FNA Reference Proposal: Prevention of Substance Use Disorder in Nursing
Submitted by:
Leticia Otero, BSN, RN
FNA Reference Proposal: Prevention of Substance Use Disorder in Nursing
Substance use disorder (SUD) is defined as the misuse of, dependence on, and addiction to alcohol and/or legal or illegal drugs; the term SUD includes a range of severity from “problem” through dependence and addiction (Cook, 2013, p. 15). SUD and impaired nursing practice is a serious concern that has plagued the healthcare arena for over a century. The prevalence of SUD among nurses parallels the prevalence of SUD among the general population; some estimates of SUD in the nursing profession range from six to eight percent while other estimates are as high as twenty percent (National Council of State Boards of Nursing, 2011).
Rationale
The impact of SUD and impaired nursing practice is extremely negative, resulting in deaths, illnesses, and disabilities. The stigma, de-medicalization, and criminalization associated with SUD hinder nurses from seeking treatment. Meanwhile, a lack of knowledge regarding the signs and symptoms indicative of SUD deters nurses from reporting concerning behaviors that jeopardize patient and workplace safety (National Council of State Boards of Nursing, 2011).
The past two decades has seen a shift from disciplinary action to alternative-to-discipline (ATD) programs for nurses with SUD; however, the concept of SUD as a treatable disease among healthcare providers is not universally accepted and a lack of knowledge regarding the appropriate steps to take for accessing help for themselves and others exists (Bettinardi-Angres, Pickett, & Patrick, 2012). Furthermore, nurses who uplift and support each other rather than display judgmental and condemning behaviors promote positive outcomes and professional morale. Nurses have an ethical obligation to abide by a code of ethics which includes “mandat[ing] workplace advocacy and promotion of well-being” (Monroe & Pearson, p. 538).
Statement of Position
SUD is a disease of the brain, not a symptom of moral deficiency; as such, this issue warrants continued serious attention and action. Addressing SUD in the nursing profession should include mandatory SUD education on an organizational level. Although ATD programs provide nurses with SUD a better chance for recovery and successful reentry into the workforce, there are still limitations in terms of eligibility and proactivity.
Recommendations for Action [LB1]
A proposed change to address this issue entails providing mandatory SUD education for nurses and nurse managers on an annual basis. Mandatory SUD education serves as a proactive means of addressing this issue that complements public and workforce safety provided by ATD programs. Implementing an institutional policy facilitates compliance with exposure to SUD education that will serve to increase awareness and timely intervention. The implications of SUD education include increased knowledge of substance abuse and mental disorders, decreased stigma and bias towards nurses with substance abuse issues, and provision of evidence-based techniques for constructive confrontation of nurses demonstrating signs of impaired practice (Cadiz, Truxillo, & O’Neill, 2012). The idea is to arm nurses and nurse managers with this type of knowledge prior to needing it and/or engaging in impaired practice Proactively addressing SUD in the workplace positively impacts the nursing workforce in terms of direct hours of patient care; this is vital in the face of the current and future nursing shortage (Monroe, et. al., 2011). Additional topics for mandatory SUD education will include a discussion of ATD programs, their purpose, and procedures and stress management. According to the National Council of State Boards of Nursing (2011), these elements are necessary requirements for SUD education and outreach. It is also worth noting that SUD prevention education has cost-saving potential in terms of reducing adverse outcomes related to impaired practice in the healthcare setting and funds spent on criminal processes and lost productivity (National Council of State Boards of Nursing, 2011).
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References
Bettinardi-Angres, K., Pickett, J., & Patrick, D. (2012). Substance use disorders and accessing
alternative-to-discipline programs. Journal of Nursing Regulation, 3(2), p. 16-23.
Cadiz, D., Truxillo, D., & O'Neill, C. (2012). Evaluation of a training program for nurse supervisors
who monitor nurses in an alternative-to-discipline program. Advances in Nursing Science,
35(2), p. 135-144.
Cook, L. (2013). Can nurses trust nurses in recovery reentering the workplace? Nursing Critical
Care, 8(6), p. 14-17.
Monroe, T., & Pearson, F. (2009). Treating nurses and student nurses with chemical dependency:
Revising policy in the United States for the 21st century. International Journal of Mental
Health & Addiction, 7, p. 530-540.
Monroe, T., Vandoren, M., Smith, L., Cole, J., & Kenaga, H. (2011). Nurses recovering from
substance use disorders: A review of policies and position statements. The Journal of
Nursing Administration, 41(10), p. 415-421.
Substance use disorder in nursing: A resource manual and guidelines for alternative and disciplinary
monitoring programs. (2011). National Council of State Boards of Nursing. Retrieved
from
[LB1]I am unclear if this is a request that institutions implement a mandatory inservice program or if it is a recommendation for mandatory CE content for license renewal? If it is institutional, the FNA can make recommendations and provide educational materials to institutions, but not ‘mandate’ anything.