The Chemically Impaired Coworker Paper

The Chemically Impaired Coworker Paper

The anguish caused by substance abuse extends far beyond the devastating effects on safety, wellbeing, and health. Substance abuse significantly exacerbates the global burden of disease as it represents a spectrum of behaviors that range from misuse to dependence to addiction (Tsai et al., 2019). This piece of writing reflects on a case scenario of Karen, a skilled emergency department nurse, who progressively strolls from opioid misuse to dependence to addiction.


How Would You Expect Karen to Initially Respond?

Karen would initially respond by declining that she has a problem with her performance and behavior. Denial is a powerful defense strategy to delay facing the truth (Stewart & Mueller, 2018). Denial can take several forms such as minimizing people’s concern, rationalizing, self-deception, or blaming others. Furthermore, Karen would deny trying to circumvent the repercussions associated with substance abuse in a workplace setup. Lastly, Karen would deny trying to avoid stigma related to substance abuse particularly in her profession as a nurse (Worley, 2017). However, when confronted with evidence, Karen would remorsefully reveal her situation.

How Karen’s Manager Should Respond to Karen’s Situation

The nurse manager has a responsibility and ethical obligation to report any substance abuse disorder of her staff to protect the safety of the patients. Similarly, the nurse manager should understand that nurses, like the general public, are not immune to substance abuse. Therefore, the focus is to identify the disorder promptly and initiate interventions that will enable the nurse to recover from this treatable menace. Bearing these in mind, Karen’s manager should utilize alternative- to- discipline programs as opposed to non-punitive methods such as revocation of license (Abram, 2018).  In this case scenario, an extensive discussion between the nurse manager and Karen should be held to arrive at the best alternative-to-discipline program that is acceptable to Karen. Consequently, the nurse manager should enroll Karen in a non-disciplinary alternative-to-discipline program that will assess and treat her condition, keep an eye on her compliance to therapy and recovery recommendations, superintend her abstinence from substance abuse, and keep track of her performance upon job resumption (Worley, 2017). Lastly, the nurse manager should mobilize other staff members to help and support Karen during and after her treatment. According to Worley (2017), this program has good retention rates, and nurses who complete it transform and retain their jobs leading to a prosperous future nursing career.

Return To Work in Future and End of Treatment for Karen

Karen should be granted an opportunity to resume her work in the future after completion of the program. This will instill confidence in her and could even lead to better performance as she will feel she is still part of the team and not abandoned. Substance abuse disorder is treatable and therefore demonstration of successful completion of the treatment and rehabilitation program should be followed by job resumption. Worley (2017) gives an overview of nurses who have completed the program highlighting key benefits such as good retention rates, low rates of criminal convictions, job retention, and successful future nursing careers. Nevertheless, substance abuse disorder is a chronic disorder that necessitates the continuation of treatment even after the completion of the alternative-to-discipline treatment program. The nurse leaders should ensure continued counseling, education, and support for Karen.


Substance abuse disorder is a chronic progressive disorder that can affect any individual regardless of occupation, age, ethnic background, gender, and economic circumstances. This disorder is treatable although early detection and prompt institution of alternative-to-discipline programs are vital to treatment success.

The Chemically Impaired Coworker Paper References

Abram, M. D. (2018). The role of the registered nurse working in substance use disorder treatment: A hermeneutic study. Issues in Mental Health Nursing39(6), 1–9.

Stewart, D. M., & Mueller, C. A. (2018). Substance use disorder among nurses: A curriculum improvement initiative. Nurse Educator43(3), 132–135.

sai, A. C., Alegría, M., & Strathdee, S. A. (2019). Addressing the context and consequences of substance use, misuse, and dependence: A global imperative. PLoS Medicine16(11), e1003000.

Worley, J. (2017). Nurses with substance use disorders: Where we are and what needs to be done. Journal of Psychosocial Nursing and Mental Health Services55(12), 11–14.