Introduction
Alcohol consumption, abuse, and addiction grow as a series of stages that leaves the individual helpless. The individual develops a habit that grows with time to an advanced stage that is difficult to control. Alcohol addiction threatens the life of the affected persons, their families, and the society (Rehm et al, 2016). In the United States, the nursing population has been impacted by this problem of alcohol abuse. Recent statistical data presented has shown that 10% of all registered nurses are alcohol addicts. More than 6% of the nursing community have consumed alcohol to an extent of impairing their judgment (Strobbe & Crowley, 2017). Since nurses work in direct contact with patients, alcohol influence can lead to fatal errors.
Population
The population of interest includes registered nurses (RNs) working in healthcare centers in direct contact with patients. The exclusion criteria include licensed practical nurses (LPNs), nursing assistants (CNAs), advanced practice registered nurses (APRNs), and all RNs in private practice, homebased settings, and areas outside of a hospital. RNs are a significant population because they work long shifts, attend to several patients daily, and must adhere to the systems set up by hospital administrators. All the mentioned factors increase their risks of workplace stress and predispose them to alcohol abuse.
Risk Factors
RNs are at increased risk of developing alcohol addiction due to factors relating to their work environment. These factors include constant stress, sleep deprivation, exposure to pain, fatigue, gender, and low education on substance abuse. RNs are burdened with the pressure of being accountable for other people’s wellbeing. In addition, the hospital environment might lack sufficient support system and include work overloads, further adding to their stress. When stress becomes chronic, it leads to alcohol abuse and later addiction. Adding to the stress is sleep deprivation due to longer shifts and night duties for three days per week (Sun et al., 2019). Understaffing leads to overtime work, which extends the RNs 12 hour shifts to 15 hour shifts, denying them time to sleep and rest. RNs might use alcohol and other substances to stay awake during a long shift or to reduce the stress when away from work.
Social Determinants of Health
The RNs work culture places them as care givers, who are strong enough not to seek help. The notion that nurses are super beings, who live for others, has created an environment that prevents RNs from asking for help. The constant pressure and demands of work, leave them without the energy or will to care for themselves. As such, the nursing culture is a significant social determinant of health among RNs. Nurses face disciplinary action when they violate the code of ethics established by the nursing profession bodies and hospitals. Boards that focus on such actions miss the opportunity of supporting their RNs out of addiction. However, the trend is changing as more boards and programs encourage alternatives methods of supporting the nurse.
Priority Population Health Needs
The most vital health needs and factors for RNs include screening, referral to treatment, and intensive substance abuse education. Screening will identify early addiction signs and facilitate timely prevention of excess and unhealthy alcohol drinking (Mitchell et al., 2018). Nurses must be screened using validated equipment, and those exceeding the normal drinking limits should be given helpful advice or put on a brief intervention to prevent addiction. Referral to treatment involves linking all the nurses with unhealthy drinking habits to services that offer intense treatment programs (Zickafoose, 2018). Trained clinicians oversee the entire process to ensure that it is successful and effective by providing evidence-based treatments to the addicted nurse-patients (Smothers et al., 2018). Intense training on alcohol abuse, avoiding it, and its long-term effects should be integrated into the nursing curricula and taught to all the student nurses to increase knowledge and awareness among RNs (Zickafoose, 2018). Nonetheless, RNs require a healthy and supportive work culture to stay healthy and provide quality services to patients.
Data and Sources
New Jersey program, which helps nurses with certain addictions through treatment and recovery, presented that over 100 cases of addicted nurses are reported each month. Annually the caseload is around 800; after successful interventions and treatment procedures, many recover. The program has experienced a success rate of over 97% (Russell, 2020). Some sources have presented the health data of nurses in the United States by carrying out different studies. Research has shown that 2%-10% of nurses are under dependency in the United States and that 14%-20% abuse alcohol, and that 12% (Strobbe & Crowley, 2017) have been presented for treatment with extreme and adverse conditions regarding alcohol abuse.
New York State Nurses Organization created SPAN, which acts as a linkage of help to nurses under certain addictions like alcohol. SPAN takes care of the issues by withdrawing the Nurse’s practice certificate and presents the nurse to the PAP program for treatment and rehabilitation (Shen, 2018). After successful recovery, the nurse is given back a practicing certificate and continues working. American Nurses Association is carrying out studies daily to identify the number of affected nurses to undergo treatment programs. The National Institute of Alcohol abuse and Alcoholism is working on researching and treating alcoholism in society (Shen, 2018). These organizations and programs focus on helping nurses with alcohol addiction issues.
