ICU nurses rank high among RN substance users
Poll shows 6% to 8% of nurses use
Nurses who work in critical and emergency care are among the most likely in the profession to be at risk for using chemical substances to excess, according to a recent poll, and the trend is likely to continue.
Nurse managers who are in charge of those nurses are being urged to discuss the problem of substance abuse with their staff and encourage them to seek treatment. They should also view state nursing organizations as a helpful resource.
It’s quite likely, some health officials say, that certain members of your staff may have a substance use problem that includes frequent marijuana or cocaine use, a prescription-drug dependency, or regular binge drinking.
If ignored, the condition is likely to have serious consequences for both the nurses and patients under their care, according to poll researchers.1
"Based on estimates, we believe that 15% of nurses will have a drug problem at some point in their career," says Valerie Murchake Wright, RN, MLHR, alternative program coordinator with the Ohio Board of Nursing in Columbus.
The outlook may be shocking but not surprising, according to a study of substance use among registered nurses, which included the poll, released last year by the University of Maryland School of Nursing (UMSN) in Baltimore.
Substance use among nurses in all specialties is increasing. However, the amount of increase isn’t certain, mainly because there have been few recent studies that track such figures, UMSN researchers asserted.
According to the American Nurses Association (ANA) in Chicago, between 6% and 8% of nurses have a drug or alcohol problem. Some 40,000 or more U.S. nurses are alcoholics, according to the UMSN research.
Nursing specialties more likely to be associated with substance use paralleled similar high substance use among physicians. The coincidence suggested that working conditions and access to substances may be partly responsible for the problem.
The UMSN study found that 32% of nurses in 12 specialties surveyed engaged in substance use on a regular basis. Binge drinking and cigarette smoking accounted for the largest percentage at 16% and 14%, respectively.
Oncology nurses, psychiatry, and emergency and adult critical care reported the highest prevalence for all substances surveyed at 42%, 40%, and 38%, respectively. Emergency and pediatric critical care nurses had the highest prevalence of marijuana and cocaine use at 7% followed by adult critical care nurses at 6%. (The above chart shows a comparison among specialties.)
Some experts say stressful working conditions may be responsible for these findings. "There is a strong connection between psychological trauma and substance abuse," says Madeline Naegle, RN PhD, an associate professor at the division of nursing at New York University in New York City and an adviser to the ANA on substance abuse.
Nurses, including their managers, should use the resources of the nursing specialty societies and state organizations for help in addressing the problem at their work site, Naegle urges.
Comparison of Substance Use Among RNs |
|||||||||
| Marijuana/Cocaine | Prescription-type drugs | Cigarettes | Binge drinking | ||||||
| Specialty | n | % | OR* | % | OR | % | OR | % | OR |
| Adult ICU | 486 | 6.2 | 2.6 | 7.2 | 1.4 | 16.1 | 1.5 | 22.2 | 1.7 |
| Pediatric ICU | 123 | 6.8 | 3.4m | 5.9 | 1.0 | 7.6 | 0.7 | 20.8 | 1.5 |
| Emergency | 198 | 7.3 | 3.5 | 7.8 | 1.3 | 18.0 | 1.7 | 24.5 | 1.9 |
| Operating/PACU** | 406 | 4.6 | 2.4 | 7.3 | 1.4 | 12.0 | 1.1 | 16.5 | 1.6 |
| Medical/Surgical | 723 | 3.0 | 1.7 | 7.9 | 1.6 | 16.5 | 1.5 | 14.9 | 2.1 |
| Gerontology | 352 | 1.4 | 1.2 | 4.7 | 1.0 | 18.2 | 1.9 | 11.3 | 1.3 |
| Oncology | 116 | 3.6 | 1.6 | 8.8 | 1.8 | 15.2 | 1.3 | 25.5 | 2.1 |
| Administration | 171 | 2.4 | 0.9 | 5.6 | 1.3 | 15.1 | 2.0 | 16.2 | 2.1 |
| Total*** | 4438 | 3.6 | N/A | 6.6 | N/A | 14.4 | N/A | 16.0 | N/A |
| _ | |||||||||
| *OR: odds ratio, or likelihood of substance use compared with other specialties (2.0=200% likelihood) | |||||||||
| **PACU: post-anesthesia care unit | |||||||||
| ***Total: Includes 12 specialties surveyed | |||||||||
| Source: Trinkoff AN, Storr CL. Substance use among nurses: differences between specialties. Am J Public Health 1998; 88:581-585. | |||||||||
Reference
1. Trinkoff AN, Storr CL. Substance use among nurses: differences between specialties. Am J Public Health 1998; 88:581-585.
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