The Impaired Nurse

Would You Know What to Do if You Suspected Substance Abuse?

Cynthia M. Thomas, EdD, RNC, CDONA; Debra Siela, PhD, CCNS, ACNS-BC, CCRN, CNE, RRT


Am Nurs Journal. 2011;6(8) 

In This Article

Signs and Symptoms of a Substance-abusing Nurse

As nurses we care for our patients, but we don't always care for our coworkers or ourselves. As you read the list below you may discover you are working with or have worked with a nurse who displays signs, symptoms, and behavioral changes that may indicate substance abuse.

The most common substances abused by healthcare professionals are alcohol, cocaine/crack, Ritalin, marijuana, inhalants, ultram, methamphetamines, ecstasy, hallucinogens and stadol, sleeping pills, antidepressants, morphine, Demerol, percodan, vicodin and codeine. However, coworkers should never underestimate the need or desire for drugs from a substance-abusing nurse. The nurse might use whatever drug is available to satisfy the addiction while at work.

As a peer you should be aware that an impaired nurse who abuses alcohol would probably drink before reporting to work, during breaks and meals. Soft drinks, coffee, mouthwash, mints, and gum can be used to mask the alcohol odor. When signs and symptoms are obvious to others the substance-abusing nurse may be in the later stages of the disease.


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