The nursing profession can be highly stressful and one outcome from that stress is that nurses tend to have high rates of substance abuse and addiction. Coupled with this stressful profession is access to drugs at the workplace. An impaired nurse can be a danger to patients, co-workers and themselves; their ability to provide safe and appropriate care is impacted.
In Pennsylvania, hospitals, health care facilities, peer or colleagues have a mandatory requirement to report to the Bureau of Professional and Occupational Affairs “substantial evidence that a nurse has an active addictive disease for which the professional is not receiving treatment, is diverting a controlled substance or is mentally or physically incompetent to carry out the duties of his license…” Many nurses go unreported because employers and other nurses don’t know what “substantial evidence” of impairment means. Fortunately, the Pennsylvania Nurse Peer Assistance Program (PNAP) exists and can assist employers and colleagues with such questions. PNAP works with the Professional Health Monitoring Program (PHMP) which provides a way for impaired nurses to obtain treatment and monitoring.
Nurses must educate themselves on the signs, symptoms, behaviors, myths, and truths that represent substance abuse. Nurses need to educate themselves on the organization’s policy and procedures for employee substance abuse and employee assistance programs. Careful documentation of any changes in the suspected impaired nurses’ behaviors is important.
Some, but not all, of the signs of impairment include noticeable mood changes; brief, unexplained absences from the nursing unit; rounding at odd hours; frequent reports of lack of pain relief from assigned patients; isolation or withdrawal from fellow staff; requests to work shifts with less supervision; and lateness for work or absenteeism.
If you suspect someone is impaired, urge the individual to get help. If they refuse, discuss your suspicions with your supervisors and/or reach out to PNAP to get some guidance. Failing to report may end up endangering patients, the impaired nurse and even yourself. All nurses must avoid doing anything to enable the impairment to continue.