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Substance Abuse Among Nurse Practitioners Term Paper

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Updated: Jul 8th, 2021

Substance abuse and drug addiction among medical professionals and nurse practitioners (NPs) is a major problem that undermines their standards of practice. When NPs become addicts, chances of providing high-quality and timely care to their patients decrease significantly. Addiction and substance use disorder (SUD) are social issues that many communities have to deal with. This means that all stakeholders should examine how they affect NPs and other medical experts and propose superior solutions to meet their needs. Many citizens in countries that have ignored the complexity of this problem continue to record negative health outcomes. Most of the affected individuals become disoriented and find it hard to fulfill their duties, act in accordance with the stipulated scope of practice, and be unable to meet the diverse needs of underserved populations. The purpose of this term paper is to analyze the nature of substance abuse among nurses and examine various arguments, principles, and perspectives that different stakeholders can consider to address this ethical issue.

Ethical Issue and Importance

Substance abuse remains high among registered nurses (RNs) in the United States and across the world. A study by Burkhardt and Nathaniel (2014) revealed that around 10 percent of all nurses had a problem to do with drug abuse or alcoholism. The latest report by the American Nurse Association (ANA) indicated that about 6-8 percent of RNs in the United States had serious addiction issues that could interfere with their practice capabilities and goals (Epstein, Burns, & Conlon, 2010). Some of the affected professionals face the challenge of substance overuse. There are other nurses whose drug abuse might have been triggered by treatment of an underlying illness, such as depression, mental complication, or back pain (Burkhardt & Nathaniel, 2014). Nurses who encounter these problems require evidence-based care and empowerment in order to provide exemplary and timely medical services.

This predicament qualifies to be an ethical issue due to various reasons. Firstly, NPs who suffer from this problem will divert different drugs and substances intended to meet the medical demands of patients. Nurses who use them will threaten the medical outcomes of such individuals. Pilgrim, Dorward, and Drummer (2016) acknowledge that such professionals eventually become liabilities in their respective facilities and organizations. Secondly, most of the existing codes of conduct require that they report or identify workmates who might be stealing medical substances and drugs. However, the practice is associated with social stigma and rejection in the workplace.

Thirdly, forcing professionals to report individuals who might be suffering from drug use is a practice that can trigger various workplace challenges. Nurses who are labeled “whistleblowers” will be unable to practice independently or effectively due to isolation (Pilgrim et al., 2016). The established friendships in such working environments can also make it impossible for nurses to report their colleagues for drug addiction or theft. Finally, NPs are expected to use their skills and competencies to deliver exemplary care to their respective patents (McHugh, Papastrat, & Ashton, 2011). When the problem of addiction occurs, such professionals will be unable to provide high-quality support. This becomes a major dilemma that calls for immediate action plans. Understanding the nature of this difficulty can encourage different stakeholders, policymakers, and health leaders to implement superior measures that have the potential to empower all the affected RNs.

Dimensions

Being in a position to identify and make concrete decisions regarding the ethical issues experienced in the field of nursing is something critical. Health professionals should be aware of all emerging concerns and help each other to overcome and provide exemplary services to the targeted patients. The issue of drug abuse among RNs has an ethical dimension. This is true since this problem affects individuals who should provide medical services to patients (Pilgrim et al., 2016). Those who have become addicted will be unable to achieve this objective and make it impossible for the targeted people to lead high-quality lives (Pilgrim et al., 2016). This dimension also attracts the attention of different stakeholders in the field of care delivery, including psychologists, NPs, psychotherapists, and clinicians.

This ethical issue can be examined and studied from the lens of the professional dimension. Kopp (2009) asserts that nurses have to focus on the established principles and guidelines of care delivery. Those who become addicted will be unwilling to provide exemplary services to their patients. They might remain unsupportive and fail to collaborate with others to ensure that quality medical care is available to all people. This dimension also makes it possible for managers to appreciate the fact that drug abuse among nurses is a major problem that undermines nursing as a critical profession in the health care sector.

The personal dimension is critical when focusing or analyzing the nature of this ethical dilemma. Monroe, Pearson, and Kenaga (2008) reveal that RNs formulate evidence-based or powerful philosophies that guide them to identify their respective patients’ demands and offer high-quality care. Those suffering from addiction might not pursue their personal goals diligently. They will cause disturbance in their respective workplaces and make it impossible for their colleagues to deliver desirable care (Epstein et al., 2010). Any strategy implemented to address this issue should, therefore, be holistic if it is to deliver positive results.

Although the issue of substance abuse is a major predicament making it impossible for nurses to achieve their goals, it is very hard to separate it from the social dimension. Despite being in the medical field, RNs constitute an integral part of the societies they are in. Just like any other member of the community, nurses experience stressful life situations that compel them to use of addictive drugs. Socioeconomic issues and availability of various substances have exposed many people to this problem, including nurses and other medical professionals (Pilgrim et al., 2016). This analysis or dimension explains why there is a need for all stakeholders to treat substance abuse as a serious public health concern.

