What are the warning signs of chemical dependency?
What are the warning signs of chemical dependency?
Listed below are some signs and symptoms that may indicate a nurse is experiencing problems with drugs or alcohol and needs to be referred for help.
Job Performance
— Inconsistent work quality, alternate periods of high and low efficiency
— Increased difficulty meeting deadlines
— Unrealistic excuses for decrease in work quality
— Job shrinkage, doing the minimum work necessary for the job
— Sloppy or illogical charting
— An excessive number of mistakes or errors of judgment in patient care
— Long breaks or lunch hours
— Frequent or unexplained disappearances during the shift
— Lateness for work and/or returning from lunch
— Volunteering to work overtime despite difficulty showing up for scheduled shifts
— Excessive use of sick time, especially following days off
— Absences without notice or last-minute requests for time off
— Repeated absences due to vaguely defined illnesses
Behavior, Attitude, Mood, and Mental Status
— Wide mood swings from isolation to irritability and outbursts
— Difficulty in concentration
— Marked nervousness on the job
— Decrease in problem-solving ability
— Diminished alertness, confusion, frequent memory lapses
— Difficulty in determining or setting priorities
— Isolation from others, eats alone, avoids informal staff get-togethers, or requests transfer to the night shift
— Unwillingness to cooperate with co-workers or inability to compromise
— Avoided contact with supervisor
— Overreaction to real or imagined criticism
— On the unit when not on duty
Medication-Centered Problems
— Consistently volunteering to be the medication nurse
— Offering to hold narcotic keys during report
— Volunteering to work with patients who receive regular or large amounts of pain medication
— Frequently found around medication room or cart
— Insists on administering drugs via intramuscular when other nurses give it by mouth to same patient
— Patient charting reflects excessive use of as-needed pain medication compared to shifts when other nurses are assigned to the same patient
— Patients complaining of little or no relief from pain medications when nurse is assigned to patient
— Use of two smaller tablets of medication to give prescribed dose (two 30 mg codeine tablets instead of one 60 mg tablet)
— Use of larger than necessary dose, wasting the rest (100 mg Demerol when patient is to receive only 50 mg)
— Missing drugs or unaccounted doses
— Frequently reporting spills, wastage, or breakage of medications
— Charting errors include medication errors
— Defensive when questioned about medication errors
[For further information or assistance, call the Colorado Nurse Health Program at (877) 716-0212 or (303) 716-0212, or the program’s Western Slope office at (970) 261-5770.]
Source: Colorado Nurse Health Program, Lakewood. Adapted from Hughes TL, Smith LL. Is your colleague chemically dependent? Am J Nurs 1994; 94:31-35; and Catanzarite A. Managing the Chemically Dependent Nurse: A Guide to Identification, Intervention, and Retention. Chicago: AHA Books; 1992.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.