Nursing Dilemmas : Nursing Impairments And Consequences

The Missouri Nursing Practice Act governs the requirements for obtaining and it also empowers the Missouri State Board of Nursing with the ability to take disciplinary action against a nurse’s license. The Missouri State Board of Nursing can issue, deny, or reinstate a license. The board can also take disciplinary action against a license and “impose any of the following disciplines singularly or in combination: censure, probation, suspension, & revocation” (Missouri State Board of Nursing, 2015a) when a registered nurse violates the Nursing Practice Act. A license can be denied, revoked, or suspended for the following reasons: drug abuse, alcohol abuse, incompetency, negligence, fraud, dishonesty, over charging, over treating, misconduct, misrepresentation, unethical conduct, unprofessional conduct, inappropriate relationships, performing duties beyond the scope of practice, inappropriate delegation, being listed as a sex offender, failure to pay license renewal fees, failure to cooperate with the board during an investigation, for a full detailed list see 335.066 of the Missouri Nursing Practice Act (Missouri State Board of Nursing, 2014).

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

“Be the one who nurtures and builds. Be the one who has an understanding and forgiving heart one who looks for the best in people. Leave people better than you found them.” Nursing is more than just doing assessments and giving medications; it is going beyond that to know what is right or wrong, what can and cannot be done, and what is considered harming the patients rather than doing them good. In nursing, there is a fine line between what is considered to be negligence and beneficence. According to Marquis (2017), “Ethics is the systemic study of what a person’s conduct and actions should be with regard to self, others human beings, and the environment (pg. 83), on the other hand, it does not necessarily mean that their

Jackie was one of the growing numbers of nurses who are impaired because of addiction. Sullivan (1994) cited that “nurses who abuse substances not only place themselves at risk for physical, emotional, and professional harm, but also create hazards for the institutions in which they work as well as the public” (p. 20). To deal with the issue posed by an impaired nurse, “nursing leaders must consider legal, regulatory, ethical, humanistic, and practical considerations in

Nurses rely on personal knowledge and their professional skills to provide ethical care (Creasia & Friberg, 2011). In everyday practice, nurses must balance the needs of their patients against those of the organization, society and themselves. They strive to deliver the highest level of care for patients, but adjusting for limited organizational and personal resources often requires difficult decisions. This paper explores the following scenario suggested by Maville and Huerta: “You are a nurse providing home care to a mother, and you suspect child abuse after observing the mother’s reaction to her child” (as cited by Arizona State University, 2014). When faced with a moral dilemma, a competent nurse incorporates ethical, bioethical and legal considerations. In the proposed story, incorporating the nursing ethics of advocacy, beneficence, nonmaleficence and collaboration will guide the nurse towards an appropriate and legal course of action.

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

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 decision made by the Virginia Board of Nursing concluded with an indefinite suspension of her license until a monitoring rehabilitation program has been completed. The Health Care Practitioners Program will be customized for the specific criteria that the defendant needs. If the defendant does not complete all parts of the program, she will have to come before the board to discuss the issue. The defendant stated during the hearing that she “does not trust herself around narcotics and needles.” Therefore, the board decided that she will not be able to work in a setting where she has access to either of those. The rest of the details of her implications are to be determined as a later time.

is a nurse practicing in Missouri that has, already, previously been placed on probation for testing positive for heroin. She has recently had a relapse in her recovery and is fighting to get her license back so she can practice nursing. The state board has already given her one chance and she was practicing in Missouri. She has been sober for nearly 3 years and has taken suboxone the entire time of her sobriety to help with withdrawal. E.M. hates that she has a dependency on the suboxone and wanted very badly to wean herself off of it. She spoke with her physician about this matter and her physician strongly suggested that she not be taken completely off her prescription of suboxone. Her physician lowered her dose and she began taking a lower dose. After time passed, E.M. felt like she had things under control and she completely stopped taking her prescription. E.M. went under some stress at her job and ended up leaving the facility she was working at. She knew that one of her old co-workers had access to heroin and after running into him at a local store, she started abusing again. Beginning at the time of her first time being placed on probation E.M. has been required to provide urine samples at randomly selected intervals. During her time of remission, when she was abusing, she failed to call and leave urine samples. At this time, E.M. explained that she was focusing on bettering herself and working on her sobriety. I feel that E.M. was very sincere and was accountable for her actions. She truthfully took responsibility for her wrongful actions. E.M. stated that she now realizes that her heroin addiction is a lifelong addiction that will always be knocking at her door and she cannot stop taking suboxone. The board questioned her and wanted to make sure she did not have plans of going against her physician’s orders again. E.M. was in tears almost the entire time she was explaining her actions to the members of the board and I feel like they were true

Nurses have a professional responsibility to ensure that safe boundaries are kept in the relationship between patient and Nurse. It is these boundaries that provide the nursing profession with integrity, and according to Baca (2010, pp.195) it is essential these boundaries be maintained because of the difference in power between the nurse and patient. However, boundary violations can occur, when a nurse crosses from the zone of helpfulness to over involved, the ANMC (2011 pp.3) believes that when a violation occurs a nurse is behaving unprofessional manner and misusing their power in the patient nurse relationship. This misuse of power can be categorized into 3 types; boundary crossing, boundary violation and the extreme form of sexual misconduct. Often by mistake a nurse could cross the boundary without thought, a

It is essential that nurses are capable of incorporating theory into their practice. Recognizing fundamental concepts such as vulnerability is a crucial element to providing effective care. Vulnerability is an elusive concept that is described as part of the human condition (Sellman, 2005). The process of vulnerability itself is very individualized and may be presented differently for each person experiencing it (De Santis & Barroso, 2011). Within this paper, I will extensively explore the definition of vulnerability, the defining factors that embody the concept, and how the knowledge of this concept can influence nursing practice.

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.

Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriate legal and ethical decisions. Even though most nursing programs cover the ethical and moral issues in health care, it is questionable if new nurses have the depth of knowledge and understanding of these issues and apply them in their practice

Ethical issues in nursing will always be an ongoing learning process. Nurses are taught in nursing school what should be done and how. Scenarios are given on tests with one right answer. However, there are situations that nurses may encounter that may have multiple answers and it is hard to choose one. “Ethical directives are not always clearly evident and people sometimes disagree about what is right and wrong” (Butts & Rich, 2016). When an ethical decision is made by a nurse, there must be a logical justification and not just emotions.

When reflecting on the above situation I think it is clear that Emily had a responsibility to act. The act of falsifying training documents to increase staffing on the floor seems, at first glance, relatively benign. However, think of the backlash this could have not just operationally but to someone’s personal life. The impact a misinformed or inadequately trained nurse could have is profound as a simple wrong move could cost someone his or her life. Due to the severity of the situation and as a nurse, Emily had the responsibility to take action. Despite how unpopular a decision it was Emily did the right thing. Getting through the near-term negative backlash is easy in comparison to dealing with the long-term effect of not taking action.