This site contains no information directly related to the problem of substance abuse within the profession. The industry related information on the workplace environment is geared towards serving the nursing professional, and especially protecting their rights in the various nursing workplace settings. It begs the question of why, when substance abuse is a problem in the profession, the site offers no resources to the nursing professional as to where they might confidentially turn to for help with substance abuse problems, nor does it encourage the nursing professional who might be suffering such a condition to seek help. This might be as a result of the very public exposure that is inherent in its internet setting, and suggests that perhaps the industry considers substance abuse and guidance for the nursing professional who might seek help to be a condition or problem that is not best addressed on such a public forum level.
One of the professional journals which have published current and pertinent articles on the subject of substance abuse in the nursing profession is the Clinical Journal of Oncology Nursing. An article in this journal by JeanAnne Johnson Talbert (2009) boldly discusses a specific case of a nurse, Tammy, in a hospice setting who puts a patient at risk when she steals the medications of patients under her care (p. 17). In the case discussed, the nurse who follows Tammy notes the level of distress of one particular patient, and, upon examining the patient's chart and medication record, takes action to relieve the patient's distress and pain (p. 17). This action by the nurse who follows Tammy causes the patient to code, and even though the patient recovers, the nurse following Tammy becomes suspicious, and practices good nursing medicine by trying to understand what went wrong with her patient's care (p. 17). The follow-on nurse has actually had a suspicion about Tammy and the patients' medications for some time, but having now experienced a direct patient crisis as a result of what she believes is a case of a nurse stealing patients' pain medications, she reports Tammy (p. 17).
This very important case study, the only one its kind found in the literature, segues to a discussion by the author on substance abuse by nurses (p. 17). The article is well organized, and examines the nurses as substance abusers with criteria for recognizing signs and symptoms of the nurse substance abuser, underlying causes for substance abuse, and, most importantly, the issue of whether or not colleague, fellow nurses, should become involved if they suspect a nurse they work with is abusing substances (p. 17).
The flow of the article is logical, citing current sources in the literature, and even the Drug Enforcement Agency (DEA). It is important because it is the only article of 49 articles that specifically cites a case study involving a patient put at risk because of a nurse's substance abuse. It also demonstrates that while nurses are more likely to abuse prescription medicines, those medicines are not necessarily prescribed for the nurse by a physician, but actually come from the nurse's access to powerful narcotics intended for patient care. It is not only a case of drug abuse, but theft, and patient abuse, because the medications for patients experiencing end of life pain and distress from cancer are being deprived of a quality of life that can only be achieved by administering to their needs with pharmacological interventions. It brings up serious issues about nurses and substance abuse which warrant further studies.
An article found in the American Journal of Public Health, written by Carla L. Stor and Alison M. Trinkoff (1998). This article is one of two found through the search engine query that contains quantitative statistical data as a result of direct research. The statistics support the data cited in other reports as it pertains to the percentages of nurses who have substance abuse problems, and the percentage of nurses, six percent, whose impairment as a result of substance abuse is putting patients in harms way. This study is cited in other articles selected for inclusion here. The data yield is supported by the second article, by Margaret West (2002), which uses the same anonymous mailed survey approach. West, however, employs Donovan's multifactorial model of impairment and the Rogerian Theory of Unitary Human Beings. The Trinkoff and Stor article was available through the search engine only in its abstract form, although the abstract was succinct in the data results of the study. The West article was available as a full-text article.
The West article cites as its weakness the anonymous mailer approach, and we can ostensibly...
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