Empowering Nurses at the Bedside and in Business

The Truth About Impaired Nurses

Many nurses incorrectly believe that the only nurses who end up before the Licensing Board are impaired.  This is simply not true.

An impaired nurse is someone who uses alcohol or a controlled substance on a regular basis and to the extent that it interferes with their work.  And here’s a sad fact, many of these nurses don’t know that they have a problem.

Yes, there are a fair number of impaired nurses and, surprisingly, the incident of impaired nurses is the same as the general public even though nurses have increased access to controlled substances.

I have had nurses forge prescriptions or call in a prescription for a friend or loved one.  I’ve had some steal other nurse’s Pyxis code to obtain narcotics.  Others “cheat” the monitoring programs while still using.  Some nurses also try to obtain materials that neutralize the controlled substance or dilute their urine so it will not show on a urine drug screen.

I believe that alcohol and drug use somehow creates a chemical reaction in the mid-brain that is so powerful that it creates an intense desire for the substance that cannot be sated.  This intense desire causes someone to act in ways that he/she would not normally act so as to feed the craving and achieve the desired chemical reaction in the mid-brain.

In Indiana, where I live, I have represented many nurses who were accused of stealing controlled substances from a hospital.  In fact, there are software programs out there that will track to see if a nurse administers narcotics more frequently than other nurses on the unit.

There even is software that can track every time a nurse fails to co-sign a waste.  Therefore, your employer is watching you.

I think most nurses would never do this as we are trustworthy, caring people.  I think is so sad though that the addiction can be so powerful that it overcomes the impaired nurse’s inhibition and they will do anything to get that substance.

If you are using any controlled substance other than for acute situations go to an addictionologist who can evaluate you and do an assessment on you to determine your propensity for addiction.  It is better if you don’t use controlled substances except for limited circumstances such as when you need them after surgery or an acute injury.

Unfortunately, many doctors are so quickly to resort to prescriptions.  Most states have a Peer Assistance Program.  If you do have an addiction or use problem, the best way to protect your license is to get help.  The nurses who have gone through the recovery program have learned skills to deal with problems and seem to be happier and more fulfilled in their jobs and in their lives.



  1. Elizabeth Scala

    Nurses who have addictions need help and support. There is something that underlies the reason as to why they are using drugs and/or alcohol to cope. So glad that nurses have resources out there to help them through the recovery process.

  2. Joyce

    Lorie, I like the point you bring on ‘nurses stealing another nurses Pyxis code to get narcotics.’
    Nurses need to guard their Pyxis code and change their password frequently.
    It feels like watching your back -but unfortunately, when it comes to the pyxis, nurses need to be careful.
    Great Post.

  3. Jennifer Olin

    Lorie, great piece. Kind, caring people do things we normally can’t imagine doing when they are under the influence of what ever they are using. I have a family member with a serious drug addiction and some of her action were unimaginable. Now, we add them to a list of things to watch for in the future. Sad but true. My state has a peer assistance program and, at least front the outside, it looks like a really good program. Caregivers are human and humans sometimes suffer from addictions. It is our responsibility to look out for ourselves and our colleagues for the safety of our patients.

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