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Spotting and Addressing Impairment in Nurses

Working in the nursing field may be tremendously demanding and emotionally draining and on some occasions, push nurses to use of substances. Among other risk factors of alcohol and drug intake in nurses are family history and coexisting mental illnesses. When uncontrolled, recreational use may escalate to substance abuse which is likely to inhibit nurses from fulfilling his or her professional duties.

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One may readily see the dangers of such impairment in medical staff. This paper discusses the measures that coworkers may undertake to help an impaired nurse and ensure patients’ safety and the impact that the issue might have on my role in health care.

Coworkers’ Professional Obligations Within Four Component Model

A glance at recent statistics paints a pessimistic picture of the impairment prevalence in nurses. Out of more than 4 million nurses in the labor force of the United States of America, 10-15% reported persistent dependency on drugs and alcohol (Lockhart & Davis, 2017). The approach that a nurse should adopt if he or she gains knowledge of the impairment in a coworker may be explained within the framework of Four Component Model (FMC).

FMC describes four stages which when followed precisely, may help a health professional turn thought into action (McBride, Tietze, Robichaux, Stokes, & Weber, 2018). First, a nurse should possess ethical sensitivity which may be interpreted as a heightened awareness of his or her surroundings in which ethical violations do not go unnoticed. Further, ethical judgement comes into play, and a nurse should thoughtfully evaluate the situation and its gravity.

The third component of FMC is ethical motivation which explains that observing is not enough, and nurses should be ready to engage if they spot impairment. Lastly, a nurse should take ethical action which may be particularly distressing. However, McBride et al. (2018) emphasize the point that the distress from failing to do what is right might be greater than the emotional strain that tackling a problem puts on a professional.

Coworkers’ Institutional Obligations

In a medical facility, a nurse’s primary institutional obligation is informing colleagues and administration about the issue. The success of such an intervention, however, closely correlates with the way a nurse decides to approach the situation. It is crucial to understand that when disclosing information about a coworker’s substance addiction, one should abstain from using labels, name-calling, and any other behaviors that may be harmful or disrespectful.

With the help of a colleague or a supervisor, a nurse should decide on the course of action. It is recommended to confront an impaired nurse on his or her habit which, however, should include acknowledgement of his or her worth as a human being. Further, coworkers and supervisors may discuss treatment options among which is contacting referral sources.

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Referral Sources for Impaired Nurses in Florida

Coworkers may restore an impaired nurse’s faith in recovery by providing him or her with the contact information of local referral sources. In Florida, medical staff may refer an impaired nurse to Florida Nurses Association (FNA) that runs Florida Intervention Program for Nurses (Smith & Greene, 2015). FNA receives calls regarding alleged substance abuse and examines every case closely, after which a nurse may be admitted to a sponsor-based support group.

Ethical considerations are taken into account: FNA ensures anonymity and confidentiality. The organization works on building and maintaining a secure network of impaired medical professionals that could aid each other on the road to recovery. Its educational efforts are aimed at stigma reduction so that more health professionals could overcome shame and come forward with a confession about their situation.

The Impact of the Issue on My Role in Health Care

In case I assume an advanced practice role in a medical facility, it will be my obligation to monitor staff for behavioral patterns that raise concern. The prevalence of this issue and dire need for effective solutions will probably be one of the reasons why I will get involved in lifelong learning which is currently being promoted among nurses. Many states among which is Florida now require nurses to take a course on recognition of substance abuse in health professionals (Lockhart & Davis, 2017).

Besides the scope of formal education on the phenomenon, it will be imperative to develop my critical thinking in order not to yield to common misconceptions. For instance, in many cases, alcohol and drug use might no longer be voluntary, and an impaired nurse might be not capable of quitting on his or her volition. Thus, I will need to make an effort to put judgment and disdain aside and offer a struggling nurse a helping hand. Continuing education and genuine personal involvement may be useful in approaching coworkers that act suspiciously and may be violating the medical ethical code and safety guidelines.


Working in health care requires a high degree of precision, sound mind, and composure. The detrimental effects of substance abuse on job performance may be mitigated or eliminated when spotted and addressed promptly. It is imperative that coworkers are well-educated on the issue and can notice most subtle signs of alcohol and drug addiction. Medical professionals may find Four Component Model useful since it may guide an individual through the process of planning and taking ethical action. One should not proceed with an intervention alone as supervisor and colleagues may be of great help in evaluating the situation. One of the most effective ways to address impairment is admission to a support group.


Lockhart, L., & Davis, C. (2017). Spotting impairment in the healthcare workplace. Nursing Made Incredibly Easy! 15(3), 38-44.

McBride, S., Tietze, M., Robichaux, C., Stokes, L., & Weber, E. (2018). Identifying and addressing ethical issues with use of electronic health records. The Online Journal of Issues in Nursing, 23(1).

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Smith, L. L., & Greene, M. (2015). Florida intervention project for nurses: A national model for ADP and nurse assistance. Journal of Addictions Nursing, 26(3), 159-162.

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"Spotting and Addressing Impairment in Nurses." StudyCorgi, 19 Dec. 2020,

1. StudyCorgi. "Spotting and Addressing Impairment in Nurses." December 19, 2020.


StudyCorgi. "Spotting and Addressing Impairment in Nurses." December 19, 2020.


StudyCorgi. 2020. "Spotting and Addressing Impairment in Nurses." December 19, 2020.


StudyCorgi. (2020) 'Spotting and Addressing Impairment in Nurses'. 19 December.

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