NUI: Nursing Under the Influence

As nurses, we are charged with a tremendous amount of responsibility.

From cleaning up after a patient to protecting their lives, we are called on to do more in one day than the average person does in a lifetime.

Part of our profession is and always will be faced with the temptation of narcotics and other drug usage.

Although most nurses would rather work two straight double shifts rather than take from their patient, nurses still divert medication from patients for use or profit.

Diversion, addiction, and drug abuse are hot button topics in the world of nursing.  When I became a nurse six years ago, I know that some of my classmates were told they could not sit for boards in the great state of Pennsylvania due to a DUI charge on their record.

Nursing doesn’t seem to have a concrete rule about this, though, and the cut off line is similarly blurred.

This article from Muncie, Indiana, shows how some new grads with records are given the opportunity to sit for boards while some licensed nurses are punished for similar drug infractions.

No matter where you stand on the issue, each side makes a point.  Either we allow nurses some leeway in the world of substance abuse, or we don’t allow any nurse with any history to enter or stay in the profession, period.

Policy of Allowance

Everyone makes mistakes, including nurses.  Maybe you were a hell raiser in your teen years, or maybe you just happened to be at the wrong place at the wrong time.

For some nurses, the pressures and stresses of the job push them into substance abuse, and the profession cannot very well punish those who are trying to cope – even if it is the worst way.

After all, nursing is the business of compassion, and shouldn’t we extend that compassion to each other first?  For passing indiscretions or even out right poor judgment, people can make mistakes.

Some nurses work for years to achieve the education to become an advanced standing nurse.

If they make a mistake on the job and have sanctions against their license for it, then their primary means of earning a living are removed.

The focus should not be on punishment.  It should be on rehabilitation, fixing the profession, and extending the hand of mercy to help one of our own who is struggling.

Substance abusers can make mistakes, but that doesn’t keep them from being a great nurse.

No-Tolerance Policy

Nurses are in a business primarily based on trust.  If you have a record of substance abuse, it stands to reason that you are no longer trustworthy, especially where the use of controlled substances is concerned.

Nurses are also called on to make judgment calls in the care of their patients.

If a person has a history of poor judgment, such as through a prior arrest, then they cannot be expected to make sound judgments when caring for sick patients.

It would erode our profession to cover up the acts of nurses who divert, and this can decrease our trust with patients and doctors alike.

Those who enter nursing know that using narcotics is wrong, and the choice to abuse substances is theirs alone.

However, we cannot allow that person the opportunity to continue making the mistake or to possibly make a worse one.
“When a nurse makes a mistake, we understand. We are human.”
If we dealt in manufacturing or business, the subject of substance abuse would not loom as large.  Who cares if you are high and accidentally hit the wrong key on a computer?

Sanctions against nurses who abuse substances are not a character issue or a way of singling out those who have made mistakes.

It comes down to the simplest charge that we have: what is in the best interest of the patient?

Perhaps this is how to make the choice easier, as all nurses should be reviewed on a case-by-case basis.

When a nurse makes a mistake, we understand.  We are human.  We have compassion.

Until we determine where to draw the line, how to punish abusers, and the nature of offences that should eliminate a person from the profession, the topic will be hotly debated in nursing for years to come.