Given the rate of substance use disorders (including alcohol) currently found in the nursing field, a pressing question has been, “How is this problem best addressed?”
It would be good to start by identifying whether or not there is indeed a problem at all. Based on research done by Monroe and Kenaga and published in the journal Nursing Research, approximately one out of every five to seven registered nurses (RNs) in the U.S. (between 14 – 20%) “may have a problem with dependence on or abuse of drugs and/or alcohol, which likely addresses the suspected prevalence of unreported substance dependence cases.”[1] And though this is significantly higher than the 10% figure put forward by the American Nurses Association,[2] even knowing one out of every ten RNs is struggling with issues of substance abuse is enough to warrant this being called a “problem” – especially because having a substance use disorder affects not only the nurse her/himself, but also the patients, coworkers and families of each. That is, a substance using/abusing nurse’s proximity to critical patient care and the potential threat to the public’s health can ripple out and cause untold damage in their own and countless other people’s lives. When you add to this the fact there are nearly 4 million RNs nationwide, per the American Association of Colleges of Nursing,[3] you quickly recognize the extent of this “problem.”
Fortunately, studies have been conducted on alternatives to punitive and disciplinary approaches to nursing management, suggesting alternative-to-disciplinary (ATD) approaches—emphasizing early intervention, confidential addiction treatment, and non-punitive follow-up support, including the potential for continued employment after treatment completion—produce significantly better results.[4]
The findings of these studies show such ATD programs have good retention rates, and the nurses who complete them are more likely to retain their nursing licenses and maintain their nursing careers, as well as have fewer criminal convictions.[5]
Some of the recommendations offered to help nurses facing substance use disorders or substance abuse include:
- Make changes to nurse practice acts to make ATD programs more uniform, including allowing nurses to seek and obtain treatment for substance use disorders without disclosing directly to Boards of Nurses;
- Provide adequate funding for all nurses and nursing students to get treatment for substance use disorders;
- Provide adequate funding for more treatment services and facilities for nurses and nursing students seeking recovery from chemical dependency issues; and,
- Nationwide implementation of policies at colleges of nursing to encourage early identification and treatment for nursing students.[6]
Through an increased emphasis on providing early intervention, confidential assistance and supportive addiction treatment and care, ATP approaches—such as Physicians Resource Network[7] –offer both nurses and nursing students who are struggling with issues of drug and/or alcohol dependency the ability to begin walking a “road to recovery” and thereby start enjoying a life free from active addiction, with a significantly increased likelihood of preserving their licensure and continuing their careers as nurses in the professional healthcare field.
[1] Monroe TB, Kenaga H, Dietrich MS, Carter MA, Cowan RL. The prevalence of employed nurses identified or enrolled in substance use monitoring programs. Nurs Res. 2013;62(1):10–15.
[2] American Nurses Association. Position statements on abuse of prescription drugs and random health care worker drug testing. http://www.nursingworld.org.
[3] AACN Fact Sheet – Nursing (aacnnursing.org)
[4] Monroe, T., Kenaga, H. “Don’t Ask, Don’t Tell: Substance Abuse and Addiction Among Nurses.” Journal of Clinical Nursing 2011
[5] Nurses With Substance Use Disorders: Where We Are and What Needs To Be Done. | Semantic Scholar
[6] Ibid.
[7] Professionals Resource Network – Impaired Practitioners Program of Florida (flprn.org)
