Jackie : The Impaired Nurse Essay

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

According to Suzanne Gordon “ whether young or old, nurses are disillusioned because they believe that health care systems guided by bottom-line concerns simply don’t recognize the specificity of their work” (234). Nursing is more demanding than many other professions or occupations, due to the combination of difficult patients, exhausting schedules and arduous physical work (Gordon 235). It can take a significant emotional toll on many, hence the higher levels of burnout. Job dissatisfaction as a result of increased workloads and unreasonable demands, such as inappropriate nurse staffing levels, was cited as the number one reason that drives many experienced nurses to leave the profession (Sanford 38+). Studies have shown that such working conditions also affected the retention of new graduate nurses by leaving their first hospital jobs within two years of graduating (Sanford 38+).

The responsibility of regulating nursing practice that ensures public safety, health and welfare and accountability to the public for proper governance falls on the State Boards of Nursing (BONs). Substance abuse is the most common disease that affects healthcare workers (Darbro, 2009). The disease of substance abuse disorder is preventable (Darbro, 2009). The intent of this paper is to discuss the ethical issues of nurses with substance abuse disorder, stigma of addiction, challenges that nurses with substance abuse problems face to include acceptance of the disease, treatment, rehabilitation and monitoring, the incidence of addiction among nurses, how to recognize an impaired colleague, nurses’ attitudes about addiction within the profession and the ethical issues that the nurse, employer and society face when dealing with a nurse who is an addict. It was in the 1980s that professional nursing organizations recommended alternative to discipline (ATD) programs to help rehabilitate nurses (Sigma Theta Tau, 2014). In the past 20 years 46 states have gone with this approach as opposed to traditional discipline (Trussman, 2003). In most cases, these ATD programs provide nurses with intense monitoring for 5 years to aid in their recovery so they may return to work and provide safe patient care to the

Easy access to the drugs is another important factor contributing to nurses who substance abuse. As stated by Serghis (1999) the availability of medications in the workplace has been linked to substance abuse among nurses (as cited in Talbert, 2009, p.17). Part of the nurse’s duty every day is to give medication to their patients, which exposes them to have easy access to drugs. Nurses who take medication from their patients for their own personal use are "always using the maximum PRN dosage when other nurses use less" (DeClerk, 2008, p. 12). The healthcare field accepts the use of medication and so nurses may perceive the wrong idea by making use of patients drugs themselves. "Medications are easily accessible to nurses, who may believe erroneously that they have the ability to control their own medications use because of their experience with administering medication to patients" (Talbert, 2009, p. 17). In the case

According to the SAMHSA (2010) report on the national survey on drug use and health almost 22.5 million people are reported to be associated with substance abuse disorder (SAMHSA, 2010). This illness was found to be very common in all age groups, both sex, and seniors. There are several effects on these individuals and their families. Many people who suffer from substance abuse disorders fail to acknowledge these serious consequences. First of all, no response of pain relief can be seen with smaller doses of pain medications, as their bodies are used to high levels of various substances at the same time. Nurses become frustrated when they try to treat and help these patients with pain. Sometimes it is difficult to think about ethical principles when nurses have to deal with such patients with pain and suffering.

Within the pilot episode of Nurse Jackie, which premiered in 2009, Jackie Peyton, an emergency department RN is introduced. Nurse Jackie is an American television show set in New York city. It’s main character, Jackie, is a mother of two, married, and is addicted to prescription drugs. There are many events within this first episode, both in Jackie’s personal and work life. Jackie forges a patient’s signature on a donor card, flushes a patient’s ear down a toilet, almost kills a patient, and is having an affair with the pharmacist, who in turn is providing her with prescription drugs which she has become addicted to. Within this episode alone, Jackie goes against many nursing ethics, which does not portray nursing in a very good light.

Substance abuse continues to be a serious health care concern with millions of American 18 and older using illegal drugs. Substance abuse occurs across all generations, cultures, and occupations, including nursing. “About 1 in 10, or 10-15% of all nurses, may be impaired or in recovery from alcohol or drug addiction” (Thomas & Siela, 2011). When a nurse is impaired they will not be able to function at their normal capacity, and are not able to provide quality patient care. They may not be able to think as quickly, and have a delayed reaction time.

