An impaired nurse is a health professional that becomes unable to provide safe, appropriate care to their patients. Impaired nurses are still responsible and legally liable for their actions while on the job. Nurses can become impaired in different ways and each has its own risk factors associated with them. It is important that other individuals are able to recognize a nurse’s impairments because it can have a major impact on patients, coworkers, themselves, and agencies. Nurses are ethically and morally obligated to intervene when the safety of others is compromised by an impaired nurse, and we must be prepared to know how to handle that type of situation. Impairment in the nursing profession is an important problem to be aware of because …show more content…
A few of the impairments that can affect nurses is mental, physical, and substance and/or alcohol impairments. Nurses can be mentally impaired through depression, personality disorders, or anxiety and panic attacks. Nurses are at risk for mental impairment because they are exposed to high amounts of tragic and emotional situations. Due to this increased amount of exposure, nurses could develop major depression or mood instability, be at risk for suicide, and have increased incidences of anxiety or panic attacks during critical situations. In fact, mental disorders among nurses are usually ignored and nurses usually just push through it. According to the Minority Nurse magazine, “medicine is concerned with what it can see, touch, and heal, mental health concerns are often shunted to the side. Nurses not only dismiss the idea of depression in their profession, but they also do it to themselves” (Lampert). Aside from nurses being mentally impaired, nurses can also be physically impaired as well. Nurses can be physically impaired through exhaustion, stress, and a physical disability or injury. Nurses are at risk for physical impairments because they are exposed to long work hours and overtime, which leads to exhaustion. According to the book Patient safety and quality: An evidence-based handbook for nurses, “An integrative review by Caruso and colleagues reported that overtime was …show more content…
If a nurse is mentally impaired, signs and symptoms would include, but not limited to: isolation, insomnia, poor concentration, mood changes, feelings of panic, weight loss or gain, or being disconnected. Usually these signs and symptoms would be noticed gradually overtime and not instantaneously because nurses can exhibit some of these signs and symptoms on occasions due to the nature of their job. It’s when the nurse is continuously displaying evidence of a mental impairment that someone should be concerned. Evidence of a nurse being physical impaired would be falling asleep while driving or while working, unable to complete tasks, displaying signs of pain or illness, irritability, and increased absences. Nurses who are physically impaired can be careful at hiding their impairment or using excuses. So it’s very important to understand the true warning signs and symptoms of a physically impaired nurse. Friends and family are usually the first ones to recognize a physical impairment. For nurses who have a substance and/or alcohol impairment, they will display I wide range of signs and symptoms. Some signs and symptoms include slurred speech, shakiness/tremors, smell of alcohol on breath, frequent reports of patients not getting adequate pain relief, unsteady gait, dishonesty, refuses drug testing, anger outburst, and increased narcotics being
Lemiengre, J., Nelis, T., Joosten, E., Braes, T., Foreman, M., Gastmans, C., et al. (2006). Detection of Delirium by Bedside Nurses Using the Confusion Assessment Method. The American Geriatrics Society , 685-689.
In 2011 The Joint Commission called attention to healthcare worker fatigue and the impact it was having on patient safety. They found a direct link between healthcare worker fatigue and adverse events. They recommended healthcare facilities assessed their policies to identify fatigue-related risks, such as off-shift hours and consecutive shift work, and review their staffing to address areas that may be contributing to nurse fatigue (Martin, 2015).
The framework of this model is utilized throughout hospital settings to form a basis for all nursing decisions in respect to nursing diagnosis, care plans, discharge planning, and quality assurance (Reynolds & Cormack, 1991). This conceptual model focuses on the effects of internal and external environments that contribute to someone’s behavior. Pain (being the internal force) in patients with altered mental status usually manifests externally in non-verbal cues. Nursing as the external force can use tools that focus on the non-verbal cues given by the patients to accurately assess the pain and properly treat it.
...is causes injury or not is an example of unsafe practice. This act could also be categorized as careless or repetitive conducts that puts a patient in danger. Drug diversion is a type of drug dealing, nurses have access to many drugs and it is a part of the nurses’ responsibility to ensure those drugs go where they should, precisely document and closely supervised. Criminal conduct can happen in the work place or on personal time. If a nurse is convicted of a crime, such as Driving While Intoxicated, it could affect their ability to practice nursing. It is out of a RNs legal scope of practice to medically diagnose any patient, order a medical treatment or conduct a medical treatment that has not been ordered by a physician. It is the nurse’s duty to their patient’s to exhibit sound clinical judgment, with in their scope of practice to ensure patient safety.
