Chemical Dependency: Introduction
Many people you talk with agree that our culture has become one of high stress and fast paced living. Families shuttle children to multiple activities; cell phones and beepers demand immediate attention; and e-mail and the Internet often draw our time and energy away from what really matters. These and other stresses of modern life can lead to problems with substance abuse, as an attempt to cope with these pressures. Healthcare workers, nurses, and physicians have been shown to be more at risk for developing problems with substance abuse than members of the society as a whole. Anesthesia providers are no exception. We experience our own set of predisposing factors in that we often work long hours, have ready access to these addictive agents, and assume responsibility for another person's well being each time we perform an anesthetic. In order to address these concerns within the profession, the American Association of Nurse Anesthetists has established the Peer Assistance Advisors Committee (PAAC) to serve as a resource and support for nurse anesthesia practitioners and students. Furthermore, the Alabama Association of Nurse Anesthetists recognizes that anesthesia providers appear to be at high risk for substance abuse and have developed a number of programs and information for those concerned. Chemical dependency is defined as the use or abuse of a substance by persons unable or unwilling to terminate its utilization. The ALANA recognizes addiction as a disease characterized by a chronic, progressive process that may destroy the professional, the family, and the community.
It is often difficult to identify an impaired colleague. Two reasons for this are denial on the part of the chemically dependent professional, as well as colleagues, and the enabling behavior of coworkers. Watch for trends and patterns that indicate a change in the person and his or her job performance. These can initially be very subtle and may occur over many months or years. We have included on this site a list of behaviors that may suggest that a colleague has a problem with chemical dependency. Coworkers have certain legal responsibilities in identifying and reporting the chemically dependent CRNA. Many states have mandatory reporting laws that may hold colleagues responsible for harm to patients if they fail to report a coworker in whom abuse is suspected. Confidential reporting to the Alabama Voluntary Disciplinary Alternative Program (VDAP) absolves the colleague from reporting to the nursing regulatory board. The VDAP provides a framework for evaluation, treatment, and re-entry into the practice area for CRNA's, giving structure and boundaries while the anesthetist develops healthy adaptation skills. VDAP offers opportunities for education, treatment, recovery and hope rather than disciplinary action against the CRNA's license. The American Association of Nurse Anesthetists, the Alabama Board of Nursing, and the Alabama Association of Nurse Anesthetists all have trained Peer Assistance advisors available to answer any questions that may arise. Contact information for these resources, as well as for the VDAP program is included on this website. This information is drawn primarily from the AANA publication entitled "Chemical Dependency and the Nurse Anesthetist", and is funded by a portion of your national dues that are earmarked for your state association by the AANA. This information was put together by your Board of Directors for the Alabama Association of Nurse Anesthetists. Brent H. Ledford CRNA, CDC Chair 01-02.
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