Impaired Nurses: Substance Abuse Treatment


Impaired nurses are regarded to be the victims of drug and alcohol dependence. The cases of substance abuse in the workplace have become a frequent occasion and, therefore, it constitutes a serious threat to the patients and the health care system in general. The percentage of nurses who have a substance abuse problem is increasing in the United States and, therefore, it should be carefully considered by many health care organizations. To enhance the welfare of patients, the nurses who are dependent on alcohol and drugs should be monitored to take preventive measures and different kinds of treatments (Kozier et al. 1992, p. 23).

There are many organizations and research centers whose primary purpose is to identify, evaluate, examine, and prevent the causes and outcomes of nurses’ impairment. To protect patients from the impact of medical professionals abusing drugs and alcohol, numerous approaches and schemes have been worked out to identify the behavioral patterns and salient symptoms. Such approaches are supported by the law regulating license suspension issues and penalty levels for patients. About the presented researches and evaluations, many organizations are more likely to provide impaired nurses with substance abuse treatment rather than with punishment that is considered to be a less effective approach.

Alarming Statistics of Impaired Nurses

Over the years, the number of nurses suffering from substance abuse has been increased. The rate among the practicing nurses working under the influence of drugs and alcohol in the entire world amounts to 20 % of the overall nurses (Blais, 2006, p.81). Nurses are exposed to numerous types of addictions, such as alcohol abuse and chemical dependence. According to recent statistical data, nearly 13 % of the US employed population is dependent on alcohol and other substances. The dominance of substance abuse among the nurse staff is not officially documented. Nevertheless, it is estimated that about 10 % of nurses are impaired (Dun, 2005, p. 10). Hence, the American Nurses Association has revealed that about 7 % of nurses are addicted either to drugs or to alcohol (Dun, 2005, p. 10).

The hospital professionals usually admit that substance addiction is an issue of concern among the nurse staff. The point is that nurses have access to drug supplies, which increases the extent of drug availability. More importantly, nurses are obliged to ensure the patient’s welfare and security. The nurses, thus, find it admissible to perform their responsibilities under the influence of drugs. Therefore, the problem of drug abuse by the nurses becomes more attached to legal issues (Blais, 2006, P.83).

Causes of Impairment in the Workplace

Impairment of nurses in the workplace is caused by an individual, lifestyle, family, developmental, and environmental factors (Stuart and Michele, 2001, p. 64). Individual or generic factors cause impairment of nurses in their workplace and are presented through the different extent of individuals’ susceptibility to addiction. In other words, specific traits of personality influence individuals experimenting with various substances. Thus, some of the reasons for impairment may be attributed to hereditary aspects.

Family factors causing impairment are largely connected with family problems. In particular, family with positive relations seems to be less encouraged to use illicit drugs. However, children brought up in an unfavorable climate are more likely to addict to alcohol and drugs.

Emotional or developmental factors cause addiction in the workplace. Hence, people usually abuse drugs and alcohol to get rid of stress and problems. Certainly, health professionals are often under pressure, and therefore, they become impaired to reduce their job-related stress (Stuart and Michele, 2001, p. 65).

Environmental factors in the workplace also influence nurses’ rejection or acceptance of substance abuse. Taking into account various stresses and problems of life can negatively contribute to an individual’s professional qualities and awareness (Stuart and Michele, 2001, p. 65). In this respect, to handle those difficulties and adjust to the environment, nurses often abuse alcohol and other chemical substances.

Finally, the developmental factors have also a huge impact on the problem of nurse impairment. The issue is particularly connected with the formation of specific behavioral patterns and role models played by people in life. Hence, some individuals are not aware of the actual outcomes of their inappropriate behavior and, therefore, they are incapable to solve the problems in a different way (Stuart and Michele, 2001, p. 66). In this regard, it is necessary to identify those factors and evaluate the seriousness of this problem for individuals working in the health care field.

In general, all these factors should be carefully tackled to understand the appropriateness of applying to substance abuse treatment rather than punitive measures preventing impairment in the workplace.

Impacts of Impairment on Nurses in the Workplace

Impairment of nurses has certain consequences. Firstly, the impairment of nurses is associated with inconsistency and problems with working conditions, and, therefore, addicted nurses usually act negligently in their workplace. Such inconsistencies may include the failure to accurately maintain the patient’s records, taking incorrect entries in the patients’ records, among others. Impairment of nurses usually leads to serious difficulties fulfilling duties and obligations to patients.