Community Stakeholders
At the community level, hospital administrators, families, religious leaders, and clergy members should be at the frontline on instilling teachings about alcohol abuse. Values learned early act as control during adulthood and can prevent harmful and morally unacceptable activities. Professionals and clinicians must intervene, carry out assessments, and give appropriate directions regarding RNs alcoholism. They should join hands to help affected nurses get through alcohol abuse using friendly approaches and interventions.
Stakeholders and Champions
Alcohol manufacturing companies in the United States have pledged to restructure their product designs and marketing strategies that may lure many people into drinking alcohol. They have started campaigns in the communities to teach and educate on the effects of unhealthy alcohol consumption. American Nurses Association has set policies regarding alcohol consumption to be followed by all RNs. The association has vowed to track and help all the nurses impacted by alcoholism in both treatment costs and recovery procedures.
Barriers Associated with Population
Affected RNs claim that they lack time to attend to intervention programs aimed at helping them. Some nurses also argue that they have capacity to manage their drinking habits and avoid addiction. Others are rejecting treatment sessions from professionals by claiming that they can treat themselves. Health care professionals lack intense knowledge and skills to treat alcohol-related disorders. Therefore, they may employ inferior treatment methods in assessing and treating patients, which are ineffective. As a result, the recovery process takes longer than expected and RNs might give up. Treatment costs of any alcohol-related disorders are expensive because of the procedures and assessments carried out on a patient using evidence-based approaches. RNs who fear the costs will end up not availing themselves of treatment, further delaying help.
Proposed Healthcare Program
Following the high treatment costs for alcohol-related disorders, all health organizations should discuss and reduce the costs to affordable levels. The government and nursing organizations should ensure that each nurse has a medical insurance cover that takes care of all the charges in a medical emergency. Deductions will be made from the nurse’s monthly salary for the insurance upon agreement of the amount.
Methods and Statistics
The prospective study method will be used as the epidemiological method because it is carried out for three years to monitor RNs’alcohol consumption. Chi-square test will be used for statistical analysis to compare observed data with the expected outcome. A prospective descriptive study will be carried out from 2017-2020 on the nurses in all the departments in the Johns Hopkins Hospital. Specific inclusion and exclusion criteria will be employed to sample the population. A questionnaire will be applied in the research to meet the research objectives. The questionnaire contains questions that the study population will answer. As a long-term solution to this problem, alterations and improvements should be made to the nursing school curriculum by including thorough teachings on alcohol-based education.
Evaluation
The long-term outcome for RNs is improved quality of life demonstrated by lower stress, fatigue, and pain, and increased patient outcomes and quality of life. For the short-term outcomes, RNs must report less fatigue and stress symptoms in three months of interventions, improve job satisfaction ratings within a month, and report reduced need for alcohol in the first three months.
Conclusion
Nurses with unhealthy alcohol consumption and abuse exist and have been significantly impacted by this habit both professionally and in health matters. Proper interventions like using advanced EMR machines to aid in the screening process should be employed. EMR machines with advanced evaluation capabilities like clearly documenting patients’ entire intervention and linking the patient’s alcohol-risk level with clinically approved algorithms.
References
Mitchell, A. M., Finnell, D. S., Kane, I., Halge, H., Puskar, K., & Savage, C. L. (2018). Time-conscious alcohol screening and brief intervention for students, nurses, and nurse leaders. The Journal of Continuing Education in Nursing, 49(10), 467-473. Web.
Rehm, J., Anderson, P., Manthey, J., Shield, K. D., Struzzo, P., Wojnar, M., & Gual, A. (2016). Alcohol use disorders in primary health care: what do we know and where do we go? Alcohol and Alcoholism, 51(4), 422-427. Web.
Russell, K. (2020). Components of nurse substance use disorder monitoring programs. Journal of Nursing Regulation, 11(2), 20-27. Web.
Shen, W. W. (2018). Anticraving therapy for alcohol use disorder: A clinical review. Neuropsychopharmacology reports, 38(3), 105-116. Web.
Sun, Q., Ji, X., Zhou, W., & Liu, J. (2019). Sleep problems in shift nurses: A brief review and recommendations at both individual and institutional levels. Journal of Nursing Management, 27(1), 10-18. Web.
Strobbe, S., & Crowley, M. (2017). Substance use among nurses and nursing students: A joint position statement of the Emergency Nurses Association and the International Nurses Society on Addictions. Journal of Addictions Nursing, 28(2), 104-106. Web.
Smothers, Z., Reynolds, V., McEachern, M., Derouin, A. L., Carter, B. M., & Muzyk, A. (2018). Substance use education in schools of nursing: A systematic review of the literature. Nurse Educator, 43(3), 136-139. Web.
Zickafoose, P. C. (2018). Substance use disorder: Efficacy of educational strategies in Delaware. The Journal of Continuing Education in Nursing, 49(1), 42-48. Web.