How Do Nursing Students Perceive Substance Abusing Nurses?

Substance abuse among nurses was recognized by nurse leaders and professional nursing organizations as a growing threat to patient safety and to the health of the abusing nurse more than 30 years ago. Although numerous studies on nurse impairment were published in the 1980s and 1990s, there was minimal focus on student nurses' perceptions about impaired nurses and less research has been published more recently, despite a growing rate of substance abuse. A quasi-experimental study to explore the perceptions of student nurses toward nurses who are chemically dependent was conducted using a two-group, pretest–posttest design. The Perception of Nurse Impairment Inventory (PNII) was completed by student nurses at the beginning of their junior course work, prior to formal education about substance abuse. The PNII was repeated after the students received substance abuse education. The PNII was also completed by a control group of sophomore student nurses who did not receive the formal substance abuse education. A repeated measures analysis of variance was used to measure the differences between the two groups of students. Students who received the education chose more compassionate responses on the PNII and were more likely to respond that an impaired nurse's supervisor is responsible for supporting and guiding the impaired nurse to access professional care. Discrepancies in study findings about the efficacy of education for effecting positive attitudes of student nurses toward impaired nurses may be related to the length and type of the education.     

Nurses' Attitudes Toward Impaired Colleagues

This study describes the attitudes of Oregon nurses toward substance abuse, substance abusers in general and impaired nurses in particular. Questionnaires were mailed to 500 randomly selected nurses, and 396 replied. Overall, nurses' attitudes, as measured by Chappel's Substance Abuse Attitude Survey (SAAS), were positive, as were their attitudes toward impaired colleagues. Regarding alcohol-impaired nurses, 77 percent of the respondents were willing to confront them, 67 percent favored their return to practice and 85 percent would accept them as co-workers if hired. Corresponding percentages for drug-impaired colleagues were 76 percent, 54 percent, and 73 percent. Nurses less approving of treatment interventions, more optimistic about treatment, employed for fewer years and with a baccalaureate or higher degree were more positive and supportive of impaired nurses than were their counterparts.     

Mental health professionals' attitudes to drugs and substance abuse

The purpose of the present study was to investigate the mental health professionals' attitudes to drug and substance abuse in Victoria, Australia. The drug- and alcohol-related attitudes of clinicians were examined in order to develop a relevant training curriculum for clinicians. A questionnaire on knowledge, skills, attitudes and practises was distributed to mental health clinicians (n = 378) in Victoria. One hundred and seventy-three clinicians returned the questionnaire, giving an overall response rate of 46%. The survey results show that the attitude of mental health professionals to drug and substance abuse is generally a positive one. The majority of respondents held positive views on treatment interventions and they are optimistic that drug and alcohol dependence are treatable illnesses. A positive and more optimistic attitude towards treatment interventions should enable health professionals, particularly nurses, to provide the necessary care for those in need of medical care.     

Attitudes of staff towards mothers affected by substance abuse

The purpose of this study was to explore the influence of education and experience on the attitudes of neonatal nurses/midwives when caring for mothers and infants affected by substance abuse. A self-report questionnaire was completed by 50 nurses/midwives. The attitude of nurses/midwives towards mothers affected by substance abuse was generally negative/judgemental, and their knowledge base was low. The most experienced nursing staff generally had a more negative attitude than those nurses/midwives with less neonatal experience. Formal neonatal education did not appear to have a positive effect on knowledge base or attitudes; however, results implied that in-service education on substance abuse might have a mildly positive effect on attitudes. Results indicate a need for formal education on substance abuse and its effect on the neonate and mother, and that specialist education on substance abuse may influence attitudes.     

AIDS attitudes and attitudes toward caring for dying patients

This article reports on a survey of nursing staff working in AIDS residential health care facilities. More than two - thirds of respondents expressed non - punitive attitudes towards AIDS. Certified nursing assistants were more likely to report negative attitudes toward caring for dying patients than registered nurses. In general, respondents who had less punitive AIDS attitudes also reported less negative attitudes toward caring for dying patients. Nursing staff in AIDS residential facilities may benefit from further training that addresses issues involved in working with AIDS patients and caring for dying patients.     

Perceptions and attitudes toward nursing impairment

Perceptions and attitudes toward nursing impairment held by 1,047 registered nurses were examined. Factor analysis of the 32 Likert-type items in an original survey questionnaire revealed an underlying structure of nine dimensions characterizing attitudes toward impairment. Analyses of variance and covariance gave evidence that supervisors were more likely than staff nurses to perceive a need for disciplinary action in responding to cases of nursing impairment; staff nurses were more likely to view impairment as treatable. Significant differences were found among attitudes toward drug abuse, alcohol abuse, and emotional distress as forms of impairment.     

