The prevalence and impact of substance abuse among nurses (impaired nursing)

Student’s Name
Institutional Affiliation
Course Title
Instructor’s Name
Assignment Due Date

Slide One - Title slide

Slide Two - Why the topic was chosen
 Impaired Nursing
 Definition
 Background and description
 Why the topic was chosen

The topic selected for this project is the prevalence and impact of substance abuse among nurses
or impaired nursing. Impaired nursing refers to the nurse’s inability to perform their duties and
responsibilities due to a dependency on chemical substances such as drugs, alcohol, or mental
health problems. Nurses turn to drug abuse mainly due to occupational strains that are the result
of the nursing shortages that increase their workload. Other risk factors, such as low tolerance for
stress, drug accessibility, fatigue, and childhood trauma, can make nurses uniquely vulnerable to
maladaptive coping strategies. I selected this topic due to its adverse impact on patient and
treatment outcomes. Impaired nurses are more likely to make medication errors and divert
medication meant to alleviate patient symptoms, leading to poor patient care and prolonged
hospital stays. According to Luurila (2023), substance use among nurses ranges from 5% to 20%.
The use of a range is due to the nursing population’s fear of self-reporting because of the fear of
repercussions.

Slide Three - Impact on Nursing Practice

 Impaired:
o Judgement
o Decision Making
o Memory
o Behavior
o Capacity to deal with stress
 Impact on My Practice
o Learn About the Manifestation of symptoms
o Be aware of the reporting mechanisms in the clinical settings in which I operate
o Mindfulness meditation for burnout and stress relief
Nurses are responsible for providing patients with effective, quality care to improve their health
outcomes. To achieve this, these professionals must promptly make clinical decisions,
accounting for any changes in the patient’s condition. Further, the nurses must have clear
judgment and the capacity to operate in a high-stress environment. Prolonged drug use changes
the brain's chemistry, impairing these capacities.
Impaired nursing will impact my practice since I will have to be vigilant in my workplace to
identify any cases of substance abuse among my coworkers and report any instances I identify to
the relevant authorities based on the existing protocols. Notably, I will also have to develop
practices such as mindfulness meditation to help me cope with stress and burnout to avoid
developing maladaptive coping methodologies (Green & Kinchen, 2021).

Slide Four - Current relevance of the topic

Description and development
Risk Factors
Signs and symptoms
Relevance to Nursing Practice
Drug and substance abuse is a social problem that affects the entire US population. Nurses are
not immune to drug use and dependence. Arguably, they are more vulnerable to drug abuse due
to the ease of access to psychoactive substances, occupational strain, and the psychological
dependence on medicines as solutions to the body’s challenges. Several risk factors can
predispose an individual nurse to drugs and substance abuse. These risk factors include
occupational strains (stress, fatigue, and access to psychoactive substances), psychiatric factors
(low tolerance for stress, depression, and anxiety), behavioral factors (such as poor interpersonal
relationships and conduct disorder), and genetic factors (an inherited predisposition to drug and
substance abuse). Typically, substance abuse among nurses manifests through behavioral changes
such as increased practice errors that were previously lower or absent, dilated pupils, and
frequent bathroom trips. Drug abuse among the nursing population negatively impacts nursing
practice since impaired nurses are incapable of providing competent patient care and
guaranteeing the patient’s safety during the treatment process (Salani et al., 2022). This is
because impaired nurses can divert patient medications and make medication errors, leading to
poor patient outcomes.
Cont’d
 A Comparison of Commonly Abused Substances in the
Nursing Population According to the Nurse Worklife and
Wellness Study (N = 1170), 2020–2021
35

