Substance use disorders among registered nurses: prevalence, risks and perceptions in a disciplinary jurisdiction

AIM: To investigate substance use disorders, impaired practice and health risks among nurses in a disciplinary jurisdiction. BACKGROUND: The relationship between substance-related risks to patient safety, nurse health and discipline is understudied. METHOD: A convenience sample of 4064 registered nurses responded to an Internet survey in 2010. Self-reports were given to psychometrically robust measures of health, substance use disorders and organisational support. Perceptions on the treatment and disposition of impaired nurses were also asked. RESULTS: The prevalence of substance use disorders was similar to the general population. Most nurses' coded high risk for impaired practices were working, unknown by their employer/regulator and not receiving treatment. When compared with nurse-peers, their health and organisational support were compromised. Nurse-peers viewed impaired nurses as having a treatable illness that their employers/regulators should assist and afford confidentiality. CONCLUSIONS: In this jurisdiction, discipline was not rated as effective for risk mitigation, supportive of nurses with substance use disorders or in alignment with nurse perceptions. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers play a significant role in addressing substance-related issues among nurses and can be key to influencing the outcomes of these difficult situations. For these reasons, it is important they recognize the ineffectiveness of discipline for substance-related risk mitigation.