Substance abuse and addiction in

health professionals
William Russell BS, RN.

Welcome!

You all have been selected to participate in a
seminar addressing the issue of substance abuse
and addiction in health care professionals
(nurses). The objective of this seminar is not to
lecture on the dangers of addiction, or to be a
venue to persuade you all to think of addiction in
one way or another. The objective of this seminar
is to bring up the topic of addiction in nursing for
discussion and to collect opinions from class
members. Various ways of collecting data will be
used in this seminar.

Introduction
Issue: The health care environment is a
stressful one. Though recent studies suggest
that the prevalence of substance in no higher
in health care professionals (HP) than the
general population, given the responsibility to
the public, any impairment could place the
public at increased risk for errors. (Kenna &
Lewis, 2008)
Nursing is no exception.


Introduction continued.
Alcohol and other drug dependence in nurses
reeks havoc in the nurses life, the nurses
coworkers, the nurses friends and family, as
well as the patients he or she serves. The pool
of research available to explore the risk factors
of addiction in nurses, prevention and
treatment for addicted nurses is rather
limited.
Objectives

Follow directions of the seminar. The
directions are highlighted in the following
slides.
Participate in the following assignments

Theory base
National and state organizations need to develop policies
that focus on prevention, treatment, and the rehabilitation
of alcohol and other drug-using professionals. (Kenna &
Lewis. 2008)
Poor or ineffective policies that mandate punitive action
endanger the public by making it difficult for impaired
students or professionals to ask for help. (Monroe &
Kenaga. 2011).
Addiction among nurses has been recognized professionals
in the field for over 100 years, and current estimates place
rates of substance misuse, abuse and addiction rates as
high as 20% among practicing nurses. (Monroe &Kenaga.
2011).


Theory base continued
Like many psychological disorders, drug
dependence depends on several things. Two
main factors include:
Environment. Environmental factors include
your families beliefs and attitudes and exposure to
a peer group that encourages drug use seem to play
a role in initial drug use.
Genes. Once youve started using a drug, the
development in to addiction may be influenced by
inherited traits. (Mayo Clinic 2014)

Theory base conclusion
The theories about the cause of addiction and
what to do about it are numerous. Again, this
seminar is not to influence the reader in one
way or another. The purpose is to hold a
discussion about the various theories and
opinions within the class.
Root Cause Analysis (RCA)
Using the fish bone application, I applied
several questions to the reason addiction has
continued to be addressed for more than 100
years.
Problem Statement:
No clear pathway or consensus exists in
managing addiction in nurses.
RCA continued
Too many theories exist of why addiction
happens an what to do about it.
The relationships of the theories to the problem
all address the issues from very different angles.
The theories may have bias due to the authors
opinions about addiction.
Does an author have the opinion that addiction is
a disease? A moral failing? A weakness?
Treatable? Punishable?
With these questions applied to a fish bone
diagram all verified the problem statement.

RCA continued
Safety of nurses and patients must be
addressed. Each of the United States has
different policies of how to address addiction
in nurses and other health professions.
Direction #1
Please select only one of the following reading
selections listed on the last page of the
presentation.
Direction #2
Please email me through our class message
venue and tell me why you selected the article
you selected. Why did it appeal to you? Each
article has a different focus on addiction. Did
you select the article because you feel
similarly to the title? Have you had some
experience that the article you chose
addresses?
Direction #3
Please add to your email to me your thoughts
about the article you selected. Did the article
help you form an opinion about addiction in
nursing? Did your reading selection change
your mind about addiction in nursing? Did
your reading change your mind about
addiction in the general population?
Implications and consequences and
inferences
If addiction in nurses is not addressed in a
systematic and unified framework, the issue may
well be explored for another 100 years.
Patients are at high risk of nurses making clinical
errors until a systematic approach is in place.
Opinions on this issue must be considered and be
applied to a systematic approach (Fish bone)
After consensus has been reached, it must be
applied and evaluated to determine if the
systematic approach has a positive effect
addiction in nursing. (EVP)
Quality and safety improvements
Standardize an algorithm for addressing addiction in
nurses with a patient safety focus as first priority.
Form national task force to include all disciplines of
care, addition specialists, nurses, law enforcement, etc.
with a teamwork approach.
Center the task force on considering existing evidence
practice (EVP)and the creation of more EVP.
The goal should be to increase safety for the public and
to establish EVP on the best way to manage addiction
in nurses.


American Nurse Association standards

If nurses were to take a leadership role in directing
a national task force to address the problem the
varying theories on the addiction in nurses, a
systematic approach could be formed. This task
force would be by nurses for nurses. The task for
would include resources from all disciplines that
needed to be included. The priority of task force
would be to keep patients nurses and the families
of both safe from addiction induced errors. It would
be incumbent on the task force to determine EVP
and to then educate the health care practitioners in
the United States.

Resources
Boulton, M., Noesek, L. (2014) How do nursing
students perceive substance abusing nurses? Archives of Psychiatric Nursing. 28,1

Burton, K. Nurse (2013) Nurse addictionan unexpected journey: A phenomenological study of
nurses in recovery. College of Natural and Health Sciences, School of Nursing. University of Northern
Colorado.

Hamilton, B., Taylor, G. On our way with alternatives-to-discipline for nurses with addictions?
Commentary on Monroe T & Kenaga H (2011) Dont ask dont tell: substance abuse and addiction
among nurses, Journal of Clinical Nursing 20, 504-509. doi: 10.1111/j.1365-2702.2011 1.0379.x

Kenna, G. Risk factors for alcohol and other drug use by health care providers.
Http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2265282/

Monroe, T & Kenaga, H. Dont ask dont tell: substance abuse and addiction among nurses. Journal of
Clinical Nursing, 20-504-509. doi: 10.1111/j.1365-2702.2010.03518.x