Barriers to Reentry Into Nurse Anesthesia Practice Following Substance Use Disorder Treatment: A Concept Analysis

Carter, T’Anya; McMullan, Susan P.; Patrician, Patricia A.

doi:10.1177/2165079918813378

Cited by 7 publications

(10 citation statements)

References 27 publications

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“…After treatment for SUD, the act of reentering the profession is a process mired with challenges that can be managed if reentry into practice is carefully coordinated (Carter, McMullan, & Patrician, 2019; Higgins Roche, 2007; Valdes, 2014; Wright et al, 2012). The AANA have return-to-work guidelines, reentry-into-practice guidelines, and fitness-for-duty recommendations that indicate that although case specific, they may be beneficial in facilitating a successful and safe reentry pathway into practice for recovering anesthesia providers.…”

Section: Discussionmentioning

confidence: 99%

“…The following criteria, frequently cited in SUD literature, provide a guideline for aftercare or treatment maintenance for recovering anesthesia providers (Baldisseri, 2007; Bettinardi-Angres & Garcia, 2015; Bryson & Silverstein, 2008; Carter, 2021; Hamza & Monroe, 2011; Higgins Roche, 2007; Wright et al, 2012):…”

Section: Discussionmentioning

confidence: 99%

“…During their daily work performance, anesthesia providers administer substances that have the potential for abuse and misuse. Access to powerful narcotics and anesthetic agents is a top occupational hazard for anesthesia providers (Bajwa & Kaur, 2012; Carter, McMullan, & Patrician, 2019; Collins et al, 2005). To date, predicting which individuals with a history of SUD will relapse and when relapse will occur remains unreliable.…”

mentioning

confidence: 99%

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Relapse Prevention and Prediction Strategies in Substance Use Disorder

Carter

Heaton

Merlo

et al. 2023

UJAN

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Background: Relapse prevention for those with substance use disorder (SUD) is an evolving practice. Initiatives focused on relapse prevention from other populations may provide the foundation for future considerations and recommendations for recovering anesthesia providers in the workplace. The purpose of this scoping review was to examine what is known about return-to-use prediction and prevention strategies in various populations struggling with SUDs to inform future considerations and implications for recovering anesthesia providers with a history of SUD. Methods: The Arksey and O'Malley framework was used to conduct a scoping review of the literature. A systematic search was conducted across three databases (PubMed, CINAHL, and PsycInfo) for relevant literature. Search terms used were "measures predicting relapse in substance use disorder" and "relapse prevention in substance use disorder AND anesthesia." Data from articles that met the eligibility criteria were extracted and summarized by the primary author. Results: The search identified 46 articles highlighting various relapse prediction and prevention strategies related to craving and stress, underlying biological factors, neuroimaging, and mindfulness. Relapse prediction and prevention strategies ranged from cell phone applications, monitoring biological markers, and functional neuroimaging of the brain. Conclusions: Relapse is a concern for individuals with a history of SUD. For anesthesia providers, immediate access to powerful anesthesia medications requires returnto-use prediction and prevention strategies when anesthesia providers return to work after SUD treatment. Although some identified strategies are practical, more research is needed to predict and prevent return to use for recovering anesthesia providers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Relapse Prevention and Prediction Strategies in Substance Use Disorder

Carter

Heaton

Merlo

et al. 2023

UJAN

Self Cite

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“…Challenges included financial factors and the positioning of nurses with SUD or recovering from SUD in the work community when returning to practice. Similar challenges have been reported in several studies (Carter et al, 2019; Matthias-Anderson & Yurkovich, 2016; Mumba, 2018; Ross et al, 2018). In this respect, the results of this review support the findings of previous studies and may be useful in the development of refined programs.…”

Section: Discussionmentioning

confidence: 99%

An Integrative Review of Programs for Managing Nurses' Substance Use Disorder in the Workplace

Luurila¹,

Kangasniemi²,

Häggman‐Laitila³

2022

UJAN

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Background: Nurses' substance use disorder (SUD) endangers patient safety and decreases nurses' work ability and health. To better understand the methods, treatments, and benefits of the programs used to monitor nurses with SUD and promote their recovery, a systematic review of international research is needed. Aim: The aim was to gather, evaluate, and summarize empirical research on programs for managing nurses with SUD. Design: An integrative review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis instructions. Method: Systematic searches were conducted in the CINAHL, PsycInfo, PubMed, Scopus, and Web of Science databases between 2006 and 2020, complemented with manual searches. Articles were selected based on inclusion, exclusion, and method-specific evaluation criteria. The data were analyzed narratively. Results: The review identified 12 studies of which nine focused on recovery and monitoring programs for nurses with SUD or other impairment and three concerned training programs for nurse supervisors or worksite monitors. The programs were described in terms of their target groups, goals, and theoretical basis. The programs' methods and benefits were described together with challenges in their implementation. Conclusion: There has been little research on programs for nurses with SUD, the programs that exist are heterogenous, and the evidence available in this field is weak. Further research and developmental work are needed on preventive and early detection programs as well as rehabilitative programs and programs supporting reentry to workplaces. In addition, programs should not be restricted to nurses and their supervisors; colleagues and work communities should also be involved.

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“…Shame, guilt, denial of symptoms, loss of professional confidentiality, and fear of discrimination or stigmatization as an "addict," may discourage nurses from seeking or continuing care. Structural barriers to care include 45,36 • the costs related to legal fees or frequent urine drug screens, which are paid by the nurse out of pocket. • loss of health insurance, as some states and employers require nurses with SUDs to stop working during treatment.…”

Section: Barriers To Treatmentmentioning

confidence: 99%

The Impaired Nurse

Salani

Goldin

Valdes

et al. 2022

AJN, American Journal of Nursing

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Substance use disorders (SUDs) do not discriminate. Anyone can be affected regardless of age, sex, ethnicity, socioeconomic status, or profession. Nurses with SUDs present serious risks to both their patients and the nursing profession. Frontline nurses' responsibility to provide patients with safe, high-quality care may be too great a challenge for those with SUDs, resulting in adverse consequences. Early recognition and treatment of nurses with SUDs promotes patient safety and retention in the profession. For this reason, all nurses and other health care professionals should be able to recognize behaviors associated with SUDs and should be familiar with the available treatment modalities.

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Barriers to Reentry Into Nurse Anesthesia Practice Following Substance Use Disorder Treatment: A Concept Analysis

Cited by 7 publications

References 27 publications

Relapse Prevention and Prediction Strategies in Substance Use Disorder

Relapse Prevention and Prediction Strategies in Substance Use Disorder

An Integrative Review of Programs for Managing Nurses' Substance Use Disorder in the Workplace

The Impaired Nurse

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