Addiction in Nurses: Recognizing Impaired Colleagues


You’ve been working with one of your nursing colleagues for some time now. They have an excellent background and skillset. They finished nursing school at the top of their class. They come to work early, stay late and are always willing to pick up an extra shift. They seem to be almost super human, going above and beyond the call of duty as a nurse. You have no idea you could be working with an impaired nurse because recognizing addiction in nurses can be tough.

Estimates suggest 10 percent of nurses are dependent on drugs. With some 3 million registered nurses (RN) in the United States, the number of impaired nurses is about 300,000. To put it simply, if you work with 10 nurses, it is likely that one of them is struggling with addiction.

Addiction in Nurses: Triggers

The physical and emotional strain of a nurse’s job can cause a nurse to resort to using or abusing drugs at work. Research implies that certain nursing specialties are likely to have higher levels of addiction. Nurses specializing in anesthesia, critical care, oncology, and psychiatry deal with intense emotional and physical demands that may lead them to turn to drug abuse.

All nurses, regardless of specialty, feel the stress or burnout associated with long shifts, mandatory overtime, and inefficient shift rotations. Not only is a nurse’s job physically straining, it is also emotionally taxing. Nurses are expected to hide their feelings, remain in control, and make split-second or life-and-death decisions. Nurses have to go from one stressful situation to the next without getting the chance to decompress.

Drug addiction in nurses is a major health issue that is not getting the attention necessary to make changes. Impaired nurses can jeopardize patient safety due to their addiction. Nurses struggling with addiction are more likely to have impaired judgment, slower reaction time, and steal drugs from patients. This causes the impaired nurse to make mistakes or neglect patients, which can result in devastating effects.

Medication Knowledge and Availability

Another reason why nurses and other healthcare physicians are susceptible to addiction is due to their medication knowledge, and the availability of those medications. Nurses see the power of medication every day. Also, nurses have almost unfettered access to drugs.

Because nurses have the skills to administer medication and the knowledge of medication effects, they may feel they can self-treat without developing drug dependency.

Recognizing Addiction in Nurses

It can be hard to recognize nurses struggling with substance abuse because they are high functioning addicts. They are still working and caring for patients and may not even realize they have an addiction problem. Typically, fellow colleagues will be the first to notice substance abuse.

As a colleague, you may feel uncomfortable with the idea of reporting a fellow nurse for addiction issues. However, remember that it is important for you to remember that an impaired nurse is risking patient safety, the organization’s reputation, and their life.

Signs of Addiction in Nurses

To recognize addiction in nurses, here are the signs you should look for:

  • Extreme or rapid mood swings
  • Illogical or sloppy charting
  • Always absent from unit
  • Comes to work early or stays late for no reason
  • Using many days of sick leave

Additionally, an impaired nurse will usually exhibit suspicious behaviors when it comes to handling drugs in the healthcare setting. Some of the signs you should look for include:

  • Continually signing out more drugs than anyone else
  • Frequently breaking or spilling drugs
  • Only accessing narcotics cabinet when alone/unsupervised
  • Always volunteers to be med nurse
  • Consistently using the bathroom after visiting the narcotics cabinet
  • Incorrect narcotics count
  • Defensive stance when asked about medication errors

As a nurse, you have an ethical duty to report your colleague if you suspect or witness drug abuse. Remember that addiction is an illness, and an impaired nurse needs your help.

Self-Reporting Addiction

While nurses are encouraged to self-report in the case of substance abuse, self-reports are extremely rare. Nurses may fear they’ll lose their job, license, or even their livelihood. Also, knowing the nature of addicts, the impaired nurse is probably confident in their self-treatment. They believe that they are in control of what they are doing , and may not even believe that they have an addiction issue.

Addiction Treatment Considerations

Addiction is a chronic, progressive, and treatable disease. This is a condition that only worsens when left untreated. Addiction only becomes fatal due to overdoses, accidents, and health effects from substance use. Nursing staff should help a nurse going through rehabilitation for drug dependency. Healthcare organizations should also provide supervision while these nurses are working towards practicing again.

Many healthcare organizations will immediately fire an impaired nurse, rather than get them help to treat the addiction. When this happens, these impaired nurses are able to apply for positions at other places, putting other patients at risk.

Addiction in nurses is a topic that many are uncomfortable talking about even though many nurses have worked or suspect they are working with an impaired nurse. If you suspect one of your colleagues is struggling with drug dependency, make sure you report them. Not only might you help save a patient’s life, you might save your colleague’s life as well.

Author: Ekom Enyong

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