IMPAIRED NURSES

 
 
 
 
IMPAIRED NURSES: A DISCOURAGING PHENOMENON

Nurses who are impaired because of the misuse of chemical substances, both alcohol and narcotic drugs, are no longer an isolated phenomenon. Almost one-half of active registered nurses report having experiences with one or more impaired nurse coworkers over a 12-month period. Impaired nurses are threats to patients, health care institutions, the health care system, the profession of nursing, and to themselves. Several states have established structured programs to deal with the problem, although none of these programs has reported sufficient levels of success to serve as a model for other states. In the mid-1990s, the problem of impaired nurses is growing more serious, and definitive strategies to deal with the phenomenon remain in developmental stages.

This research provides an overview of the phenomenon of the impaired nurse. The toll exacted by chemical substance abuse on the American society and on individuals within the society in both social and economic contexts is both appalling and enormous. Governments in the United States commit an enormous amount of public resources--financial, human, and physical--to fighting the country's substance abuse problem. In spite of all of these efforts, and in the face of claims of great success by the Drug Enforcement Agency, however, the substance abuse problem appears to be intractable. Unfortunately, the problem now has rooted itself in the nursing profess


     
 
 
 
    

 

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al health and more psychosomatic complaints than nurses working fixed-shifts (Jamal, 1989, p. 115). Specifically, nurses working rotating shifts report difficulty in sleeping, upset stomachs, headaches, sickness in the early morning, and dizziness later in the day (Jamal, 1989, p. 115). Nurses working rotating shifts also report lower social involvement than fixed-shift nurses. All of these problems work together to motivate chemical substance abuse among some professional nurses (Tranberger, 1991, p. 134). A 1991 study found that fatigue was experienced by nurses working rotating shifts at levels far higher than that experienced by nurses working any other schedule (Gold, Rogacz, Bock, Tosteson, Baum, Speizer, and Czeisler, 1992, p. 1013). Staving off fatigue is a major reason cited by impaired nurses for their misuse of chemical substances (Tranberger, 1991, p. 136). Nurses working rotating shifts reported a higher incidence of the use of sleep medications than did nurses working any other schedule (Gold, Rogacz, Bock, Tosteson, Baum, Speizer, and Czeisler, 1992, p. 1013). Nurses working rotating shifts reported a far higher incidence of alcohol use to promote sleep than did nurses working any other schedule. Patient m

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