Page 530 - Encyclopedia of Nursing Research

SUBSTAnCe USe DISORDeRS In RegISTeReD nURSeS n 497

role of theory in selecting appropriate modi- professional ethical code and standards of
fications is crucial. nursing practice because cognitive, inter-
personal, and/or motor skills of the practi- S
JoAnne M. Youngblut tioner are impaired by psychiatric illness or
excessive use of alcohol and/or other drugs.”
The 1982 AnA house of Delegates passed a
resolution on impaired practice, and a pol-
SubStance uSe diSorderS in icy statement, Addictions and Psychological
Dysfunctions: The Profession’s Response to
regiStered nurSeS the Problem, followed (AnA, 1984). The eco-
nomic consequences of substance-related
disability, risk management, and contin-
Addiction, a health problem for registered uing quality assurance still make substance
nurses and other health professionals, came dependence in health professionals an
to the attention of nurse researchers in the important policy issue.
1980s. Social stigma, denial in the profession, The prevalence of substance depen-
and a dearth of willing research subjects are dence in nurses and health professionals
all reasons for a paucity of research in this as compared with the public was among
area. In framing a research review and the the first research questions addressed.
scope of this professional issue, the term Approximately 9% of Americans abuse or
“substance dependence” is recommended are dependent on alcohol and 2% abuse or
over “addiction.” Substance dependence is are dependent on other drugs (grant et al.,
a maladaptive pattern of substance use with 2004). The recognition of nicotine addic-
a cluster of cognitive, behavioral, and phys- tion and efforts to limit its prevalence have
iologic symptoms, outcomes of neurologic resulted in female nurses’ decreased rates
adaptation. An individual continues use of smoking (8.4% in 2003 from 33.2% 1976)
despite significant impairment in social, pro- (Sarna et al., 2004), significantly lower than
fessional, and/or legal function. “Substance the public’s 20.6 % prevalence (Centers for
abuse” has as its essential feature, this mal- Disease Control and prevention, 2010a).
adaptive pattern of use along with “recurring Because the majority of nurses are women
and adverse consequences” without phys- and the prevalence for alcohol dependence
iologic dependence (American psychiatric is 3 to 1, m/F, and because illicit drug use is
Association, 2000). These disorders result in lower in women, the prevalence of depen-
significant disability and death for nurses dence on alcohol, nicotine, and illicit drugs
and can contribute to below-standard nurs- was estimated to be lower in nurses than
ing practice (impaired practice), endangering in American women in general (Clark &
public health and safety. Farnsworth, 2006; Trinkoff & Storr, 1998a,
Substance dependence in registered 1998b; West, 2003). The findings of Trinkoff,
nurses challenges the profession to regu- eaton, and Anthony (1991) provided sound
late its practitioners’ delivery of high qual- epidemiologic data about prevalence
ity care. In 1982, a climate of social concern based on a small sample of nurses in the
and the visibility of substance-related prob- epidemiologic Catchment Area Study
lems in nurses led to the American nurses (national Institute of mental health). This
Association (AnA) and several specialty was a multisite, probability sample of 142
nursing associations, support of research nurses and suggested that nurses and con-
and development of organizational posi- trol group members had similar rates of
tions about impaired practice, defined as illicit drug use—marijuana, cocaine, heroin,
“nursing practice which does not meet the psychedelics, tranquilizers, amphetamines,