In today 's world, many health care organizations encounter the most critical problem, such as chemically impaired nursing practice, on a daily basis. All areas of the nursing profession are affected by a chemical dependency and the cost associated with this problem is a great concern for the health care organizations. According to Church (2000), “nurse impairment affects the safety of the public, the nurse’s well being and the profession as a whole” (p. 2). The delivery of care provided by the chemically impaired nurse lowers the standards and the prestige of the whole profession, creates serious liability for the employer, lowers productivity, increases the turnover rate, decreases staff members morale, and increases the risk for medication error (Wennerstrom and Rhooda, 1996). People’s lives, function and lifestyle can be dramatically changed due to a medication error caused by a chemically impaired nurse (Cook, 2014). The chief nurse executive (CNE) is frequently confronted with the problem of impaired nurse, furthermore, the CNE is responsible for the policy and decision making involving this issue (Hughes, 1995). The purpose of this paper is to examine nurse executives response to allegations of a chemically impaired nurse.
Guidelines to Establish Fitness for Duty All employees of health care organization are expected to report for duty in a condition that is fit for appropriate, capable, and safe performance of their responsibilities and such a fit need
The job description developed in accordance with the standards of the JCAHO should clearly mention the qualifications and competencies required for the job. This is an important requirement of the JCAHO standards where the health care organization is expected to derive the job description for each position on the basis of the care, treatment and services requirement for the entire organization. Since the organization may invite applications on its own or delegate the function to a third party, it is necessary that the job descriptions explicitly identify and define the competencies required for the position.
As the article The Impaired Nurse stated, “Impaired nurses can become dysfunctional in their ability to provide safe, appropriate patient care” (Thomas, C.M., & Siela, D. 2011). As we learned in class the four ethical principles include; beneficence which is the act of doing the most good, non-malfeasance which is the act of doing the least amount of harm, autonomy which focuses on allowing each individual to make their own decisions and justice which focuses on being fair to all involved. Nurses who are abusing substance typically can’t follow these for ethical principles to the best of their ability because they are too focused on themselves. As mentioned in the article Substance Abuse among Nurses, nurses who are abusing substances are not able to complete tasks and function as a typical nurse would (Talbert, J. J. 2009). These types of nurses are not able to apply the four ethical principles to their everyday work environment because they are too focused on the substances they need. These nurses would not be able to function and apply to principle of doing the most good because they will not be doing the best if on substances. As mentioned in both articles, these nurses will spend a good amount of time in the bathrooms hiding and using, take medications from patients, and forget tasks that need complete. Beneficence and non-malfeasance in my opinion could not apply to nurses who are abusing substances because they are not caring for their patients as
Jackie was one of the growing numbers of nurses who are impaired because of addiction. Sullivan (1994) cited that “nurses who abuse substances not only place themselves at risk for physical, emotional, and professional harm, but also create hazards for the institutions in which they work as well as the public” (p. 20). To deal with the issue posed by an impaired nurse, “nursing leaders must consider legal, regulatory, ethical, humanistic, and practical considerations in
As the nursing profession progresses throughout the years, its nature becomes more complex in meeting the professional standards and codes of ethics that are required by all nurses. The American Nurses Association has a specific code of ethics that each nurse should follow and adopt as their own beliefs. The public and the patients should be the priority when providing care in the healthcare setting. The knowledge and education that nurses’ gain is valuable and allows them to encourage health, avoid illness, restore health, and aid in coping for those who are all ill. (LeMone, pp.192) Given that the code of ethics is put into place, there are many registered nurses who violate these codes in various situations. The following will discuss
Poor record-keeping can have serious implications for the patient and the nurse. Professionally, colleagues rely on the information recorded on a patient to maintain continuity of care (Wood 2003). The patient’s progress could rapidly deteriorate due to poor record-keeping, holding the nurse responsible and accountable for the patient’s decline in condition. Poor record-keeping in this instance could include a nurse not documenting a nursing intervention such as administration of a medication. If this is not recorded another nurse could easily believe the patient did not get the medication and administer it again, causing overdose and possibly have severe implications for the patient depending on the medication. Another example could be if the nurse noticed the patient’s condition worsening but did not document it. Consequently the patient may get significantly worse before it is detected by the next nurse on duty. In these instances the nurse responsible for the poor record-keeping will most likely be brought to the Fitness to Practice Inquiry and as a result may lose his/her registration as a practicing nurse. If the nurse has made a grievous error a patient or family member could take civil action.
In a profession where others' health and well-being are priority, there leaves room for neglect of those who are delegated to care for these people. As a professional nurse, there are many obstacles that arise and affect the care provided to a patient, as well as the livelihood of the nurse. The current deteriorating and unsafe staffing conditions in hospitals and other institutions prompts workplace advocacy as the universally appropriate concept for maintaining professional nursing practice. Common
Every health professional has a legal obligation to patients. Nurses as part of the health care team share an important role in the quality and safe delivery of patient care. They have the major responsibility for the development, implementation and continuous practice of policies and procedures of an organisation. It is therefore essential that every organization offer unwavering encouragement and resources to support their staff to perform their duty of care in every patient. On the other hand, high incidences of risk in the health care settings have created great concerns for healthcare organizations. Not only they have effects on patients, but also they project threat to the socioeconomic status. For this reason, it is expected that all health care professionals will engage with all elements of risk management to ensure quality and safe patient delivery. This paper will critically discuss three (3) episodes of care from the case study Health Care Complaints Commission [HCCC] v Jarrett [2013] Nursing and Midwifery Professional Standards Committee of New South Wales [NSWNMPSC] 3 in relation to Registered Nurse’s [RN] role as a leader in the health care team, application of clinical risk management [CRM] in health care domains, accountability in relation to clinical governance [CG], quality improvement and change management practices and the importance of continuing professional development in preparation for transition to the role of RN.