Ethical Argument

The ultimate objective of every healthcare practice is to ensure that more patients have access to sustainable and timely medical services. Unfortunately, the current issue of nursing shortage makes it impossible for many American citizens to get proper health care (McHugh et al., 2011). This challenge is complicated by the fact that around 10 percent of all nurses are affected by drug abuse. Dunn (2005) indicates that RNs facing the problem of addiction require timely care and help. This is something necessary since they are in danger of affecting the experiences of their patients and making it hard for them to record positive health outcomes. When the percentage of professionals suffering from addiction or drug overuse rises, the reputation of the identified institution or facility will be damaged (Dunn, 2005). Such an ethical challenge also affects the effectiveness and the true meaning of nursing practice.

While this problem has continued to persist, many societies and cultures view drug addiction is a major issue that affects individuals who do not have will power. They also indicate many victims are usually reckless and incapable of focusing on their goals in life. Nurses who suffer from this condition find it to acknowledge are accept the reality (Pilgrim et al., 2016). Instead, they continue to take alcohol or drugs that will make it easier for them to overcome most of the challenges they encounter in life. Additionally, many RNs will remain silent and fail to report when one of their own becomes addicted. Dunn (2005) indicates that such professionals do so to ensure that they do not jeopardize their colleagues’ licenses. These malpractices have resulted in a code of silence that is capable of affecting the experiences and welfare of many victims of drug addiction.

Since many nurses fail to acknowledge that their workmates are patients of addiction or drug abuse, they fail to report them to the right authorities. This gap explains why such individuals are usually unable to receive high-quality support or counseling. Consequently, the affected professionals continue to practice in their respective settings or units, thereby increasing chances of medication errors and sentinel events. Since these RNs are incapable of exercising prudent or acceptable behaviors, their patients are always at risk of injury or abuse. Kunyk and Austin (2011) go further to acknowledge that RNs who abuse prescription drugs make it impossible for citizens to access high-quality care. Such developments eventually make it impossible for the entire healthcare system to achieve its objectives.

The structure of medical profession complicates the nature of this ethical dilemma. Although drug addiction is a major challenge capable of affecting any individual, many “nurses erroneously believe that they are immune to the negative consequences of drug use and that they have the ability to control their own medication use” (Dunn, 2005, p. 577). Since they have basic training in medical use and knowledge of various illnesses, such professionals assume that they can apply their competencies and achieve their health goals. This gap explains why other RNs suffer in silence and ignore the need to seek timely and desirable medical attention.

Theological and Cultural Dynamics

Theological and cultural dynamics are powerful forces that nurses and other professionals in the field of health should always consider when relating with each other. These concepts guide human beings to establish meaningful relationships with God and discover His intentions for creating the universe. Focusing on theological notions and teachings, it can be possible for every individual to appreciate the importance of human life and transform his or her experiences (Monroe et al., 2008). Through the lens of religious teachings and values, RNs can understand the relevance of keeping their bodies holy and avoiding the use of various drugs that can result in addiction.

Similarly, cultural dynamics gives a wider view of people’s lives and experiences. Every society has its unique principles, ideologies, norms, and aspects that dictate the way its members view or treat reality. Many citizens in the American society expect their neighbors and colleagues to behave positively and engage in activities that will promote each other’s welfare (Monroe et al., 2008). From this analysis, it is evident that the problem of alcoholism among nurses can benefit from these dynamics. For instance, those who have strong religious foundations will be willing to educate others about the nature of alcoholism and why it amounts to sin (Kunyk & Austin, 2011). Cultural attributes encourage people to do what is right and provide adequate care to their neighbors. These aspects explain why community members should understand that drug abuse among nurses is a reality that requires evidence-based strategies or solutions.

Using the dynamics of culture, it is evident that many people will regard those who are affected by addiction as immoral or unable to take control of their lives. Consequently, such individuals will not receive adequate attention or empowerment, thereby being unable to re-pattern their lives. Burkhardt and Nathaniel (2014) explain why people should consider these gaps and implement superior initiatives that will ensure that all addicts get timely care and guidance. This achievement can address this problem and make it possible for many nurses to continue providing exemplary services to their respective patients.

Alternative Ethical Perspective

The above discussion has examined the problem of substance among nurses as a critical ethical dilemma. This analysis has portrayed it as a major challenge that has theological, cultural, and social implications. These arguments have not delivered meaningful support or empowerment to most of the affected RNs in the United States. This is a clear indication that a superior alternative to this ethical issue can present evidence-based ideas for guiding and empowering more victims (Epstein et al., 2010). Such a move is necessary since the ultimate objective is to examine the nature of the current challenge and implement sustainable measures that can eventually address this situation.

A relational perspective to this ethical issue can become an effective model or framework for identifying nurses with drug addiction as patients and ensuring that they receive timely support. When colleagues of affected RNs embrace this concept, they will be willing to provide sustainable support, make appropriate decisions, and transform the quality of care (Monroe et al., 2008). This kind of perspective requires that all nursing institutions, agencies, and organizations promote adequate values that can guide and encourage nurses to seek support whenever they encounter various problems throughout their careers.

