m for the global health care arena.
Nursing professionals, although they daily witness the manifestations of chemical substance abuse in patients, are not immune to such behavior. Substance abuse among nursing professionals has been found to be five times that of the general population (Michigan Nurses, 1987, p. 8). Some researchers attribute the high incidence of substance abuse among nursing professionals to the stressful character of the responsibilities of nurses (Naegle, 1988, p. 24). If this contention is valid, effective support and intervention programs for nursing professionals are required.
By the beginning of the 1990s, two problems of significance that will, to a great extent, influence the character of the nursing profession in the future had already become evident. One of these problems is the serious shortage of professional nurses that exists in most geographic areas of the United States (Higgins, 1990, B1). The second of these problems is professional autonomy, as the professional nurse contends with long-standing challenges to the nursing profession's prerogatives from physicians, and with relatively more recent challenges from hospital administrators (Scherer, 1988, pp. 34-40).
There is, however, a third significant problem of professional interest in the 1990s that will also influence the future character of professional nursing. This problem is embodied in the concept and phenomenon of the impaired nurse (Naegle, 1991, pp. 69-70). When the concept of the impaired nurse is considered at all by most observers, it is considered in the context of the professional nurse whose performance as a nurse is adversely affected by the misuse of chemical substances (Sussman, 1992, p. 8). In point of fact, however, a wide range of factors can contribute to the development of impaired performance in the professional nurse. Job dissatisfaction and on-the-job stress, both of which contribute to the shortage of pro...