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186 unit 3 | Professional Issues CikguOnline
expected to be of good moral character.The problem The National Council of State Boards lists all
of addiction among nurses was not discussed until state boards of nursing. Information on support
the 1950s, with addicted nurses receiving little sym- programs for impaired nurses can be obtained
pathy or treatment from their peers. Research on from each state board (ncsbn.org/regulation/
addicted medical professionals increased in the nursingpractice_npa_pennrn.asp).
1970s,followed by major help for nurses with addic- Upholding the standards of the nursing profes-
tive disease in 1980. At this time, the National sion is everyone’s responsibility. Often coworkers,
Nurses’ Society on Addictions (NNSA) task force noticing a change in another’s behavior, become
and the ANA task force on addictions and psycho- protective and take on more work to ease the bur-
logical functions jointly passed a resolution calling den of their coworker. Although it is difficult to
for acknowledgment of the problem and guidelines report a colleague, covering up or ignoring the
for impaired nurse programs (Heise, 2003). problem can cause serious risks for the patient and
Alcohol and drug abuse continue to be major the nurse. Many state boards make it mandatory
health problems in the United States. Health-care for nurses to report suspected impaired coworkers;
professionals are not immune to alcoholism or most states accept anonymous reports. In many
chemical dependency. In addition, various kinds of states, state law requires hospitals and health-care
mental illnesses may also affect a nurse’s ability to providers to report impaired practitioners, but the
deliver safe, competent care. Impaired workers can law also grants immunity from civil liability if the
adversely affect patient care, staff retention, morale, report was made in good faith (Blair, 2005; Sloan
and management time as team members try to pick & Vernarec, 2001).
up the slack for the impaired worker (Damrosch &
Scholler-Jaquish, 1993). The most common signs Microbial Threats
of impairment are (Blair, 2005; Damrosch & Health-care workers are an at-risk group for several
Scholler-Jaquish, 1993): microbial threats. Severe acute respiratory syn-
dromes (SARS) is a respiratory illness that has
■ Witnessed consumption of alcohol or other sub-
been reported in Asia, Europe, and North America.
stances on the job
According to the World Health Organization,
■ Changes in dress, appearance, posture, gestures
8098 people worldwide became sick with SARS
■ Slurred speech; abusive/incoherent language
during the 2003 outbreak.
■ Reports of impairment or erratic behavior from
SARS begins with a high fever and mild respi-
patients and/or coworkers
ratory symptoms. Other symptoms may include
■ Witnessed unprofessional conduct
headache, an overall feeling of discomfort, and
■ Significant lack of attention to detail
body aches. It is not uncommon for the person to
■ Witnessed theft of controlled substances
have diarrhea and develop a dry cough. Most
■ When assigned patients routinely request pain
patients develop pneumonia. The virus that causes
medication within a short period of being
SARS is thought to be transmitted most readily by
medicated
respiratory droplets. The virus can also spread
Most employers and state boards of nursing have when a person touches a surface or object contam-
strict guidelines related to impaired nurses. inated with infectious droplets and then touches
Impaired-nurse programs, which are conducted by his or her mouth, nose, or eyes. In addition, it is
state boards of nursing, work with the employer to possible that the SARS virus might spread more
assist the impaired nurse to remain licensed while broadly through the air (airborne spread) or by
receiving help for the addiction problem. It is other ways that are not known.The CDC provides
important that you become aware of workplace current information on the handling of SARS in
issues surrounding the impaired worker, signs and the workplace (cdc.gov).
symptoms of impairment, and the policies and Unlike the newer microbial threat SARS, tuber-
reporting procedures concerning an impaired culosis (TB) was a leading cause of death among
worker. Compassion from coworkers and supervi- infectious diseases from the 19th into the mid-
sors is of utmost importance in assisting the 20th centuries. Although TB rates declined in the
impaired worker to seek help (Damrosch & 1990s, they are currently on the rise as resources
Scholler-Jaquish, 1993; Sloan & Vernarec, 2001). that were committed to fighting the disease were