An Overview of the American Nurses' Association's Action on Impaired Practice with Suggestions for Future Directions

Abstract

Society expects high performance levels of health professionals because of their advanced education, clinical expertise, and access to personal information about patient’s lives. The recently revised American Nurses’ Association (ANA) Social Policy Statement (ANA, 2003) delineates nurses’ responsibilities to the profession, American society, and the health of the nation. The notion that a health professional could be practicing while under the influence of alcohol and other drugs, or while psychiatrically ill, is one that evokes strong responses from the public and from members of the profession. Since the 1960s, issues of professional responsibility, including licensure and state mandated legal regulation, have received greater attention, and three important perspectives on impaired practice, professional, ethical, and legal, have become articulated and refined. Self-regulation of a profession in relation to impaired practice emerged in the American Medical Association in the 1970s. Nursing soon followed with the 1978 organization by the Maryland Nurses’ Association of the Committee for the Rehabilitation of the Registered Nurse, one of the first peer assistance initiatives, and with participation in interdisciplinary activities directed toward policy development and peer assistance. Unified national action by the American Nurses’ Association began with advocacy for nurses by committed nursing and medical experts and a policy statement developed by three cooperating organizations. In 1981, the ANA convened the Task Force on Addictions and Psychological Dysfunctions with representatives of the ANA, the Drug and Alcohol Nurses’ Association (which has since joined with IntNSA), and the National Nurses’ Society on Addiction, now known as the International Nurses’ Society on Addiction (IntNSA). The statement, which emerged from this group collaboration, became a resolution to the American Nurses Association’s House of Delegates (HOD) and was subsequently passed and became ANA policy in 1982. The preparation and ANA publication of the monograph, Addictions and Psychological Dysfunction, the Profession’s Response to the Problem, was published in 1984. This included the pol