Colorado Nurse - May 2016

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Page 6 • Colorado Nurse May, June, July 2016 Peer Assistance Saving the Nursing Workforce: Final Edition Learning from Colorado Peer Health Assistance Program Participants Authored by Jennifer Place, MA, LPC, LAC The repercussions of untreated and unmanaged mental health and substance use disorders (SUD) among nurses can lead to employment, legal, and licensure consequences, in addition to patient harm. Considering that nurses experience mental health and substance use disorders at the same or higher rates than the general population (Griffith, 1999), early intervention and treatment are critical. A unique study published in the January 2015 edition of Substance Abuse identified barriers and opportunities for early identification and intervention for nurses with SUD and mental illness (Cares et al., 2015). The result of a partnership between Peer Assistance Services, Inc., OMNI Institute, and the University Of Colorado Anschutz Campus School Of Public Health, the study analyzed survey responses from over 300 nursing professionals in the Colorado State Board of Nursing (Board) Peer Health Assistance/Alternative to Discipline Program (PHAP). Come shop with us! Scrubs, lab coats, stethoscopes, shoes, medical supplies, & accessories– from all your favorite brands! Enter code GOG10 to save 10% on all orders! Substance use among participants Eighty-five percent of study participants indicated their PHAPinvolvement was due to a SUD and roughly 20% acknowledged a co-occurring mental health disorder. Most participants with SUDs acknowledged problems with alcohol, the most abused substance (other than tobacco) in the U.S. (SAMHSA, 2014). Only 25% admitted to using medications obtained from their workplace. Within that 25%, most admitted to utilizing wasted medications or ordering drugs for their own use. Less than one-third of the 25% stated they replaced drugs they had taken with other drugs. Less than 1% indicated possible cross-contamination from “used” needles. Two-thirds have observable signs and symptoms When asked about impairment at work, 48% of participants with a SUD felt their job performance was negatively affected by their substance use. Sixty-eight percent of participants thought their problem could have been identified earlier, possibly by an employer or colleague. The primary observable workplace warning sign participants identified was “a change in physical or emotional condition” (Cares, et al. 2015, p. 63). Additional warning signs included increased use of pain medication documented in patient charts, decreased reliability, increased wastage or breakage of drugs, repeated absenteeism, and/or excessive tardiness. Barriers to seeking assistance Study participants listed the following reasons for not seeking assistance earlier: Feeling too scared, too embarrassed, having concerns about confidentiality, and fearing the loss of their license. Participants also stated lack of knowledge about the PHAP and/or being too ill to seek assistance were barriers to seeking help. This information indicates the workplace plays an integral role in saving the nursing workforce by reducing stigma and encouraging treatment. Educational efforts must be made to increase awareness and recognize early warning signs; resources such as employee assistance programs (EAPs) must be promoted and utilized; workplace policy must encourage and not punish help-seeking behaviors; and nurses must support one another throughout this process. The American Nurses Association Code of Ethics states, “Nurses must advocate for appropriate assistance, treatment, and access to fair institutional and legal processes” for impaired colleagues (ANA, 2015, p. 13). It further avows nurses must advocate to support a nurse’s return to practice following treatment. Ignorance, fear, and punishment cannot save our nursing workforce. However, prevention, education, and early identification can. Contact Peer Assistance Services, Inc. We can help! Peer Assistance is a regular column in the Colorado Nurse provided by Peer Assistance Services, Inc. (PAS). The Colorado Board of Nursing contracts with PAS to provide the statewide Nursing Peer Health Assistance Program. For more information please visit www.PeerAssistanceServices.org or call 1-800-369-0039. To provide comments/suggestions regarding content, email info@peerassist.org. References American Nurses Association (ANA). (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Cares, A., Pace, E., Denious, J., & Crane, L. (2015). Substance use and mental illness among nurses: workplace warning signs and barriers to seeking assistance. Substance Abuse, 59-66, DOI: 10.1080/08897077.2014.933725. Griffith, J. (1999). Substance abuse disorders in nurses. Nursing Forum, 34, 19-28. Substance Abuse and Mental Health Services Administration, S. (2014). Results from the 2013 National Survey on Drug Usee and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration. ACCREDITED ONLINE NURSING DEGREES - RN to BSN - RN to BSN to MSN - MSN – 5 High Demand Specializations - DNP – Specializations in Educational and Executive Leadership Education Partner of the Colorado Nurses and Hospital Associations. Visit ShopNurse.com today! Learn more about discounted tuition rates: 866-922-5690 | www.americansentinel.edu/cha