The responsibility of regulating nursing practice that ensures public safety, health and welfare and accountability to the public for proper governance falls on the State Boards of Nursing (BONs). Substance abuse is the most common disease that affects healthcare workers (Darbro, 2009). The disease of substance abuse disorder is preventable (Darbro, 2009). The intent of this paper is to discuss the ethical issues of nurses with substance abuse disorder, stigma of addiction, challenges that nurses with substance abuse problems face to include acceptance of the disease, treatment, rehabilitation and monitoring, the incidence of addiction among nurses, how to recognize an impaired colleague, nurses’ attitudes about addiction within the profession and the ethical issues that the nurse, employer and society face when dealing with a nurse who is an addict. It was in the 1980s that professional nursing organizations recommended alternative to discipline (ATD) programs to help rehabilitate nurses (Sigma Theta Tau, 2014). In the past 20 years 46 states have gone with this approach as opposed to traditional discipline (Trussman, 2003). In most cases, these ATD programs provide nurses with intense monitoring for 5 years to aid in their recovery so they may return to work and provide safe patient care to the
It is important that management acts quickly if they suspect a nurse is under the influence of alcohol. Acting quickly reduces the chances for harm to the patient, staff or visitors. Per Marquis & Huston (2015), nurses using alcohol at work are less likely to admit to using due to lack of peer acceptance of their use. The manager or supervisor’s greatest obligation is to protect the patient. Ethically and legally the manager or supervisor cannot dismiss this impaired behavior (Marquis & Huston,
Nurses are undoubtedly one of the most trusted professionals worldwide. Patients, family members, and doctors entrust nurses to provide the utmost quality care to sick individuals. Top priorities of all nurses are advocacy for their patients: including advocating for their physical health, holistic welfare, and utmost importantly, their safety. Patient safety will always be the top priority when providing patient care. The nurse’s responsibility during every patient encounter is to ensure that each patient under her care, receives no harm. As a direct result of the previous statement, it is crucial that every nurse knows their rights to refuse unsafe patient assignments, the process to refuse unsafe patient assignments, and the legal or ethical ramifications that could present themselves if proper judgement is not used. By understanding these rules, nurses not only achieve the responsibility of advocating for patient safety but also safeguard their careers and license.
Nurses have a professional responsibility to ensure that safe boundaries are kept in the relationship between patient and Nurse. It is these boundaries that provide the nursing profession with integrity, and according to Baca (2010, pp.195) it is essential these boundaries be maintained because of the difference in power between the nurse and patient. However, boundary violations can occur, when a nurse crosses from the zone of helpfulness to over involved, the ANMC (2011 pp.3) believes that when a violation occurs a nurse is behaving unprofessional manner and misusing their power in the patient nurse relationship. This misuse of power can be categorized into 3 types; boundary crossing, boundary violation and the extreme form of sexual misconduct. Often by mistake a nurse could cross the boundary without thought, a
According to the American Nurses Association, an impaired nurse is unable to meet the requirements of the code of ethics and standards of practice of the profession. This nurse has cognitive, interpersonal or psychomotor skills affected by psychiatric illness and/or drug or alcohol abuse of addiction (American Nurses Association, 2010). Not only do these nurses create a potential threat to their clients, but they have also neglected to care for themselves.
“The definition of a health professional is a person who works to protect and improve people’s health by the diagnosis and treatment of illness to bring about a complete recovery from mental, physical and social perspectives, either directly or indirectly (Kurban, 2010, pg. 760).” Nurses in the community today have acquired an increasing responsibility to intervene with medical decisions. In the past, there were clear differences between nurses and doctors. It was more common for a nurse to be supervised directly under the physician. They are not just performing Doctor’s orders anymore. The nurse role in patient care has been widely expanded. Allegations against someone can be one of the most stressful moments of their careers. Negligence
Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriate legal and ethical decisions. Even though most nursing programs cover the ethical and moral issues in health care, it is questionable if new nurses have the depth of knowledge and understanding of these issues and apply them in their practice
There are many different variations of healthcare professionals that assist people in regaining and maintaining a healthy lifestyle. The career field of licensed nursing is often considered to be one of the most vital professions within the medical community. Registered nurses work to prevent and heal various different types of injuries, diseases, and illnesses. They are also responsible for administering a variety of patient services, consisting of individual patient care, analyzing and monitoring patient medical reports, and also possessing the ability to operate technical medical equipment. As well as, be able provide comfort and emotional support for both physically, and mentally ill patients. All Registered Nurses are responsible for providing patients with quality health care, in compliance with professional standards set forth by the American Nurses Association. As the field continues to rapidly evolve, an increase in responsibility is placed upon registered nurses to maintain a professional standard of care. With the increase in responsibility, the role of registered nurses consistently changes to accommodate individual patient needs. As a result, the rise in responsibility placed on registered nurses correlates to a higher probability of malpractice and negligence occurring within the community. The consequences of malpractice and negligence can