Attitudes of registered nurses toward perceived substance abusing peers and education specific to substance abuse

A randomized study of 86 senior registered nurse BSN student nurses was conducted to: 1) examine registered nurses' awareness of the effects of substance abuse on their profession; 2) determine their attitudes toward education specific to substance abuse; 3) determine attitudes toward peers perceived as substance abusers; and 4) elicit responses to viewing education as a possible deterrent to drug addiction. Factor analysis for the subscales yielded Cronbach alpha coefficient reliabilities of 0.78 to 0.39. Selected cross tabulations for the independent variables showed no significant influence on the attitudes of respondents. A significant percentage of respondents believed that there was a drug problem in the profession, supported the idea of an educational program on substance abuse, and felt that a specific course could be a deterrent to drug addiction. A significant number also wanted to support the chemically impaired nurse but were less positive about the return of this person to the work place before complete rehabilitation.     

护士对惩罚性与无惩罚性差错管理方式认知和态度比较研究

目的:调查护士对惩罚性与无惩罚性差错管理方式的认知和态度,为建立无惩罚性自愿报告的差错管理制度提供研究依据。方法:对289名护理人员进行惩罚性与无惩罚性差错管理相关知识的认知及态度的问卷调查。结果:大部分护士对我国目前的护理差错管理方法比较了解,认为不能完全摒弃惩罚性管理方式,惩罚不一定能约束护士的行为且有可能影响差错报告的真实性;护士对无惩罚性自愿报告差错管理的目的及意义基本理解,对于实施无惩罚性自愿报告差错管理,大部分护士持肯定态度。结论:护理管理者应当充分认识护士对惩罚性与无惩罚性差错管理方式的认知与态度,积极倡导无惩罚自愿报告的差错管理方法,及时改进系统存在或潜在的安全问题,从而构建积极的护理安全文化。     

Perceived risk of infection and attitudes toward risk groups: determinants of nurses' behavioral intentions regarding AIDS patients.

The relationship of perceived occupational risk of AIDS and attitudes toward AIDS risk groups to behavioral intentions regarding the care of AIDS patients was examined among nurses (N = 496) residing in a selected area of New Jersey, a state with a relatively high number of reported AIDS cases. Hierarchical multiple regression analyses on anonymous mail survey responses revealed that, controlling for AIDS knowledge and years of education, nurses who perceived that caring for AIDS patients increased their risk of HIV infection scored higher on an index of intentions to avoid AIDS patient care. In addition, nurses who expressed more negative attitudes toward intravenous drug users or homosexuals were more likely to report similar intentions to avoid AIDS patient care. The implications of these findings for efforts to increase nurses' ability and willingness to provide quality care to persons with AIDS are discussed.     

Public Health and School Nurses’ Perceptions of Barriers to HPV Vaccination in Missouri

Human Papilloma Virus (HPV) is associated with various forms of cancer and is preventable with vaccination. Nurses are in a unique position to directly influence a person’s decision to receive the HPV vaccine. A statewide sample of both school and public health nurses was used to assess knowledge and attitudes related to the HPV vaccine as well as nurse’s behaviors and behavioral intentions toward educating parents and recommending the vaccine. Positive attitudes and adequate knowledge levels were found, however, the majority of school nurses did not provide information and resources to parents. Targeted health promotion programs for school nurses are recommended.     

Substance Abuse in Latin American Countries: Priorities, Challenges, and Actions

Substance abuse is a global phenomenon and its extent and nature have increased the mortality and morbidity of the population, and placed heavy demands on health and social care services. This is a selected review of some of the significant developments and the challenges faced by the Latin American and Caribbean countries in tackling drug and alcohol abuse. The Inter-American Drug Abuse Control Commission (CICAD) takes a public health approach to drug abuse prevention and treatment programs with more emphasis on the relationship among HIV/AIDS, sexually transmitted diseases, and substance abuse. In 1997 CICAD began developing a project with the aim of creating a cadre of professional nurses with academic, clinical, and research expertise in the prevention and care of substance abusers. One of the significant challenges is to overcome the marginalization of the importance of substance abuse components in nurse education curricula and clinical practice at undergraduate and postgraduate levels. Areas of concern are the professional attitudes towards those abusing drug and alcohol, the stigma attached to these conditions, and their impact on care. Another challenge for academics and clinicians is the need to develop nursing research in drug and alcohol abuse. Critical to the development and expanded role of the nurse or public health worker in working with substance abusers is the creation of a Latin American Association to act as an advocate and support group for nurses and other public health workers who are involved in the prevention, management, and treatment of substance abusers. The establishment of a communication network in examining issues related to substance abuse in those countries should be of high priority. The provision of counselling, support groups, and treatment services for professionals with problems with drug and alcohol should be part of the occupational health assistance program of any institution.     

