Alternatives to Dismissal for Nurses with Substance Abuse Problems

Nurses work in an environment that is characterized by high levels of stress and easy access to medications. As a result, nurses have a significantly higher rate of substance abuse than the general public, with experts estimating that approximately 20 percent of all nurses struggle with an addiction.

When a nurse is discovered to have a problem with substance abuse, administrators have been faced with a tough situation. While it is impossible to continue to support a nurse with a substance abuse problem working closely with highly addictive medications, it is important to show the nurse the same compassion that is offered to patients. In addition, the industry is experiencing a chronic shortage of qualified nurses.

A recent article published in the February issue of the Journal of Clinical Nursing argued that the answer to the difficult problem of nurses with addictions is to be supportive and offer rehabilitation through treatment instead of resorting immediately to punishment.

The research team reviewed findings regarding the subject and presented six key elements of an effective alternative-to-dismissal (ATD) plan. Lead author Dr. Todd Monroe of the Vanderbilt University School of Nursing in Tennessee explains that an ATD program enables administrators to better protect patients. Traditional disciplinary procedures may take months, while an ATD can be efficiently carried out.

In addition, an ATD program operates with support of the nurse and an atmosphere of non-judgmental treatment that can help nurses seek help while retaining prospects of returning to the profession following recovery.

The authors of the study also emphasize that nurses are faced with the same problems as the general population, including addiction. While nurses are expected to extend compassion to patients with substance abuse problems, they are often dismissed without the same empathy from peers and administrators for a condition widely recognized as an illness.

The ATD program suggestions include provisions for nurses returning to work after recovery. Reinstatement to the position is closely monitored, with random substance checks and support offered by managers and regulators.

One positive aspect of the ATD program is that it allows nurses to address many of the problems previously stemming from a discovery of a substance abuse problem, such as obtaining liability health insurance after discipline. Making these obstacles less daunting will help nurses reenter the workforce.

The researchers believe that ATD programs are a promising alternative to disciplinary action. They provide the protection necessary for ensuring safety for patients and allow nurses the same compassion and support that they offer to patients every day.