This means that nurses are unable to carry out their duties properly. In most cases, nurses abusing alcohol and drugs do not adhere to healthcare policies and procedures. Therefore, these professionals are less reliable as they spend much time taking alcohol or drugs instead of fulfilling their duties (Lefever et al., 2003, p.43). As a result of impairment, the nurses may find themselves repeating the same actions and, as a result, they fail to meet the deadlines.

Impairment of nurses makes the nurses have unrealistic excuses about low performance. Under such circumstances, the nurses who work under the influence of drugs and alcohol resort to lame excuses once their low performance is questioned. The impaired nurses are always complaining rather than finding means of enhancing their performance.

Nurses suffering from alcohol and drug addiction may make gross mistakes while carrying out their duties and responsibilities. There are frequent cases when those serious mistakes can lead to considerable financial losses. What is more problematic is that they may prescribe the wrong medication to the patients, which can cause death, or deterioration of the diseases. Therefore, the wellbeing and safety of patients are largely dependent on the healthcare providers and attitude to patients’ care.

In most cases, impaired nurses tend to have long breaks as well as absenteeism in the workplace. They also negatively influence the overall work in the employed environment. In particular, their inappropriate action can cause serious derails in the work of the medical staff (Lefever, p.43). The slightest deviations from the working process can lead to inevitable consequences and impose some legal obligations on impaired nurses.

Key Leaders Involved in This Issue

Substance abuse among nurses is an urgent problem; it presents itself professionally as nurse impairment in the workplace. Treating these nurses like they have a disease and providing substance abuse treatment rather than punishment should be the preferred approach. The methods that are being applied today in dealing with the problem of nurses’ impairment are not much punitive as those which were used before. So far, impaired chemically dependent nurses were dismissed from their working positions. Nowadays, preventive measures have become more democratic.

The emergence of professional associations has played a big role in dealing with the problem of impaired nurses. In particular, the passage of a law that addresses the nurses’ issues has been significant in treating the adversities. Hospitals are therefore mandated to make known to the state’s nursing boards all the cases concerning chemical dependence. The law requires the nurse to appear before the hearing panel so that substance abuse charges can be made.

It is very hard for nurses to have their licenses revoked (Marquis and Huston, 2008, p.65). In the majority of cases, the impaired nurses are put on probation, which gives them chances for rehabilitation. The number of nurses’ licenses was revoked because of substance abuse in the working place. This should not be the case in today’s world and, instead, the nurses should be treated as patients to salvage them from addiction.

The impaired nurses should be encouraged in their desire to get rid of their problems with alcohol and drug addiction. The diversion program could be the most appropriate in dealing with the issue. Diversion programs have been implemented by more than 30 states around the world to enable nurses to recover in terms of their health, self-esteem, and productivity. Many diversion programs also provide the nurses and their close relatives with free counseling services. The health condition of the nurses is also monitored to determine whether they can return to work (Marquis and Huston, 2008, p.67).


The impairment of nurses has been an issue of concern in the past few years. The impairment also affects the nurses’ cognitive and interpersonal abilities. Also, this problem of substances abuse poses a great danger to the patients. Therefore, the nurses are responsible for all deeds and problems they cause to heal care. The impaired nurse should be provided with intervention programs that are appropriate for treatment. Many countries around the world have devised programs that allow the nurses to continue working but on a license basis. Usually, many nurses fail to seek help to deal with the addiction problem due because of the fear to be punished.

However, impaired nurses need to be supported to improve the situation in the field of medical care. The impaired nurses should be treated as though they have diseases by providing substance abuse treatment instead of punishment. This should be the preferred approach in countering the growing problem of substance abuse and alcoholism among the nurses and ensuring that patients’ welfare is catered for. Punitive methods should not be used in dealing with the impaired nurses because it hinders the reporting of impairment and makes the impaired nurses continue concealing their problems.

Reference List

Blais, K. (2006). Professional nursing practice: concepts and perspectives. London: Pearson/Prentice Hall.

Dun, D. (2005). Substance abuse among nurses: defining the issue. AORN Journal. (1), 26-43.

Kozier, B., Erb, G. and Blais, K. (1992). Concepts and issues in nursing practice. US: Benjamin-Cummings Publishing Company.

Lefever, (2003). Pharmacology: a nursing process approach. London: Saunders.

Marquis, L. B. & Huston, C. J. (2008). Leadership Roles and Management Functions in Nursing. Missouri: Mosby.

Stuart, D., & Michele, S. (2001). Principles and practice of psychiatric nursing: Theory and Application. Philadelphia : Lippincott Williams & Wilkins.

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