I think shortages of nurses can also be a factor in why nurses are overworked and stressed. In most hospitals you can’t even tell if there is a nurse shortage, the nurses run around from patient to patient I’m trying to still provide the same quality care. My aunt is a registered nurse for Northeast medical center and I asked her out of the previously 11 listed reasons nurses are stressed which do you experience the most. She replied, “I have to say that I experience number one which is work overload the most. When I started working as a nurse 37 years ago there were three separate shifts throughout a day and there’s could work instead of the two 7am-7pm. The nursed patient ratio was a lot lower we got to spend time with the patients we had during the day and provide individual attention. You didn’t feel overwhelmed because the hospital had enough nurses. Now they nurses doing e same amount of work as two or three nurses combined, and are still expected to do
In the recent past, nursing has come to the forefront as a popular career amongst students across the globe. The demand for nurses has kept increasing gradually over the years. In fact, the number of registered nurses does not meet the demand of the private and public health sector. This phenomenon has resulted in a situation where the available registered nurses have to work extra hours in order to meet the patients’ needs. With this in mind, the issue of nurse fatigue has come up as a common problem in nursing. According to the Canadian Nurses Association (CNA), nurse fatigue is “a feeling of tiredness” that penetrates a persons physical, mental and emotional realms limiting their ability to function normally. Fatigue does not just involve sleepiness as has been assumed before. It involves utter exhaustion that is not easily mitigated through rest. When nurses ignore the signs of fatigue, they risk the development of chronic fatigue and other health problems that may not be easily treated. Additionally, fatigue may cause nurses to lose more time at work as they may have to be away from work for several days to treat it. The issue of nurse fatigue has permeated the nursing profession to the extent of causing errors in the work performed by nurses. Fatigue causes a decrease in a nurse’s ability to make accurate decisions for themselves and their patients. It is therefore important to find ways to curb nurse fatigue such that it is no longer a problem. Nurse fatigue is a danger to the patients, organizations and to the nurses themselves and must be mitigated adequately.
Q.3 Nurses as part of regulated health care practitioners are responsible and accountable to abide by the standards, codes and guidelines of nursing practice (NMBA, 2016). The nurse in the case study has breached the standard 1.4 of the Registered Nurse Standards for Practice. According to standard 1.4, the registered nurse should comply with "legislation, regulation, policies, guidelines and other standards or requirements relevant to the context of practice” when making decisions because this will be the foundation of the nurse in delivering high quality services (NMBA, 2016). The nurse in the scenario did not follow the hospital policy concerning “Between the Flags” or “red zone” and a doctor should be notified of this condition. Furthermore, the nurse failed to effectively respond to a deteriorating patient.
Kleim et al. (2015) referenced other studies indicating burnout and stress in medical professionals having a positive correlation with work volume, patient load, number of night shifts, number of consecutive work days as well as females and alcohol consumption having a positive correlation with PTSD presence. The prevalence of physical violence upon ED nurses has been studied and indicates twenty-five percent of ED nurses reporting physical violence occurring more than twenty times in the past three years (Lavoie et al., 2016). Further research in this area is likely to indicate a positive correlation between the two per the above statistic and results of high PTSD. Lavoie et al. (2016) further highlighted the impact on attendance with nurses missing an average of 14.5 work days per year for health-related reasons with 11.6% being attributed to psychological health. These studies in comparison to those referenced in my research are crucial indicators for the need to address PTSD and treat those involved, as well as the need for further research to compile more accurate
After a long while of looking at small tools and a lack of sleep, a nurse’s eyes can be weary, just like anyone else. Nurses need rest just as much, if not more than, the rest of the general population. There are only twenty four hours in a day and if one works for a twelve hour shift it does not leave much room to enjoy family or have a social life. Because of this, nurses are often sleep deprived and they find alternative sources of escape. Some of the so called sources or coping mechanisms are medicinal. Nurses have a good knowledge of medications and their side effects, so one might think they would be confident in taking drugs they provide their patients on a regular basis; however, many nurses use that knowledge to abuse these medications. They may take some from work instead of giving their patients their full dose and may overdose on those drugs to escape the stresses of daily
There are several contributing factors to substance abuse among nurses such as family, and stress. Nurses who have family members with emotional problems and inability to cope, alcoholism, and drug use, have been linked to a higher risk of substance abuse (Talbert, 2009). Coming from a family that relies on substances tempts the nurse to be chemically dependent when experiencing high job demands. "Stress in the workpl...
Psychiatric nurses have been found to experience high levels of emotional tiredness and reasonably high levels of stress when compared with other employee. Therefore, there is an urgent and definite need to identify factors that are effective in reducing stress and burnout amongst mental health
Mitchell, P. H. (2008). Defining patient safety and quality care an evidence-based handbook for nurses. Rockville,Maryland: Hughes. DOI: //www.ncbi.nlm.nih.gov/books/NBK2681/
Spark Ralph, S. & Taylor, C. M. (2011). Nursing diagnosis reference manual (8th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
When hospitals do not have enough staff to care for patients, nurses are required to work overtime and because of that, 50% of nurses quit their job (Martin). This is not healthy for nurses and not safe for patients because if nurses are constantly working overtime, they can become tired and dissatisfied with their job. Moreover, when nurses are dissatisfied with their job because of always working overtime, it lead nurses to quit their job which can become a problem for hospitals because it is hard to keep training new nurses all the time. This can cost money and effort. In addition, it will affect patients because it nurses are tired from working overtime, quality of care for patients can suffer. According to Sung-Heui Bae, author of “Nursing Overtime: Why, How Much, and Under What Working Conditions?”, When a nurse works for over 12 hours or more than 60 hours a week, nurses are more prone to making medical errors which can compromise a patient’s safety (Bae). Like what Fackelmann says, “Overworked nurse may not get to a patient quickly enough to catch a subtle sign of a potentially deadly complication”. This can be one of the reason of 20,000 death of patients each year because of overworked nurses
Spark Ralph, S. & Taylor, C. M. (2011). Nursing diagnosis reference manual (8th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.