N108: Transition to the Registered Professional Nurse

N108: Transition to the Registered Professional Nurse Role Study Guide resulting in physical injury with possible damage to internal organs, sense organs, the central nervous system, or the musculoskeletal systemof another person. Psychological abuse is emotional or mental abuse that is a form of mistreatment in which there is intent to cause mental or emotional pain or injury. It includes verbal aggression, statements intended to humiliate or infantilize, insults, threats of abandonment or institutionalization, and results in stress, social withdrawal, long-term or recalcitrant depression, and anxiety. Assisted suicide involves the act of helping another individual end his or her life. In 1997, the U.S. Supreme Court rendered a decision on physician assisted suicide (PAS). This decision took the position that there was no constitutionally protected right to PAS on behalf of terminally ill patients. In the 1990’s retired Michigan pathologist, Jack Kevorkian was convicted of second degree murder for the delivery of controlled substances to assist patients in suicide. The ANA has developed a position statement in which it states that nurses should not participate in assisted suicide. Participation by nurses in assisted suicide is seen as a violation of the Code for Nurses. The nurse’s role should be aimed at reversing the despair and pain experienced in the last stages of life, and in fulfilling the obligation to provide competent, comprehensive, and compassionate end-of-life care. Chemically-impaired professional is a term used to describe a person whose practice has deteriorated because of chemical abuse, specifically, the use of drugs and alcohol. Factors that lead to chemical dependency include the stress of the nursing profession, frequent shift changes, staffing shortages, and musculoskeletal injuries and pain. All areas of the profession are affected by the problem of chemical dependency in nursing and include financial impact as a result of increased sickness, absenteeism, tardiness, accidents, errors, decreased productivity, and staff turnover. Problems related to drug abuse are complicated by the fact that the nurse often obtains the drugs from the workplace and is therefore in violation of the Controlled Substances Act. Common signs of recognizing the chemically impaired colleague: • Mood swings • Inappropriate behavior • Frequent absences from work or using the bathroom frequently • Noncompliance with policies and procedures • Deteriorating appearance • Inconsistent job performance • Inadequate documentation • Unusual prescribing practices • Alcohol on breath • Poor judgment and concentration • Dishonesty • Missed appointments • Boundary violations • Impaired coordination; bloodshot, teary eyes, slurred, or rapid speech • Excessive wasting of drugs • Volunteering often to medicate another nurse’s patients • Somatic complaints with prescriptions for pain medications In many states, every professional is legally obligated to report a chemically dependent healthcare worker. When a nurse is planning to report substance abuse, he or she does not have to be sure beyond a reasonable doubt that a problem exists. The nurse should have enough data to present a reasonable concern. The worst thing the nurse can do, if a problem is suspected, is to ignore it or help a colleague cover for inadequacies. The chemically impaired nurse is a concern to the profession and

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