Nurses' attitude toward alcohol abuse and alcoholism

Nurses have the opportunity to make significant contributions to primary, secondary and tertiary prevention of alcoholism because of their proximity to patients in inpatient, ambulatory and community settings. However, often nurses do not intervene because of attitudinal barriers. This paper addresses the attitudes of nurses toward alcohol abuse and alcoholism and how these attitudes are developed. Strategies for promoting attitude change are discussed.     

Tried, True, and New: Public Health Nursing in a County Substance Abuse Treatment System

Abstract The Milwaukee Target Cities (MTC) project was the only site within 19 federally funded Target Cities programs to feature a public health nursing model as its sole means of providing comprehensive health-related services to indigent substance abuse clients. We first describe MTC's implementation process, focusing on the public health nursing component, and then present a program evaluation section with selected findings from the ongoing qualitative evaluation. Initially, misunderstandings about the nurses' community-based, family-centered strategy of assuring access to health care through cross-system service linkage dogged the nurses' efforts to explain their roles and mission to federal funders, project management, coworkers. and treatment providers. In the end, after federal funding ended, public health nursing left an enduring legacy of partnerships in the county substance abuse treatment system: education about public health nursing, networking, referral processes, and resources to meet the complex health-related needs of indigent substance abusers. Despite the project's many changes, the nurses (a) became specialists in substance abuse, gaining expertise and recognition in a new community, particularly with isolated subpopulations; (b) assured substance abuse clients and their families access to health-related resources through core public health nursing skills; and (c) educated project staff, administrators, providers, and clients about public health nursing.     

Community Health and Pediatric Nurses' Knowledge, Attitudes, and Behaviors Regarding Child Sexual Abuse

Abstract Community health and other child care nurses can play a major role in the prevention, early detection, referral, treatment, and rehabilitation of victims of child sexual abuse (CSA) and their families. It is not known, however, whether these health care professionals are well prepared or feel sufficiently confident to address these challenges. The present study provides some information on this matter by examining their knowledge, attitudes, practices, and degree of confidence concerning CSA. The total population of community health and pediatric nurses of a Canadian province were surveyed using a mail out questionnaire. The results revealed that these nurses need and want to improve their knowledge and skills regarding the identification, referral, and treatment of victims of CSA. Small but significant differences were noted between the nurses and other professional and non-professional workers who had been surveyed in a previous study regarding their applied knowledge of CSA, attitudes toward victim credibility and culpability, and punishment for offenders.     

Cross-cultural differences in psychiatric nurses' attitudes to inpatient aggression

Little is currently known about the attitudes of psychiatric nurses toward patient aggression, particularly from an international perspective. Attitudes toward patient aggression of psychiatric nurses from five European countries were investigated using a recently developed and tested attitude scale. Data were collected from a convenience sample of 1,769 student nurses and psychiatric nurses. Regression analysis was performed to identify personal and occupational characteristics of the respondents able to predict their attitude toward aggression. Analysis of variance was used to identify significant differences in attitudes between and among countries. Attitude was predicted by sex, contractual status (full vs. part time), and the type of ward on which subjects worked. With one exception (communicative attitude), attitudes differed across countries. More research on attitude formation is needed to determine which factors account for these differences.     

Relationship Between Cross-Cultural Health Attitudes and Community Health Indicators

Improving health standards both nationally and cross-culturally is a goal for all community health nurses. Previous research has supported links between health attitudes and behavior. The purpose of the present study was to investigate the relationship between attitudes toward health and indexes of community health using a cross-cultural data set. Concepts selected from the data set were I (myself), body, sickness, disease, life, doctor, health, medicine, hospital, nurse, death, and insane. Community health indicators were male and female life expectancy, infant mortality, economic and public health expenditures, and net social progress. The original sample included 1200 high school males within each of 30 language and cultural communities. Data were derived from students' ratings of the dimensions of evaluation, potency, and activity for each concept. The results supported the association between attitudes and objective community health indicators. Unexpected negative correlations were found between attitudes toward medicine and nurse attitudes toward body and life, perhaps indicating that extended contact with health care providers may result in negative attitudes toward them. Positive relationships were found between public health expenditures and nurses, indicating that in countries with more expenditures for community and public health, attitudes toward nurses were more positive.     

