in danger, sometimes even causing their death.
Since the 1980s, when the medical community came to view a substance use disorder as a disease, “many states have enacted non-disciplinary rehabilitation programs to assist nurses with recovery. These intensive programs allow the nurse to gradually return to the working environment once it can be established and confirmed that the nurse is safe to practice in a clinical setting.”[3]
The fact is, recognizing and addressing nurses struggling with a substance abuse disorder and then helping them get into a specialized treatment program can be the difference between life and death, both for them and their patients.
Some of the indicators a nurse has a substance use disorder include:
- Frequent bathroom visits
- Extended absences
- Excessive medication reporting errors
- Arriving late to work and leaving early
- Isolation from co-workers
- Deficient alertness on the job
- Inappropriate emotional outbursts[4]
What happens when a nurse is suspected of having a substance abuse disorder? Typically, he or she is placed on leave, pending an investigation. The suspicion of substance abuse is reported to the state’s Board of Nursing (BON) and, in some states, the local police. Fortunately, most states have developed a process for investigation and varying levels of programs to assist nurses through recovery, and upon successful completion of treatment, help the nurse in his or her return to working in the field.
In many states, there is structured oversight of the nurse in a follow-up care program—to assist them in maintaining and strengthening their foundation in recovery—with rigorous conditions set up for their going back into the workplace. These conditions may include:
- A weekly check-in with a nursing leader
- A weekly or monthly report to the BON
- Restrictions on shift assignments, such as no night shift work; or,
- Complete removal of the nurse from clinical practice, such as an advice nurse or case-manager role.[5]
There are a great number of resources for nurses and nurse leaders to help them address those with a substance abuse disorder, provided by both the National Council of State Boards of Nursing (who oversee each state’s BON) and the relevant state BON. It is highly recommended that nurses check with their local Board of Nursing to become familiar with the process of identifying and reporting a co-worker’s possible substance use disorder, as well as the treatment options and state licensed programs available to aid in their recovery.
[1] Staff Writer for RegisteredNurse.org. “What Happens When a Nurse has a Substance Abuse Problem?” May 29, 2021.
[2] Baldisseri, M. “Impaired Healthcare Professional.” Critical Care Medicine. Feb. 2007.
[3] Staff Writer for RegisteredNurse.org. “What Happens When a Nurse has a Substance Abuse Problem?” May 29, 2021.
[4] Ibid.
[5] Ibid.
