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.
A survey has been recorded about the prevalence of chemical dependency in nurses. About 2.6 million registered nurses are employed in the United States (U.S. Department of Health and Human Services, 2010). The American Nurses Association estimates that about 10% of the RN population has a drug or alcohol related problem (Dunn, 2005). Eleven percent are chemical dependent on drugs, ten percent are dependent on alcohol, and about 546,000 of the 2.6 million RNs in the United States abuse either drugs or alcohol (Dunn, ...view middle of the document...
Reporting is done for the benefit of others. This may prevent or remove harm or simply improve the situation for the impaired nurse, client, and others involved.
The opposing view may look at this situation differently and argue that it may not be necessary to report the impaired practice if there is no harm in the first place. The teleological theory supports this argument. This theory is about the consequences of one’s decisions. Some nurses consider the outcome of their decisions, following “the ends justify the means.” Nurses avoid reporting the impaired nurse due to many factors. Friendship is always at stake. Fear is also factor. There is a fear of jeopardizing another’s job or license, fear of being a “whistle blower” or snitch, fear of being criticized, fear of being sued if one is wrong, and fear of being a hypocrite. For example, going out for a drink after work with a few nursing friends is an accepted social phenomenon in the United States. A nurse who is suspicious of another nurse may feel guilty reporting a potential problem because he or she is one of the group having a few drinks after work. Some nurses do not want to be involved or confront another who may become angry or plead of another chance as well. Some nurses may even rationalize that if a patient has not been harmed already, then there is no reason to report the impaired nurse. Sometimes, it is always easier to look the other way and deny that a problem exists.
The teleological theory may support the idea that in the end, reporting the impaired nurse may not have the best outcome, but the deontological theory continues to argue against it because it still does not protect anyone from harm. Reporting an impaired nurse provides help and support for that individual. Although patients may not have been harmed, reporting will prevent any future harm by the impaired nurse. This not only helps the patients and impaired nurse involved, but it will help the nursing profession practice and employer. About 37% of nurses who had experiences of working with an impaired colleague reported them to their supervisors (Beckstead, 2002).
Beckstead, J. W. (2002). Modeling attitudinal antecedents of nurses’ decisions to report impaired colleagues. Western Journal of Nursing Research, 24(5), 537-551.