Addiction More Prevalent Than You Think….

Supporting Nursing Staff to Overcome Drug Addiction

Research suggests that the incidence of addiction amongst nurses is 10-15%, though in some areas of work this may be as great as 20%; studies have indicated that nurses working in the emergency department of hospitals are at particular risk. This isn’t just an issue for their own health, as while under the influence of drugs – whether they are prescription medications or illegal substances – their physical abilities, judgment and decision making can all be impaired, which can place patients at significant risk of harm. Although traditionally nurses with addictions would have been dismissed, the move towards providing them with support to make a recovery and return to practice has become the preferred option. Here we consider why nurses are vulnerable to addictions and how their problems can be addressed with the help of their colleagues and employers.

Contributing factors to addiction amongst nurses

A number of elements relating to the environment in which nurses work places them at risk of developing drug addictions, especially to those drugs that are prescribed. Firstly, as with many jobs, high demands are placed upon nursing staff and they can feel under a lot of pressure to achieve what feels unachievable during their shift; as a consequence stress is a common problem amongst nurses and drugs are used by some as a means to help them deal with this. Similarly, they may be taken to help manage the emotional distress felt after working with difficult cases. Shift working and the significant over-time nurses are expected to work to cover absence of colleagues and unfilled posts can soon take its toll leading to tiredness; it is understandable they may feel like they need something to pick themselves up. Working long hours on their feet and handling patients and equipment can also lead to musculo-skeletal injuries; taking pain killers to manage these problems can become a habit which is hard to break. Nurses’ familiarity with medications and their ease of access to drugs at work means that it is not difficult for nurses to know which will have the desired effect and to get hold of these.

Signs nurses may have an addiction

Although nurses may convince themselves they don’t have a problem or they try to hide this, there may be some outward signs visible to their colleagues and employers that addiction could be an issue for a member of staff. Nurses who work extra hours, but who appear to have extra breaks during a shift could be displaying this behaviour to access and take drugs out of sight. Errors in documentation for medications can be another tell-tale sign; large amounts of controlled drugs might be signed out or medication might be signed as having been given to patients who have already left the unit. Other things to be vigilant for include nurses offering to do extra medication rounds, those recording a high level of medication wastage or patients consistently complaining of pain despite it being documented they have received their pain killers. In the longer term, a nurse whose performance at work declines could also indicate a problem with drug addiction.

Addressing their addiction and aiding recovery

The Code of Ethics for Registered Nurses requires nurses who have a problem with addiction to address the issue if they wish to keep practicing; the same guidelines also require nurses to intervene if they suspect a colleague’s behaviour may place patients at risk. However, the culture that would aid either of these is not always present in healthcare settings, so nursing staff do not feel comfortable disclosing information regarding these.

The fact that addiction is still considered by some as a failing and a consequence of poor will power means that a stigma still exists around admitting that you have a problem with addiction. As with anyone, feelings of fear and guilt exist, along with worries that they will lose their friends and job if their addiction comes to light. It is however even more difficult for nurses or anyone else who works in a healthcare setting, as their addiction breaks professional ethics, endangers patients and both their professional reputation and that of their workplace are at stake. This not only acts as barrier to seeking help, but can also influence the level of support provided at work. Colleagues view them more strictly than their patients struggling with addictions and do not show the same level of compassion towards them.

Those nurses who recognize their problem as an illness are more likely to seek help by themselves; they will be respected for admitting their illness rather than being reported. Colleagues and workplaces who take the same viewpoint regarding addictions are also more likely to be supportive of staff affected by them. Offering help with addictions is indeed more beneficial to all involved than considering dismissal; this can be provided by employee services or independent healthcare services. Not only does it allow patient protection, but entry into treatment is more likely to lead to a full recovery than trying to overcome addiction alone. Research suggests that for those nurses taking part in an addiction program as many as 80% may be able to return to practice, with only 25% suffering a later relapse. Remaining in employment also provides the financial means to participate in treatment for medication addiction. However, nurses still need to be aware that addiction impacts on their practice, that they may risk losing their nursing license and the police may be involved if they are found to be diverting drugs for their own use.

While employers play an important role in developing effective strategies for controlling access to controlled drugs, they also need to address working conditions, as these can often be a cause of turning to prescription medications or illegal substances. Although the safety of patients is of prime importance, promoting the health and well-being of their staff should not be neglected. Open communication within the healthcare settings can be facilitated by discussing the problems of substance abuse, creating an atmosphere where staff feel they can report problems regarding themselves or another person. Employers also have a duty to ensure they provide their staff with time to participate in rehabilitation programs and then support nurses on their return to work.

 Lily McCann

One Response to “Addiction More Prevalent Than You Think….”

  1. Aw, this was an exceptionally good post. Spending some time and actual effort to produce a very good article… but what can I say… I put things off a lot and don’t seem to get anything done.

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