By: Angela Brooks
Over the last 23 years in mental health I have met several nurses who struggled with addiction. It all started very simple and under control, then it becomes their normal. I have worked with at least 10 nurses who have been addicted, lost their job and two lost their life to their addiction. How can we stop the addiction before it takes the person?
Most nurses regardless of their practice areas, experience the stresses of long shifts, overtime, and shift rotation, which are physically taxing and tough on family life and friendships. Added to that are emotional demands. Nurses often need to internalize their feelings to stay in control and make split-second, life-and-death decisions. Nurses go from one emotionally and physically demanding situation to another, with little time to decompress.
The availability of medications at work and the acceptance that drugs have the power to help you feel and perform better increases healthcare professionals’ risk of drug abuse.
Nurses have seen for themselves that medications can solve problems such as someone’s pain, or inability to sleep. Because of their access to and familiarity with drugs, nurses may feel comfortable using them on their own. Many nurses have the belief that, because of our skills and knowledge, we can self-medicate without becoming addicted. It is not true.
I have conversations weekly with nurses who will mention they take something to help them sleep, for anxiety, for depression, and these are just a few.
DRUGS OF CHOICE
While nurses’ abuse of drugs and alcohol is roughly equivalent to the general population’s, study have said, “dependence on prescription-type medication use is higher for nurses, and addiction to street drugs, such as cocaine and marijuana, is much lower than the population.” The most frequently abused substance is alcohol, followed by amphetamines, opiates (such as fentanyl), sedatives, tranquilizers, and inhalants, according to the ANA.
Nurses may ask doctors to write a prescription for them, or some have been known to steal a script and forge prescriptions themselves. The study also said. They also may divert drugs by administering a partial dose to a patient and saving the rest for themselves, or by asking a colleague to cosign a narcotics record saying a drug was wasted without witnessing the drug’s disposal.” Some nurses have signed out medications for patients who have been transferred to another unit or obtained as-needed medications for patients who have refused or not requested them.
Employers have an ethical obligation and most have a legal mandate to report an impaired nurse. Nurses also have an ethical obligation to address impairment of a colleague, but it is never easy and they always deny they have a problem.
Many nurses are not educated about how to recognize or intervene with a colleague who is abusing drugs or alcohol. Most healthcare facilities choose to fire employees with addiction problems rather than deal with the issue directly, leaving the addicted individual free to apply for employment elsewhere and put other patients at risk. Where does the addiction stop?
Self Reporting is Rare
If confronted and found to be using – the nurse’s license may be temporarily suspended until he or she demonstrates progress in recovery. Some nurses are never able to return to the health care profession.
Recovering nurses, however, will not have access to narcotics and must be constantly supervised by other nurses until their licenses are fully restored, which can take months or years depending on the nurse’s situation. Which then causes conflict with the nurse’s peers due to lack of trust, and their inability to work in their full scope of practice. Making it hard on the team that is already shorthanded on that shift.
A few standard signs to look for in a co-worker who is abusing:
» Changes jobs frequently
» Prefers night or off-shifts where there is less supervision and more access to medication
» Smells of alcohol or pinpoint pupils or glassy eyes
» Trouble focusing on work
» Good relationships with doctors who may prescribe medication for them
» Often volunteers to administer narcotics to patients
» Patients may complain of inadequate pain relief
» Incomplete charting and practice errors
» Anxious to work overtime or extra shifts
» Moody or isolated, lethargic or high-strung
Anyone is at risk of addiction, no matter whether he or she is young or older, an LPN or RN, or has a master’s degree or PhD.
First the person takes the drug, and then the drug takes the person.