Abstract

The nursing profession has laws, policies and codes addressing the profession's ethical responsibility to regulate its members and safeguard its clients. Nevertheless, there are an estimated 40,000-200,000 alcoholically impaired nurses in the United States who remain undetected, undisciplined and untreated. ;During the 1980s, the American Nurses' Association and various state nurses' associations began to study the problem of substance abuse within the profession and to develop policies, guidelines and programs. While the literature was silent on the subject during most of the twentieth century, there have been many articles written about chemically impaired nurses in the last decade. Still, most peers and administrators, due to lack of knowledge, embarrassment, misguided loyalty, conflict or denial, do not intervene. In spite of alcoholism being defined as a disease, alcoholic nurses, when confronted, are often treated as bad nurses rather than as sick nurses. The Nurses' Association has been unsuccessful in guiding the majority of nurses to take ethical action in matters pertaining to chemically impaired nursing practice. ;This study utilized ethical theories and principles to analyze why nursing has failed in its ethical responsibility to regulate its membership, safeguard its clients, and care for the alcoholically impaired nurse in practice. Three sample cases were analyzed using ethical theories and principles to arrive at judgments about what ethical course of action should have been taken to benefit patients, employers and the alcoholically impaired nurses. The results of these analyses consistently supported the need for colleagues and/or administration to intervene as early as possible and to assist the alcoholically impaired nurse to accept treatment. Based on the results of these ethical analyses, a model policy and model nurses' assistance program was proposed