Peer Assistance Services, a Colorado nonprofit organization that provides guidance, support, and rehabilitation services for healthcare professionals, has seen an increase in nursing clients this year—a majority of whom needed help for alcohol and drug abuse.
But, the growing number of nurses seeking treatment for substance abuse doesn’t necessarily reflect a growing problem, according to Rebecca Heck, BSN, RN, MPH, program director of the Nursing Peer Health Assistance program at Peer Assistance Services in Denver.
“We are seeing more nurses come forward, but the problem of substance abuse among healthcare professionals mirrors that of the general public,” she says. “I don’t know if there is an actual increase in the problem or if nurses are becoming more comfortable coming to us for help.”
Heck attributes recent media attention surrounding drug thefts by Colorado healthcare professionals as influencing more nurses to seek treatment. The most recent being the case of a former Rose Medical Center surgical technician, Kristen Diane Parker, who admitted to stealing fentanyl-filled syringes and occasionally swapping them with her used syringes filled with saline. The Denver Post reports that 20 patients appear to have contracted hepatitis-C from Parker as a result.
“I think the stigma is still there and is powerful,” Heck says. “But this is making the front page and people are getting scared and realizing they need help.”
Treatment plans through the Nursing Peer Health Assistance program are individualized depending on nurses’ needs and range from one to five years. Rehabilitation requirements can include therapy treatment, psychiatry, pain management, urinary analysis testing for drugs and alcohol, 12-step groups, sponsorship with a 12-step participant, and peer support groups. Any deviation from the rehabilitation may result in a referral to Colorado’s Board of Nursing, in which a nurse may deal with consequences, such as a suspended license to practice or a public discipline in the form of stipulation.
“We want to lead nurses to treatment and monitor them to hold them accountable for that treatment,” says Heck.
Literature shows that anywhere between 8%-12 % of nurses have substance abuse disorders that affect their ability to practice, says Heck. Studies have found prescription medication use to be higher among nurses than in the general population, while marijuana and cocaine use has been found lower among nurses than in the general population.
Aside from the easy access of prescription drugs on the job, a number of factors make nurses and other healthcare workers at high risk for substance abuse.
“The culture amongst all healthcare professionals is that we know how the drugs work, so therefore we think we can control them,” says Heck. “But they control us like they do everyone else.”
Nurses’ often stress-filled and lengthy work shifts and nature to “take care of others—not ourselves” are other risk factors, says Heck.
Clients receiving Nursing Peer Health Assistance services complete intensive portions of treatment before returning to work. However, some practice while receiving less serious forms of support with approval from Peer Assistance Services, a therapist, a psychiatrist, or other treatment provider.
Nurses’ identities are kept confidential, but they are required to disclose of their participation in the program to their nurse managers.
“Our number one goal is public safety,” says Heck. “If a nurse relapses, whether through behavioral symptoms or positive drug tests, we remove them from work within 24 hours and we inform the nurse manager. But then we also make sure the nurse gets treatment.”
Heck believes increased education about the causes of and prevention of substance abuse in nursing school and in the profession is needed to minimize the problem and push more nurses to get help.
“Nurses, risk management, and nurse educators do all of this work to make hospitals safer for patients, but we are all missing this huge element; to make nurses safer to provide patient care,” says Heck.