In the hospital patient and the health professional that patients have a certain specific right and must be treated as a person with dignity. They are neither mere objects to be manipulated by a professional nor subservient individual who has waived their right simple by becoming hospital patient. In Confucius ' teachings, ritual encompassed both moral practices, respect and traditional values. Confucius taught that there were mutual obligations arising between members of social relationships, for example, as between Husband and Wife, Parents and Children, Older Brother and Younger Brother, and so on. From the reads, Lisa’s articles and confess it seems both theories describes the values and morals and the relationship of humanity. However, in the article in defense of the traditional nurse, writing by Lisa H. Newton, she shows that nurse should be fully traditional become a nurturing synthetic mother of the patient.

The profession of nursing is usually described as high-demand job, as well as stressful. The American Association of Critical-Care Nurses believes that nurses can empower their work environments and truly make a difference (AACN, 2016). Although nurses have the ability to join committees and help make changes slowly, there are many factors in the nursing that cannot be changed by nurses. “The global increase in the aged population, the intensity of health care problems, the incidence of chronic illnesses and advanced technology, nurses are faced with a variety of work-related stressors” (Lambert & Lambert, 2008, p. 38). Regardless of nursing communication and social aspects of units, nurses need to accept some stressors as they are and

Many people have turned to substance abuse or experience chemical dependency for a variety of reasons. Nurses experience chemical dependency as well. According to Kunyk (2013), “healthcare professionals, including nurses, are also potentially vulnerable to substance use disorders regardless of any special knowledge, skills or insights they might have owing to their education and professional experiences” (p. 54). This paper will define what chemical dependency is, report causes of chemical dependency in nurses, describe behaviors associated with chemical dependency, and explain what needs to be done upon reentry into the work place.

Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.

In first talking about substance use, abuse and addiction as it relates to the Nursing profession it is necessary to understand the aspect of addiction. Drug use is a broad idea that refers to the use of any chemical substance rather legal or illegal. This topic includes prescription drugs, street drugs, herbal supplements, and the like. The term Drug abuse is defined as “the use of a substance or substances in such a way that it leads to measurable personal, interpersonal, or social consequences” (Faupel, C., E., Horowitz, A., M., & Weaver, G., S., 2010, p.20). Drug addiction is then regarded as “a compulsive use of chemicals (drugs or alcohol) and the inability to stop using them despite all the problems caused by their use” (National

According to Hunt (2009), feeling overworked is the number one cause for nurse turnover in health care settings. Other reasons at the top of the list include, lack of support from employers and few opportunities for advancement. Due to the nursing shortage, staffing has been an issue in many healthcare facilities. As a result, units are consistently short staffed, causing nurses to feel overworked and unsupported by management. Cline (2004) highlighted nurse frustration when a participant in the study stated, “When you’re constantly short-staffed and feel your managers aren’t supporting you at least by saying, ‘Thank you, I know you must’ve had a hard

According to the American Nurses Association, an impaired nurse is unable to meet the requirements of the code of ethics and standards of practice of the profession. This nurse has cognitive, interpersonal or psychomotor skills affected by psychiatric illness and/or drug or alcohol abuse of addiction (American Nurses Association, 2010). Not only do these nurses create a potential threat to their clients, but they have also neglected to care for themselves.

There are numerous elements that contribute to stress in the healthcare setting. Nurses’ days are full of physical, mental and emotional demands. There are societal demands and workplace demands created by the shortage. These stressors can become increasingly overwhelming and if there is no stress relief, job performance can and will be hindered. When fatigue and stress combine there is potential for “performance decrements”. This can include diminished capacity to manage a specific level of workload resulting in errors in the delivery of nursing care. This can produce damaging effects on the safety and advantageous outcomes for both the nurses and patients. (Reese, 2011). Therefore, finding a balance between lowering stress levels of