Chemically Impaired Nurses

As the article The Impaired Nurse stated, “Impaired nurses can become dysfunctional in their ability to provide safe, appropriate patient care” (Thomas, C.M., & Siela, D. 2011). As we learned in class the four ethical principles include; beneficence which is the act of doing the most good, non-malfeasance which is the act of doing the least amount of harm, autonomy which focuses on allowing each individual to make their own decisions and justice which focuses on being fair to all involved. Nurses who are abusing substance typically can’t follow these for ethical principles to the best of their ability because they are too focused on themselves. As mentioned in the article Substance Abuse among Nurses, nurses who are abusing substances are not able to complete tasks and function as a typical nurse would (Talbert, J. J. 2009). These types of nurses are not able to apply the four ethical principles to their everyday work environment because they are too focused on the substances they need. These nurses would not be able to function and apply to principle of doing the most good because they will not be doing the best if on substances. As mentioned in both articles, these nurses will spend a good amount of time in the bathrooms hiding and using, take medications from patients, and forget tasks that need complete. Beneficence and non-malfeasance in my opinion could not apply to nurses who are abusing substances because they are not caring for their patients as

Regrettably, the existence of nursing depends on the medical inadequacy of others. Unfortunately, nursing exists because people get hurt, cannot care for themselves, or need assistance with daily activities. Carol Taylor (2011), author of Fundamentals of Nursing: The Art and Science of Nursing Care, writes, “Nursing care involves any number of activities, from carrying out complicated technical procedures to something as seemingly as holding a hand” (p. 5). Taylor explains it is the duty of a nurse not only to learn the pertinent skills but also to bond with and comfort others. Nurses have to do and become many things: They must be stern when necessary, compassionate when needed, open minded

Nurse prescribing was first suggested by the Royal Collage of nursing (RCN) in 1980, it was to take another six years for it to become part of the government’s agenda with the Cumberlege Report in 1986 (Department of Health and Social Security (DHSS)(1986). These two report

Staff nurses have great responsibilities in caring for patients. Often, these nurses experience heavy workload. Heavy patient load and stress contributes to burnout. Why is burnout important to discuss in relation to nurses? Burnout affects the performance of the nurse and the quality of care he or she provides to the patient. Therefore, it is imperative that staff nurses decrease the possibility of burnout and increase or maintain excitement and enjoyment in the field of nursing. If nurses do so, they will find joy in their work and quality of patient care will be increased. Contributors to burnout and

For nurses extending their role to include prescribing there is much to consider. Revelay (1999) states that, accountability involves an individual giving an account of their actions with the rationale and explanation given for these actions. The decisions regarding boundaries of practice are firmly placed in the hands of the individual practitioner (Carlisle 1992). Accountability means being able to justify any actions and accepting responsibility for them, and is an integral part of nursing practice (Rowe 2000) The NMC Code of Professional Conduct (2004) states that a nurse is personally accountable for her practice, has a duty of care to patients and must work within the laws of the country.

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

As in the emergency department, nurses were 3.5 times as likely to use marijuana and cocaine (Young, 2008). Nurses are using substances as a coping mechanism to their stressful work environment. Excessive workload due to the nursing shortage, shift rotations, working longer hours and floating to different units leads nurses to high stress levels (Epstein et al., 2010). In addition to alcohol and substances nurses can access in the streets, nurses can also abuse substances at work through their patients medications.

In today 's world, many health care organizations encounter the most critical problem, such as chemically impaired nursing practice, on a daily basis. All areas of the nursing profession are affected by a chemical dependency and the cost associated with this problem is a great concern for the health care organizations. According to Church (2000), “nurse impairment affects the safety of the public, the nurse’s well being and the profession as a whole” (p. 2). The delivery of care provided by the chemically impaired nurse lowers the standards and the prestige of the whole profession, creates serious liability for the employer, lowers productivity, increases the turnover rate, decreases staff members morale, and increases the risk for medication error (Wennerstrom and Rhooda, 1996). People’s lives, function and lifestyle can be dramatically changed due to a medication error caused by a chemically impaired nurse (Cook, 2014). The chief nurse executive (CNE) is frequently confronted with the problem of impaired nurse, furthermore, the CNE is responsible for the policy and decision making involving this issue (Hughes, 1995). The purpose of this paper is to examine nurse executives response to allegations of a chemically impaired nurse.

The profession of nursing requires a capacity and joy for caring and healing others both mentally and physically. Nurses spend their careers caring for patients and their families often in the worst and most frightening periods of their lives. Nursing responsibilities can be lengthy, stressful and physically and emotionally demanding. The demands of the nursing profession coupled with the nursing shortage and longer work hours put even more stress on nurses. Despite these extreme demands, many nurses do not fully appreciate the importance self-care. Yet without proper care for themselves, nurses are not able to provide the best care for their patients.

Nurse prescribing was first recommended, by the RCN, in 1980 and became part of the government’s policy agenda in 1986 with the Cumberlege Report (DH 1986). Further, the Crown Report (DH 1989) advocated prescribing by trained community nurses from a limited formulary. Legislation was introduced in 1992 -The Medicinal Products: Prescription By Nurses Act, 1992 followed by secondary legislation,

The expectations for any nursing student, dedicated and compassionate, is not easily found. A hard worker is made through the experience of rigorous academic courses, balanced with character building

The specific prevalence of substance abuse among nurses seems to be up for discussion and thus far there hasn't been any factual irrefutable evidence (Chait, J., p.2). Although, “it has been estimated that ten to fifteen percent of all nurses in the United States are addicted to some type of illegal or controlled substance" (Heacock, S., 2013, p.1). Nauert believes that the incidence of substance abuse among nurses, and nursing students, is both under-researched and under-reported(2011). New research suggests as many as ten to twenty per cent of nurses and nursing students may have substance abuse and addiction problems (Nauert, R., 2011, p.1).

Looking back over 150 years ago, the nursing profession has changed drastically. Even just the uniform of nurses changed from the white dresses with panty hose and a white cap to scrubs with pants. Here are a few other examples of change in the profession: “there was a time in the past when only physicians took blood pressures, performed phlebotomy and administered blood; and not so long ago, only RNs – not LPNs – were allowed to administer IV medications” (Daley, 2013, p.4433). With our ever changing health care industry, including the 2010 Affordable Care Act, the nursing profession needs to continue to improve their

Drug administration forms a major part of the clinical nurse’s role. Medicines are prescribed by the doctor and dispensed by the

The basic insight of the sociological perspective is that the world does not consist of a reality that everyone sees in exactly the same way and that each and every one of us possesses our own individual social construction of reality (the sum total of our life experience, observations and thoughts.) The Micro level of analysis is that which pertains to the individual and the macro level applies to the larger society.