A Substance Abuse Awareness Seminar for Nursing Students

Substance abuse is a public health problem worldwide.  In fact, it is estimated that 2 billion people are alcohol users, 1/3 billion are smokers, and 185 million are drug users (WHO, 2002).  To respond to this significant health issue, the National Student Nurses Association (NSNA, 2002) and American Nurses Association (ANA, 2002) passed resolutions calling for nurse educators to address the risk of addiction.  Prevention of this health problem should begin within our own nursing profession.  Although the prevalence of substance abuse disorders among nurses is approximately the same rate as in the general population (Kenna & Lewis, 2008), there are certain risk factors, like access to drugs and job stress (Trinkoff, Storr, & Wall, 1999) that make nurses more susceptible to substance abuse.  Unfortunately, nurses often lack the awareness and skill to recognize and even help a colleague who may have a substance abuse problem.  This lack of preparedness can enable nurses to continue unsafe practices by making excuses or covering up their nurse colleague’s mistakes (Quinlan, 2003).  To respond to the gap in nursing students’ education about the risks of addiction within the profession and how best to handle a colleague suspected of abusing a substance, we developed a two-hour evidence based prevention seminar for senior nursing students.   The first hour addressed the ethical challenge of unsafe practice including the statistical picture of substance abuse in nurses, the duty to report as outlined by the ANA Code of Ethics for Nurses (ANA, 2001), and how substance abuse may impair a nurse’s work performance and conduct.  A communication model called NUDGE (Notice, Understand, Decide, use Guidelines, and Encourage (Bennett, 2010) was taught and demonstrated in a role-play scenario.  In the second hour, students in triads practiced this skill by rotating the roles of nudger, resister, and observer with a case scenario provided.  The results of an intervention follow-up study support the effectiveness of the prevention seminar in affecting knowledge about substance use disorders and the nurses’ role in intervening when substance use behaviors are observed.  The seminar also increased students’ confidence in addressing future colleagues where substance abuse may jeopardize safe nursing practice.