Substance use disorder as a form of nursing workplace impairment is a multifaceted problem that impacts patients, nurses, colleagues, family, friends, the facility, and even the community Substance use disorders are not well understood by many, even nurses, so education about them remains a critical task for nursing education and preventive employer initiatives.
A nurse operates in the world like anyone else with all the risk and protective factors of any person for substance use disorder, but nurses have some additional risk factors specific to their profession that can vary from one nursing specialty to another.
They historical model of substance use and addiction as a moral failing has been replaced with the science that shows us it is a brain disease with multiple contributing factors, including a large genetic component. In many places the old stigma of drug addiction as a choice reflecting laziness and lack of personal responsibility is still common and can make it hard for people to ask for help or get support from colleagues, family, and friends.
Perhaps the most important thing employers can do is work to erase this from institutional thinking and train staff to support and assist nursing colleagues with substance use disorders. At the same time, support does not mean tolerance of impaired practice or a failure to meet ethical and legal responsibilities. It means that nurses taking on the challenge to deal with their substance use disorder need the support of their managers, peers, and family members to succeed.
The intersection of the legal requirements in Florida Statutes and Regulations and the ethical requirements expressed in the ANA Code of Ethics for Nurses mandates that nurses be knowledgeable about substance use disorders and aware of the signs of impaired practice in themselves and in others—and take immediate steps to address the problem while prioritizing the safety of patients.