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iMpAiReD nUrSiNg

The power of storytelling.

Cathy Domingo

on 25 May 2011

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Transcript of iMpAiReD nUrSiNg

iMpAiRed NuRsInG What is impaired nursing? Cathy Domingo
Dani Johnson
Dot Bartell
Richelle Hicks Why is this important
to nursing? A presentation without a scenario
is like a cart without a horse. Increase cost to the facility Medication replacement costs increase Decreases patient care and professional standards of nursing Creates liability issues Hinders patient and nurse’s safety Statistics 1 in 12 nurses in the United States has an alcohol
or drug abuse problem that affects their practice
(American Journal of Public Health) 10 – 20% have a documented substance abuse problem (Griffith, 1999) Impaired nursing practice is defined
as a nurse’s inability to perform
essential job functions because of
chemical dependency on
drugs, alcohol or mental illness Risk factors for being an impaired nurse Family history of emotional impairment or alcoholism Emotional abuse Low self-esteem Workaholic Overachievers Increased access
to drugs and alcohol Poor coping skills and stress management Red Flags If a nurse consistently volunteers to administer medications, especially narcotics and other addictive substances
Administers the maximum dose when other nurses provide less
Initiating a physician’s order to change the amount or frequency of a PRN medication
Reporting that drug containers have been broken and contents lost
Tending to be responsible for patients who complain that a pain medication is not effective
Signing out larger doses than ordered when the required dose is available on unit
Documenting inconsistently on the narcotic control record Signs and Symptoms of Abuse Irritability, mood swings
Frequent absence from unit; frequent use of restroom
May work a lot of overtime, usually arriving early and staying late
Increased isolation from others
Elaborate excuses for behavior; unkempt appearance
Excessive discrepancies in signing and documentation procedures of controlled substances
Smell of alcohol on breath, or excessive use of mouthwash or mints What can be done? Texas Peer Assistance Program for Nurses (TPAPN) Program in
nurses can
refer nurses
to a
that helps
chemical or
abuse Nurse can voluntarily choose to participate
Referral can be done by telephone or by completing a referral form
No recourse for nurses who choose to enter the program, current position is held until nurse is able to return Educational
Programs The ANA believes that all
nurses should be educated
regarding: Abuse and addiction probability of using prescriptive drugs Factors that increase the chance of drug or alcohol abuse Legal ramifications of abusing substances What is being done? Changes in legislation and licensure boards
Addiction is no longer considered a character flaw, now considered a disease
Nurses are now given an option for rehabilitation treatment in lieu of being terminated
Increase use of automated drug dispensing systems decreases accessibility
Increased security including dual witness procedures for drawing up and wasting of high risk medications Nurse Jackie is an example of an impaired nurse! References CAN HealthPro. (2007). Intervention: risk management strategies for impaired nurses. Vantage Point: A Risk Management Resource for Hospitals and Health Systems, 07(1).http://www.cna.com/vcm_content/CNA/internet/Static%20File%20for%20Download/Risk%20Control/Medical%20Services/Intervention_Risk_Mgmt%20Strategies_for_Impaired_Nurses.pdf
Dunn, D. (2005). Substance abuse among nurses: defining the issue. AORN Journal. http://findarticles.com/p/articles/mi_m0FSL/is_4_82/ai_n15754444/
Griffith, J. (1999). Substance abuse disorders in nurses. Nursing Forum 34(4), 19-28. DOI:10.1111/j.1744-6198.1999.tb01167.x
Hrobak, M.L. (N.D.). Narcotic use and diversion in nursing. The University of Arizona College of Nursing. http://juns.nursing.arizona.edu/articles/Fall%202002/hrobak.htm
Talbert, J.J. (2009). Substance abuse among nurses. Clinical Journal of Oncology Nursing 13(1), 17-19. DOI:10.1188/09.CJON.17-19
Trinkoff, A.M., Storr, C.L. (1988). Substance use among nurses: differences between specialties. American Journal of Public Health 88(4), 581-585. DOI:10.2105/AJPH.88.4.581
Unity Healthcare. (2011). Tackle substance abuse in the workplace with these preventive measures. Strategies for Nurse Managers. http://www.strategiesfornursemanagers.com/ce_detail/75526.cfm
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