Page 532 - Encyclopedia of Nursing Research

SUBSTAnCe USe DISORDeRS In RegISTeReD nURSeS n 499

The nurses’ Worklife and health Study they “knew too much to become addicted”
findings link scheduling patterns with (Burns, 1998). These rationalizations extend
the prevalence and odds of substance use. as far as to reason that addiction is not S
Working overtime, working shifts longer possible so long as a chemical is being
than 8 hours, and working one or two week- injected intramuscularly, not intravenously
ends per month all increased the likelihood (hastings & Burn, 2007).
of alcohol use. In addition, smoking was The limited and dated research on
more prevalent among night-shift work- addictions/substance dependence in nurses
ers and those working several weekends suggests that nurses share risk factors with
per month, a factor also associated with the general population but that workplace-
increased drug use. related factors, such as access to controlled
West’s (2002) research suggests that substances and pharmaceutical knowledge,
nurses with high numbers of early risk indi- increase the risks for misuse and dependence
cators (psychological stress, low self-esteem, for some. Of concern are the 60,010 disciplin-
low religiosity, distance in family, higher ary cases (27.53%) reported by the national
sensation seeking scores and family sub- Council of State Boards of nursing (1996–
stance use histories) are at higher risk for 2006; http://www.ncsbn.org/index.htm) for
alcohol and drug dependence which results alcohol and other drug incidents, and the
in impairment. Attitudes about the benefits 16,268 cases categorized as drug diversion by
of medications and their ability to control the nurse for his or her own use. Clearly, sub-
use have also been identified as risk factors. stance abuse and dependence remain health
nurses who routinely administer medica- problems for nurses and self-regulatory chal-
tions believe them to be “safe.” Familiarity, lenges for the profession. most cases of alco-
then, precedes self-medication, which pre- holism and many cases of drug diversion are
cedes abuse (Trinkoff & Storr, 1994). not reported, suggesting a greater problem
Brown, Trinkoff, and Smith (2003), than the data support. There is a need for fur-
Burns (1998), and hutchinson (1986) ther research to explore the risk factors that
described nurses’ experiences of depen- might be influenced by professional educa-
dence and recovery as different from those tion, workplace factors, and the development
of the general population but similar to of substance dependence in nurses, the man-
other health professionals. A noteworthy agement of such problems in employment
fact is the use of prescription medications settings, and the access of nurses to “best
as opposed to street drugs, more frequently practices” addiction treatment. Findings sug-
accessed in employment settings (Clark & gest that nurses generally receive less treat-
Farnsworth, 2006). Additionally, it has been ment and return to longer working hours
shown that traditional predictors of alco- than substance-dependent physicians, plac-
hol abuse, such as age, gender, and income, ing them at high risk for relapse. nurses have
present little benefit in discovering alcohol- less economic independence than physicians,
ism in health care professionals (Kenna & which may explain shorter courses of treat-
Wood, 2004), who are generally well edu- ment. They are also more likely to face sanc-
cated and steady income earners. The role of tions which more severe on return to work
intellectualization and denial in supporting (Shaw, mcgovern, Angres, & Rawal, 2003).
use and abuse cannot be over emphasized. The differences in how addiction is per-
Despite the aforementioned prevalence of ceived and treated in physicians and nurses,
abuse and dependence in the profession, all and limitations to access to high-quality
of the nurses in one study described their treatment as a function of economic status
health as “excellent to good,” and often felt remains areas for exploration for nurses and