Pubdate: Mon, 13 Nov 2006 Source: Chronicle Herald (CN NS) Copyright: 2006 The Halifax Herald Limited Contact: http://thechronicleherald.ca/ Details: http://www.mapinc.org/media/180 Author: Sherri Borden Colley Bookmark: http://www.mapinc.org/find?232 (Chronic Pain) NURSES NOW HAVE GUIDE ON HOW TO DEAL WITH SUBSTANCE ABUSE The numbers are small but substance abuse is an issue in Nova Scotia's nursing profession. And the College of Registered Nurses of Nova Scotia, the regulating body, is so concerned with the few cases it has seen that it recently launched a resource guide on what nurses and employers should do when faced with problematic substance use in the workplace. "It's not a big problem," college executive director Linda Hamilton said in an interview. "Nurses, just like any other member of our general society, are prone to having problems with substance use, both alcohol and drugs." There is no data on how many nurses in this province or across Canada are substance abusers. But of the 138 complaints received by the college over the past five years, 12 per cent, or 17 cases, were related to problematic substance use. The college acknowledges this may not accurately reflect the actual number of nurses in Nova Scotia experiencing problems because some situations are never reported to the body. Ms. Hamilton said it is not a widespread problem but "nonetheless when you get it, it's a big problem" because it affects patient care. "And also they affect the health of nurses." The college's records indicate nurses have had problems with alcohol, narcotics such as Demerol, morphine, MS Contin and Dilaudid, other controlled drugs like Tylenol 3, Darvon and Ativan and street drugs including crack cocaine, cannabis marijuana, LSD and hashish. The resource guide is intended to educate nurses and employers about substance use, provide practical steps to address related issues in a caring and supportive manner, encourage nurses who admit they have a problem to seek help and to inform nurses of their professional responsibilities in situations where there is a risk or potential risk to patient safety as a result of a colleague's problem with drugs or alcohol. "Prior to reporting a situation to your manager, it is essential you accurately document your observations of your colleague's behaviours," the guide advises. "This documentation should be objective/factual and contain times, dates, locations, what occurred, names of witnesses, identification of any patients involved, and actions taken." Once a nurse has provided his or her manager with those observations, it is "the manager's responsibility, professionally, ethically and morally to intervene," the guide states. "If a nurse is obviously impaired while working, the manager must immediately remove the nurse from the work area. Two people should determine whether a nurse is fit to continue working or if she/he should leave the workplace." Last year, the college received funding from Health Canada to develop the resource guide and an education module for use by nursing schools. "What we're hoping is the earlier we're able to identify nurses who are at risk of going down the path of problem use that we would be able to help them," Ms. Hamilton said. Some nurses who have come before the college started using drugs because they initially had chronic back pain, could not sleep or were stressed. "So it's a combination of physical problems, emotional problems and they start very benignly in terms of just taking some Gravol to get to sleep or taking some valium and so on. And, that progresses into other kinds of drugs." Accessible drugs in the workplace make it easier for some nurses to develop problems. "Participants in one study said they were surprised at how easy it was to take discarded doses, steal patient's doses, and take medications that patients brought in from home," the 32-page resource guide states. "When policies related to the administration and documentation of narcotics are followed, it is difficult for nurses to divert drugs, and easier to identify when a nurse is attempting to divert drugs." In 2005, one patient sued a nurse whose earlier drug use came to light in a decision by the college. Lindsay Meredith Brown, a Halifax freelance journalist, sued the Capital district health authority and Colleen Taylor, a Dartmouth nurse suspended for stealing and using drugs while working in the recovery room of a Halifax hospital. Ms. Brown alleges Ms. Taylor, her recovery-unit nurse for six hours, failed to give her narcotics when she knew Ms. Brown was in pain after surgery; misappropriated and used narcotics intended to relieve Ms. Brown's pain; and administered intravenous saline to Ms. Brown without consent. Ms. Taylor was first suspended from the hospital in June 2003. In October 2003, the college temporarily suspended her licence to practise. She remains on suspension. Ms. Taylor, a recovery-room nurse since 1980, admitted to the college that she stole and used narcotics while on duty at the Queen Elizabeth II Health Sciences Centre from March to June 2003. She also said she made numerous charting errors during the period. But in a defence filed against the lawsuit, she denied withholding narcotics from Ms. Brown. In a separate defence, the authority has also denied liability. The case is still before the courts. - --- MAP posted-by: Beth Wehrman