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Keywords:

  • nursing;
  • policy;
  • risk management;
  • substance abuse;
  • workforce issues

Aim

To investigate substance use disorders, impaired practice and health risks among nurses in a disciplinary jurisdiction.

Background

The relationship between substance-related risks to patient safety, nurse health and discipline is understudied.

Method

A convenience sample of 4064 registered nurses responded to an Internet survey in 2010. Self-reports were given to psychometrically robust measures of health, substance use disorders and organisational support. Perceptions on the treatment and disposition of impaired nurses were also asked.

Results

The prevalence of substance use disorders was similar to the general population. Most nurses' coded high risk for impaired practices were working, unknown by their employer/regulator and not receiving treatment. When compared with nurse-peers, their health and organisational support were compromised. Nurse-peers viewed impaired nurses as having a treatable illness that their employers/regulators should assist and afford confidentiality.

Conclusions

In this jurisdiction, discipline was not rated as effective for risk mitigation, supportive of nurses with substance use disorders or in alignment with nurse perceptions.

Implications for nursing management

Nursing managers play a significant role in addressing substance-related issues among nurses and can be key to influencing the outcomes of these difficult situations. For these reasons, it is important they recognize the ineffectiveness of discipline for substance-related risk mitigation.