Nurses whose professional functioning is impaired due to substance abuse represent a threat to the health and safety of patients, other health care staff, and themselves. The major means for identifying impaired nurses is nonimpaired coworkers. Yet, only 37% of nurses who have had experiences working with impaired colleagues reported them to supervisors. A cross-sectional correlational research design, employing structural equation modeling, was used to explicate the relationships among the latent attitudinal constructs: permissiveness, morality, treatment efficacy regarding substance abuse, and punitive attitudes toward impaired nurses. The influences of these attitudes on perceived severity of impairment in fictitious coworkers and subsequent intentions to report these coworkers to nursing supervisors were modeled in a sample of 126 nurses. Permissiveness and positive attitude toward treatment were significantly related to intentions to report nurses. Moralistic attitude was not related to intention. Moralistic attitude was, however, strongly associated with a punitive attitude toward impaired nurses.
Get full access to this article
View all access options for this article.
References
1.
Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhl & J. Beckmann (Eds.), Action-control: From cognition to behavior (pp. 11-39). Heidelberg: Springer.
2.
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.
3.
Ajzen, I. , & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.
4.
American Nurses’ Association . (1984). Addictions and psychological dysfunctions in nursing. Kansas City, MO: Author.
5.
Beckstead, J. W. (in press). Attitudes accentuate attributes in social judgment: The combined effects of substance use, depression, and technical incompetence on professional impairment. Journal of Social Psychology.
6.
Berens, M. J. (2000, Sept. 10). Nursing mistakes kill, injure thousands. The Chicago Tribune. Retrieved September 11, 2000, from http://www.chicagotribune.com
7.
Bissell, L. , & Jones, R. (1981). The alcoholic nurse. Nursing Outlook, 29, 96-101.
8.
Browne, M. W. , & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136-162). Newbury Park, CA: Sage.
9.
Bureau of Labor Statistics . (1998). 1998-1999 Occupational Outlook Handbook. Washington, DC: Author.
10.
Chaney, E.A. (1987). Nurses and chemical dependency: Policy considerations. Journal of Pediatric Nursing, 2, 61-63.
11.
Chappel, J. N. , Veach, T. L., & Krug, R. S. (1985). The substance abuse attitude survey: An instrument for measuring attitudes. Journal of Studies on Alcohol, 46(1), 48-52.
12.
Damrosch, S. , & Scholler-Jaquish, A. (1993). Nurses’ experiences with impaired nurse coworkers. Applied Nursing Research, 6(4), 154-160.
13.
Fishbein, M. , & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.
14.
Godin, G. , & Kok, G. (1996). The theory of planned behavior: A review of its applications to health-related behaviors. American Journal of Health Promotion, 11(2), 87-98.
15.
Hendrie, H. C. , Clair, D. K., Brittain, H. M., & Fadul, P. E. (1990). A study of anxiety/depression symptoms of medical students, house staff, and their spouses/partners. Journal of Mental and Nervous Diseases, 178, 204-207.
16.
Hendrix, M. J. , Sabritt, D., McDaniel, A., & Field, B. (1987). Perceptions and attitudes toward nursing impairment. Research in Nursing & Health, 10, 323-333.
17.
Hu, L-T , & Bentler, P. M. (1999). Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. Structural equation modeling, 6(1), 1-55.
18.
Jefferson, L. V. , & Ensor, B. E. (1982). Help for the helper: Confronting a chemically impaired colleague. American Journal of Nursing, 82, 574-577.
19.
Jenkins, S. J. , Fisher, G. L., & Applegate, R. L. (1990). Factor analysis of the substance abuse attitude survey with college undergraduates. Psychological Reports, 66, 331-336.
20.
Jöreskog, K. G. , & Sörbom, D. (1996). LISREL 8: User’s reference guide. Chicago: Scientific Software International.
21.
Kaab, G. M. (1984). Chemical dependency: Helping your staff. Journal of Nursing Administration, 14, 18-23.
22.
Lippman, H. (1992, April). Addicted nurses: Tolerated, tormented, or treated?RN, 36-41.
23.
Moses, E.B. (1997). The Registered Nurse Population: Findings from the National Sample Survey of Registered Nurses, March, 1996. Washington, DC: U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions Division of Nursing.
24.
Mulaik, S. A. , James, L. R., Van Alstine, J., Bennett, N., Lind, S., & Stillwell, C. D. (1989). An evaluation of goodness of fit indices for structural equation models. Psychological Bulletin, 105, 430-445.
25.
Norman, G. , & Streiner, D. (1994). Biostatistics: The bare essentials. St. Louis: Mosby.
26.
Patrick, P.K.S. (1984). Self-preservation: Confronting the issue of nurse impairment. Journal of Substance Abuse Treatment, 1, 99-105.
27.
Pedhazur, E. , & Schmilkin, L. (1991). Measurement, design and analysis: An integrated approach (pp. 590-630). Hillsdale, NJ: Lawrence Erlbaum.
28.
Trinkoff, A. M. , Eaton, W. W., & Anthony, J. C. (1991). The prevalence of substance abuse among registered nurses. Nursing Research, 40(3), 172-175.
29.
Trinkoff, A. M. , & Storr, C. L. (1994). Relationship of specialty and access to substance use among registered nurses: An exploratory study. Drug and Alcohol Dependence, 36, 215-219.
30.
Trinkoff, A. M. , & Storr, C. L. (1998). Substance use among nurses: Differences between specialties. American Journal of Public Health, 88(4), 581-585.
31.
U.S. Department of Health and Human Services . (1990). Seventh Report to the President and Congress on the Status of Health Personnel in the United States. Washington, DC: Author.
32.
Williams, R. A. , Hagerty, B. M., Murphy-Weinberg, V., & Wan, J. (1995). Symptoms of depression among female nursing students. Archives of Psychiatric Nursing, 9, 269-278.
