Suffering in silence

Being a nurse offers no protection from illness, including substance abuse and mental health problems. Writes Annie May.

Susan had a few drinks every night after university or work to wind down. She never thought it to be a problem. One night she was caught driving over the limit. She thought it was a nuisance. Her friends thought it was funny.

Finding it hard to enjoy her study and part-time work, Susan believed she was depressed. Her partner said her drinking was making it worse. Finally acknowledging that she did have a problem she thought about getting help but was frightened of risking her future job prospects.

She kept up the drinking and was again caught driving under the influence.

Change the name and some of the particular situations and Susan’s story could be that of the many Australians who are experiencing, or have experienced substance abuse problems throughout their life.

It could be the story of the many nurses in Australia who have a substance abuse problem.

The practice of nursing offers no protection from illness, including alcohol and other drug and mental health problems. However, as a profession, where the job is to care for and look after others, there is often reluctance by the nurse to admit to these kind of issues.

It was for this reason that the Victorian Nurses Health Program (VNHP) came to exist. Established in 2006, it provides advice, support and case management to nurses, midwives and students of nursing facing the challenges presented by their substance abuse. The independent service expanded its scope in June 2007 due to a demand to support the needs of those with mental health concerns.

Run by nurses, VNHP works with nurses and midwives to provide confidential assessment, treatment and referral to a variety of services including counselling and financial support, case management, peer support groups and general support regarding industry issues.

Substance abuse among nurses and health workers is not a new issue, but one that still isn’t getting the attention it deserves, says Glenn Taylor, VNHP CEO and nurse.

“This is a real issue and the health impacts that alcohol and drug problems and mental health concerns have on our colleagues in the industry is of real concern to us. By attention, I’m not talking about sensational stories in the media about nurses gone wild, but attention from those in the position to address the issue,” says Taylor.

With statistics putting 10 per cent of the general population experiencing a substance problem in their life, Taylor says the number could be higher among the nursing population.

“The risk is much higher for those in the health industry because they have access to drugs on a daily basis. That’s not to say all nurses are tempted or just because it’s available that they choose to use drugs but, added with other factors and it is an extra risk.”

These other factors include working in a stressful environment, dealing with trauma and social circumstances.

“People die, families are upset, there isn’t near enough staff. And you just started work at 11pm and won’t see your bed until the sun is well and truly out. It is an accumulation of many things.”

Many nurses also believe that the community expects them to be perfect, says Taylor.

“Nurses are great at looking after others – the best. They are not great at looking after themselves. We push ourselves to breaking point, and the reality is that some break.”

The majority of nurses and midwives who seek help at VNHP do so for alcohol abuse. And for those with mental health problems, 50 per cent identify stress as the biggest component.

One of the main reasons given for why they hadn’t previously sought help is risking employment.

Confidentiality is therefore essential for the VNHP if it is going to make a difference.

“We don’t answer to any other body and won’t be leaned on to give or do anything for purposes outside helping the nurse who comes to use for help,” Taylor said.

“Getting employers and managers involved in the process is seen in most cases as beneficial by us, but it is never done without the nurse’s permission. If that permission is given we work with the employer to provide assistance to the nurse and develop a treatment plan that suits them.

“This includes recommending to the employer that time off is needed, or if drugs are the problem and their position puts them around drugs, to change areas. Basic reports are given to the employer so they are assured the nurse is getting the treatment they need and can perform their duties. Again, this is done only if we have the nurse’s permission.”

Of the nurse participants who engaged with the VNHP, 72 per cent were either supported to remain at work, returned to work nursing or has a plan to return to work nursing.

“This is a great result. The question I sometimes find myself asking is what happened before we arrived? If there was a problem a manager or colleagues would stick their head in the sand and ignore or enable the problem, or report it. As we are only in Victoria, this may still be the case in other states or territories,” says Taylor.

As patient safety can’t be compromised, the VNHP will notify for board of nursing if they feel a particular nurse isn’t going to make any changes and are dangerous. In the four years since opening, this hasn’t had to be done.

“Nurses are smart. By the time they come to us they know they need help.”

That was the case for Susan. One year on from seeking help at VNHP she is attending AA meetings, is sober and happy in her relationship.

The inaugural VNHP Nursing and Midwifery Wellness Conference is on 10 September 2010. For all nurses, the program includes identification of unhealthy workplace behaviours, exposure to strategies to best deal with these and an introduction to a range of innovative ideas and thinking. It will also have many fun activities. Go to www.vnhp.org.au

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