Nurs_127_S_01x_Substance_Abusex_dual_diagnosis

Nurs_127_S_01x_Substance_Abusex_dual_diagnosis - Substance...

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Substance Related Disorders & Dual Diagnosis Phyllis M. Connolly, PhD, RN, CS NURS 127A
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Questions to Consider Today 4/20/01 What behaviors indicate that a nurse may be abusing substances? What is the ego/self theory related to substance abuse? When is denial a problem? What is the relationship between childhood sexual abuse and addiction?
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Substance Disorders Facts Cost: $144 billion/year in health care and job loss Alcohol most commonly used Marijuana most commonly used illegal drug 50% auto accidents & homicides involve alcohol 500,000 deaths from Tobacco-related disorders One in 10 deaths related to alcohol More die from misuse of legal prescriptions
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Impaired Nurses 5% of 2 million nurses in 1984 (ANA) abused substances 8-10% chemically dependent Narcotic addiction 30 X higher than general population (1987 study) 67% of cases handled by 44 state BRN (1988)
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Signs of Impaired Nursing Practice Job Performance Changes, Controlled drug handling Drug counts incorrect Excessive errors Excessive wastage, often not countersigned Medicine signed out to pt. not in pain Two strengths of drugs signed out to same pt. Same time Packaging appears to be tampered Patient complaints of ineffective pain control Volunteers to give controlled drugs General Performance Medication errors Poor judgment Euphoric recall for involvement in unpleasant situations iIlogical or sloppy charting Absenteeism, esp. days off Requesting leave time just before assigned shift Lateness--elaborate excuses Job shrinkage missed deadlines
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Signs Impaired Nurse Cont . Behavioral/Personality changes Sudden changes in mood Periods of irritability Forgetfulness Wears long sleeves (hot weather) Socially isolates Inappropriate behavior Chronic pain condition Hx pain treatment with controlled substances Signs of Use Alcohol on breath Constant use of perfumes, mouthwash, breath mints flushed face, reddened eyes, unsteady gait, slurred speech, hyperactivity accelerated speech Increasing family problems interfere with work
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Interventions: Impaired Colleagues Reporting required ethical & legal obligation to supervisor Document in writing; time, date, place An advisor with (state nurse rehabilitation team) Team approach,co-workers, supervisor, nurse administrator, family member
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Prevalence of Substance-Related Disorders Alcohol abuse Males Females Substance Other drug dependency 16% 29% 6% 18% 9% Prevalence Disorder Dahme, 1998
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Classes of Substances with Potential for Abuse and Dependence Alcohol Amphetamine Caffeine Cannabis Cocaine Hallucinogens Inhalants Nicotine Opiods Phencyclidines (PCP) Sedative, hypnotic,or antianxiety agents
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5 General Categories of Substances CNS depressants,(alcohol, sedative-hypnotics, antianxiety agents,and volatile inhalants Stimulants (cocaine, amphetamine,caffeine ,
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This note was uploaded on 09/08/2010 for the course NURS 147A at San Jose State University .

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Nurs_127_S_01x_Substance_Abusex_dual_diagnosis - Substance...

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