May, June, July 2016 Colorado Nurse • Page 7 Peer Assistance What Nursing Can Do About Colorado’s High Drug Death Rate! Donna Strickland MS APRN. PMHCNS-BC Director of Clinical Services, Peer Assistance Services, Inc. “Overdose Deaths Break Record in Southern Colorado” read the headlines of The Denver Post 2/10/16. The Colorado Health Institute issued a report that analyzed new county-level estimates on drug overdose deaths by county from the Centers for Disease Control and Prevention (http://www. coloradohealthinstitute.org/). Twelve Colorado counties have drug overdose death rates of more than 20 per 100,000 residents, (U.S. average is 9.7 per 100,000 residents) deaths have reached the highest level measured by the federal Centers for Disease Control and Prevention (www.cdc.gov/). Seven of the counties Baca, Bent, Conejos, Rio Grande, La Animas, Costilla, and Huerfano-are in rural Southern Colorado. Three counties-Adams, Denver and Pueblo, are urban counties along the Front Range. The two remaining counties are Jackson County in Northern Colorado and Delta County on the Western Slope also were in the highest category. Huerfano County has had the highest drug-related death rates recorded since 2003. Drug overdoses have been on the rise nationally for several years driven by deaths from powerful prescription painkillers. What can Nursing do to help reduce and intervene in this epidemic? • Increase understanding of substance-related and addictive disorders as a chronic relapsing brain disease. The stigma regarding substance use disorders prevents people from getting the help they need. See Colorado’s plan to reduce prescription drug abuse at this website: http:// www.corxconsortium.org/ • Improve access to the overdose-reversal drug Naloxone. Have adequate supplies in your practice area. Individuals can purchase Naloxone at your local pharmacy for approximately $20 with no prescription required. • Be a champion to expand access to treatment for prescription drug abuse and heroin use. • Engage your patients in a conversation regarding their use of prescription opioids. Encourage their understanding of this potentially fatal heath condition. Further, be sure to have an understanding that individuals may seek heroin if their opioid prescription is no longer available. • Promote prescription drug take-back events in your area. See the link to CDPHE’s website that lists permanent medication drop box locations: https://www.colorado.gov/cdphe/rxdrug • Be an advocate to expand state-level prescription drug overdose prevention strategies. • Increase the availability of medication-assisted treatment (MAT) programs, which are effective in ending the tragic and costly cycle of relapse. • President Obama proposed new funding to address the prescription opioid abuse and heroin use epidemic and to expand the availability of buprenorphine and other opioidaddiction medications. Learn what the white house is doing to address the opioid crisis at https://www.whitehouse.gov/ondcp. • Use the “Prescription Drug Monitoring Program” (PDMP) in your practice setting. Look to see if your patient is “doctor shopping.” The PDMP is a statewide database of controlled substances dispensed to Colorado patients. http://www.coloradonurses. org/?s=doctor+shopping • Take advantage of your agency receiving a no cost 2 hour Screening, Brief Intervention, Referral to Treatment (SBIRT) training. It is an evidence-based approach to improve patient’s health through preventing and reducing substance use. Register at www. improvinghealthcolorado.org/events/ RN to BSN Online Program MSN Online Program No Campus Visits — Enroll Part or Full Time • Liberal Credit Transfers • Nationally Accredited Seeking RNs and LPNs We have over 25 skilled nursing and assisted living facilities in Colorado alone. Start your new opportunity today! Our business is about people – our residents, associates, family members and the community. To me, there can be no greater calling in my life than to be able to have an impact for good upon the lives of those with special needs, particularly the frail and the elderly. ~ Forrest Preston, Founder and Chairman www.lcca.com EOE • No Thesis Required • No Entrance Exams Classes That Fit Your Schedule — Competitive Tuition BSN-LINC: 1-877-656-1483 or bsn-linc.wisconsin.edu MSN-LINC: 1-888-674-8942 or uwgb.edu/nursing/msn
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