The proposed perspective supports the concept of interdependence whereby RNs collaborate, focus on their unique issues, and consider the best approaches to empower each other. Nursing organizations will also benefit from this model since they will become moral agents for guiding, empowering, and meeting the unique needs of all nurses (Kunyk & Austin, 2011). The promotion of positive relational space in every working environment will minimize tensions and improve the quality of counseling available to different professionals (Kunyk & Austin, 2011). A multifaceted approach becomes a reality whereby the existing codes of ethics are redefined and modeled to encourage all RNs to collaborate, identify emerging problems, and solve them immediately. Nurses will also receive adequate training in an attempt to appreciate their respective predicaments.

This framework goes further to reveal that drug abuse among nurses is an issue that has numerous dimensions or implications. For example, the emergence of this problem can be an indication of personal challenges and family disunity (Epstein et al., 2010). Redesigning the nature of the working environment can ensure that more managers identify followers who might be affected by drug abuse or are at risk of addiction (Monroe et al., 2008). The new culture will make it possible for practitioners to report any misuse or loss of medicines. They will also be ready to collaborate and provide evidence-based care to their workmates who might be suffering from addiction (Epstein et al., 2010). The utilization of this new ethical perspective will deliver solutions to this problem instead of victimizing the affected nurses.

Nursing Profession and Policy

The nursing profession requires that practitioners follow the outlined principles of practice and act in accordance with the stipulated guidelines. There are specific values that are essential for RNs if they are to achieve their potential and meet the needs of all citizens. In many states and regions, RNs face disciplinary actions if they fail to act in accordance with the implemented codes of practice (Monroe et al., 2008). Unfortunately, the problems of drug abuse and addiction have not received the right support or analysis. This gap explains why the number of individuals facing this ethical problem has continued to rise in the United States. Existing policies promote reporting any misuse of drugs and misbehaviors in the provision of medical services. Fowler (2015) indicates that many nurses will be reluctant to identify workmates and colleagues who are facing the problem of addiction. The existing guidelines and requirements have, therefore, created numerous challenges instead of providing adequate support to the affected RNs.

The nature of this ethical challenge has compelled nursing associations and medical institutions to introduce new measures for empowering and meeting the needs of professionals struggling with drug overuse and alcoholism. This new approach has considered evidence-based and leadership approaches that will ensure that both disciplinary and assistive programs work synergistically to empower more RNs who are facing the problem of addiction (Monroe et al., 2008). The most important thing is for all stakeholders to acknowledge the nature of this ethical predicament and pursue programs that provide sustainable support to every at risk practitioner.

The current shortage of nurses should become a guiding principle for ensuring that institutions implement appropriate rehabilitation, empowerment, and aftercare systems that will support the retention of more NPs. The use of data-driven measures will make it possible for different agencies and institutions to understand how addiction among nurses is a major ethical issue (Fowler, 2015). The acquired information will empower them to understand the most appropriate tactics for supporting the affected practitioners and ensuring that they achieve both their personal and career aims. This development can also make it possible for more citizens to receive sustainable health services.

Conclusion

The above discussion has identified substance abuse among nurses as an ethical issue that has the potential to tarnish the nature of medical profession and affect patients’ health outcomes. Acknowledging that this is a critical problem is an effective approach that will guide different stakeholders to present evidence-based ideas for supporting and empowering the affected RNS. Those involved should consider the most appropriate measures to identify the existing gaps and create new opportunities that will eventually meet the needs of more NPs. These achievements will transform the nature of the above problem and ensure that every patient in the United States receives high-quality medical care.

References

Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics and issues in contemporary nursing (4th ed.). Clifton Park, NY: Thomas Delmar Learning.

Dunn, D. (2005). Substance abuse among nurses—Defining the issue. AORN Journal, 82(4), 573-596.

Epstein, P. M., Burns, C., & Conlon, H. A. (2010). Substance abuse among registered nurses. AAOHN Journal, 58(12), 513-516. doi:10.3928/08910162-20101116-03

Fowler, M. D. M. (2015). Guide to the code of ethics for nurses with interpretive statements (2nd ed.). Silver Springs, MD: American Nurses Association.

Kopp, M. A. B. (2009, April 1). Drug addiction: Many RNs fall prey to this hidden, potentially deadly disease. RN Magazine, 40-44.

Kunyk, D., & Austin, W. (2011). Nursing under influence: A relational ethics perspective. Nursing Ethics, 1, 1-10. Web.

McHugh, M., Papastrat, K., & Ashton, K. C. (2011). Assisting the drug addicted nurse: Information for the legal nurse consultant. Journal of Legal Nurse Consulting, 22(3), 11-14.

Monroe, T., Pearson, F., & Kenaga, H. (2008). Procedures for handling cases of substance abuse among nurses: A comparison of disciplinary and alternative programs. Journal of Addictions Nursing, 19, 156-161. Web.

Pilgrim, J. L., Dorward, R., & Drummer, O. H. (2016). Drug-caused deaths in Australian medical practitioners and health-care professionals. Addiction, 112, 486-493. Web.

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