Untitled Document

Introduction

In the healthcare setting, workplace impairment refers to failing to provide patient care with reasonable skill and safety because the worker is afflicted with a substance use disorder, physical illness, or mental illness. A worker's impairment may be temporary, intermittent, or escalating. It is estimated that nurses' impairment rate is between 10% to 15%, the same as the average population (Kunyk, 2015). The significant outcome of nurse impairment is increased risk or injury to the patient, self, colleagues, and the employer.

Nursing during usual times is a stressful profession. The COVID-19 pandemic has dramatically increased that stress (McKay & Asmundson, 2020). According to the CDC (2020), this pandemic can lead to stress, anxiety, fear, and other strong emotions that can increase drug and alcohol use.

This increased stress can lead to the following behaviors and responses in health professionals, which can facilitate increased drug and alcohol use:

Feeling irritation, anger, or denial
Feeling uncertain, nervous, or anxious
Feeling helpless or powerless
Lacking motivation
Feeling tired, overwhelmed, or burned out
Feeling sad or depressed
Having trouble sleeping
Having trouble concentrating (CDC, 2020)

Dr. Michael McCormick, an addiction specialist at the Caron Treatment Center for addictions, describes how the additional stress and living situations during COVID time increased a nurses' use of alcohol.

A nurse was working long shifts in the hospital, dealing with COVID-19 patients. Then she would go home. She had isolated herself from her husband for fear of passing the virus on to him, so her time at home was spent alone, watching the news about the pandemic. Her anxiety skyrocketed, and her drinking was quickly out of control.

She described how she would go to work at the hospital but didn't talk about her anxiety or fears. She would return home and watch the news, drinking more and more over time. She eventually reached a crisis point and reached out for help. https://www.caron.org/blog/covid19-fuels-anxiety-and-substance-use-disorder-among-healthcare-professionals.

In a recent study by Arble et al (2023), the researchers found from their study of 695 nurses, there was not a statistically significant increase in substance use amongst the nurses from the stress of the COVID-19 pandemic. However, there was a statistically significant increase in anxiety, posttraumatic stress disorder and secondary trauma. These conditions have been linked to increased rates of cognitive failure, leading to errors in perception, memory, or actions (Ametz et al., 2021).

Both above research groups recommend that healthcare organizations provide nurses with the necessary support and personal protective equipment to maintain their feelings of well-being and to work safely. Regular monitoring of nurses’ work stress and interventions are warranted.

In this course, information will be presented on how employers and employees can be vigilant for workplace impairment and cognitive impairment. The following topics will be discussed:

Signs of Impairment among colleagues
Assessment of the fitness of a suspected impaired employee
Removing impaired employees from patient care
Reporting affected employees to appropriate authorities
Accommodating employees found to qualify as disabled under the Americans with Disabilities Act
Re-instating rehabilitated employees when possible.
Monitoring of nurses’ work stress
Interventions that enhance emotional well-being of nurses

Instant Feedback:

Drug and alcohol impairment is less than 2% of nurses.

References

Arble, E., Manning, D., Arnetz, B. B., & Arnetz, J. E. (2023). Increased substance use among nurses during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 20(3), 2674.

Arnetz, J. E., Arble, E., Sudan, S., & Arnetz, B. B. (2021). Workplace cognitive failure among nurses during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 18(19), 10394.

Caron Treatment Centers. (2020). COVID-19 fuels anxiety and substance use disorder among healthcare professionals. Retrieved from https://www.caron.org/blog/covid19-fuels-anxiety-and-substance-use-disorder-among-healthcare-professionals

Centers for Disease Control and Prevention (CDC). (2020). Coping with stress during the COVID-19 pandemic. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

Kunyk, D. (2015). Substance use disorders among registered nurses: Prevalence, risks and perceptions in a disciplinary jurisdiction. Journal of Nursing Management, 23(1), 54-64.

McKay, D., & Asmundson, G. J. G. (2020). COVID-19 stress and substance use: Current issues and future preparations. Journal of Anxiety Disorders, 74, 102274.