30

25

20

15

10

0
Illicit Drugs Rx-Type Drugs Alcohol Nicotine Energy Drinks Caffeine CBD
Drinks

The above graph was created from data in Trinkoff et al. (2022). It demonstrates that for the
population of nurses studied (1170), Alcohol, Caffeine, and energy drinks were among the most
abused substances. The overuse of caffeine and energy drinks is coherent with the occupational
strain nurses are exposed to. Specifically, registered nurses are forced to work long shifts and
float across different units due to nursing shortages. To alleviate fatigue and burnout, nurses may
turn to caffeine and energy drinks to enable them to continue implementing their responsibilities.
The high percentage of alcohol abuse can be associated with its legal status.
Slide Five - Clinical Practice Integration
Practitioner Vigilance
Policy Implications
Nursing Education
Alternative coping mechanisms
In clinical practice, impaired nursing is a critical issue due to the adverse effects it can have on
patient safety and treatment outcomes. To address this, nurses are trained to be vigilant of their
co-workers to identify any signs of drug and substance abuse. The main goal of this is to ensure
that impaired health professionals are identified early enough and provided with support to
handle their addictions.
Impaired nursing mainly results from the concomitant effects of occupational strains and
interpersonal issues. This has resulted in the shift of policies to include work-life balance
considerations. This allows nurses to get support from their social circles when they have
challenges rather than coping with substance abuse.
To address this issue, clinical practice contains continuous education programs. These education
programs educate nurses on drug and substance abuse in the healthcare professions and its
implications for patients and treatment outcomes. Additionally, these programs provide training
on alternative coping strategies, such as counseling.
Slide 6 - Plan for lobbying
Lobbying Approach
 Statement of the problem
 Engage Stakeholders
o Health institutions - Letter
o Insurance companies – Letter
o Patients – social media
 Meet with legislators
Main Points
 Impaired nursing is a critical issue
 It affects the entire health ecosystem
 Policy interventions are highly effective
2017 Florida Statutes Title XXXII Chapter 456.073
Lobbying Approach
My lobbying approach would begin with a problem statement defining impaired nursing and
highlighting key statistics such as the 5%-20% prevalence in the nursing workforce. I would then
proceed to detail its impact on the healthcare ecosystem. Specifically, I would describe its effects
on patient and treatment outcomes and healthcare stakeholders such as health institutions and
insurance companies. For instance, health institutions face costs through increased workplace
accidents. Similarly, insurance companies face increased workers' compensation and disability
claims.
I would then contact stakeholders such as insurance companies, health institutions, and patients.
Letters would be used to reach out to health institutions and insurance companies. Patients would
be informed about the issue through social media. Support from these stakeholders would
demonstrate the severity and importance of the problem to the legislator. I would then organize a
meeting with the legislator to request support in addressing this healthcare issue.
The 2017 Florida Statutes Title XXXII Chapter 456.073 protects any individual who reports the
impairment of a healthcare professional from civil liability. This legislation encourages nursing
practitioners to report impairment cases without fear of legal consequences.

Cont’d
Ensure consistent Implementation of policies
Funding
Public safety
Patient awareness and education
Involving legislators and the government has several advantages. First, since legislators
influence the development of legal frameworks, they can ensure that policies created to address
impaired nursing are implemented consistently across the healthcare system. Secondly,
government funding can ensure that rehabilitation, detection, and education programs are
implemented on a larger scale, thus increasing their impact. Thirdly, addressing impaired nursing
can help improve public health by delivering quality healthcare services to society. Lastly,
legislators have access to platforms allowing them to reach large populations. Utilizing these
platforms can ensure that patient education programs reach a greater audience. This can leverage
the patient base as a means of identifying impaired nurses.
Slide 7 – Conclusion
Impaired nursing is a critical health concern
Nurses are highly susceptible
Occupational strains
Access to drugs
There is a need for rehabilitative interventions
In conclusion, impaired nursing is a critical health issue that should be addressed to ensure
quality care and safeguard patients during treatment. Nurses are susceptible to maladaptive
coping strategies, such as drug abuse, due to occupational strains and access to drugs. To address
this, there is a growing need for rehabilitative programs that can help addicted health
professionals overcome their addictions and resume their roles in the health workforce. Notably,
addressing this issue requires a multidimensional approach involving individuals, society, and
legislators.
Slide 8 - Reference slide
 References
Luurila, K., Kangasniemi, M., Hult, M., & Häggman‐Laitila, A. (2023). Nurses’ substance use
disorder in disciplinary procedures: A retrospective document analysis. Journal of
Clinical Nursing, 32(11-12), 2663-2671. https://doi.org/10.1111/jocn.16343
Green, A. A., & Kinchen, E. V. (2021). The effects of mindfulness meditation on stress and
burnout in nurses. Journal of Holistic Nursing, 39(4), 356-368.
https://doi.org/10.1177/08980101211015818
Trinkoff, A. M., Selby, V. L., Han, K., Baek, H., Steele, J., Edwin, H. S., ... & Storr, C. L. (2022).
The prevalence of substance use and substance use problems in registered nurses:
estimates from the Nurse Worklife and Wellness Study. Journal of Nursing
Regulation, 12(4), 35-46. http://dx.doi.org/10.1016/S2155-8256(22)00014-X
Salani, D., Goldin, D., Valdes, B., & McKay, M. (2022). The Impaired Nurse. AJN The
American Journal of Nursing, 10-1097.
https://doi.org/10.1097/01.NAJ.0000884568.95085.dd
FindLaw Staff. Florida Statutes Title XXXII. Regulation of Professions and Occupations §
456.073. Disciplinary proceedings. FindLaw. https://codes.findlaw.com/fl/title-xxxii-
regulation-of-professions-and-occupations/fl-st-sect-456-073/#:~:text=Statutes%20Title
%20XXXII.-,Regulation%20of%20Professions%20and%20Occupations
%20%C2%A7,Disciplinary%20proceedings&text=Disciplinary%20proceedings%20for
%20each%20board,the%20jurisdiction%20of%20the%20department