Computers in nursing practice. A comparison of the attitudes of nurses and nursing students

This study was undertaken to compare the attitudes of nurses and nursing students toward computer use in nursing practice and to clarify factors that influence these attitudes. Three factors within the student sample were examined: changes over time, prior experience with computers, and attitudes toward technology in general. Second, the attitudes of the nursing students were compared with those of a sample of practicing nurses. Finally, the multidimensional structure of Stronge's attitude scale was analyzed. A total of 353 sophomore nursing students and 358 staff nurses participated in the study. The analysis produced a refined 17-item attitude scale composed of three identifiable subscales: computers and patient care, computers and personal security, and general attitude. It was found that students had less experience with computers than the investigators had anticipated, and there was little change over three successive cohorts of students. However, in general, students' attitudes toward computer use in nursing were positive, and the more computer experience students had, the more positive their attitudes. The attitudes of the practicing nurses also were generally positive, but differences between students and nurses were observed.     

Intentions of hospital nurses to work with computers: based on the theory of planned behavior

The purpose of this study was to determine registered nurses' attitudes related to intent to use computers in the hospital setting as a predictor of their future behavior. The study was further aimed at identifying the relationship between these attitudes and selected sociological, professional, and personal factors and to describe a research model integrating these various factors. The study was based on the theory of planned behavior. A random sample of 411 registered nurses was selected from a single large medical center in Israel. The study tool was a Likert-style questionnaire. Nine different indices were used: (1) behavioral intention toward computer use; (2) general attitudes toward computer use; (3) nursing attitudes toward computer use; (4) threat involved in computer use; (5) challenge involved in computer use; (6) organizational climate; (7) departmental climate; (8) attraction to technological innovations/innovativeness; (9) self-efficacy, ability to control behavior. Strong significant positive correlations were found between the nurses' attitudes (general attitudes and nursing attitudes), self-efficacy, innovativeness, and intentions to use computers. Higher correlations were found between departmental climate and attitudes than between organizational climate and attitudes. The threat and challenge that are involved in computer use were shown as important mediating variables to the understanding of the process of predicting attitudes and intentions toward using computers.     

Texas nurses respond to mandatory continuing education

This study investigated Texas nurses' attitudes toward mandatory continuing education, and their perceptions of skill improvement, knowledge enrichment, and improvement of health care to the public as a result of participation in continuing education programs. Seventy-two percent of the respondents had a positive attitude toward mandatory continuing education. Significant relationships were present between the attitudes and the perceptions of psychomotor skills improvement, cognitive improvement, affective skills improvement, and health care to the public. Four variables were predictive of the attitude toward mandatory education. In addition, the nurses preferred lecture or discussion formats and independent providers of continuing education.     

Fever management: paediatric nurses' knowledge, attitudes and influencing factors

AIMS: This paper describes Australian paediatric nurses' knowledge of and attitudes toward fever and its management and the predictors of their intentions to administer paracetamol to a febrile child. BACKGROUND: Despite evidence-based support for the beneficial effects of fever over the past three decades, health professionals' negative attitudes toward fever and their reliance on antipyretics to reduce it have persisted and continue to be reported in the literature. METHODS: A self-report questionnaire was used. An instrument was developed, piloted by test-retest and revised prior to data collection. Fifty-one paediatric nurses working in medical wards of a metropolitan paediatric hospital in Australia participated. RESULTS: Nurses' mean knowledge score about the physiology of fever, general fever management and antipyretics was 62%, which was not as high as expected. Participants reported positive attitudes toward the benefits of fever, the necessity for its reduction in children with pre-existing cardiac or respiratory conditions and towards regular antipyretic administration masking the infective process. Negative attitudes included disbelief that temperature is often unrelated to illness severity. Conflicting attitudes toward febrile convulsions were highlighted by beliefs that antipyretic therapy prevents these and that antipyretics do not prevent initial febrile convulsions. Predictors of intentions to administer paracetamol were beliefs about the effectiveness of paracetamol and nurses' beliefs about the expectations of others in relation to paracetamol administration. Nurses reported strong intentions to administer paracetamol to the next febrile child they cared for. Limitations of the study include the use of a nurse manager for recruitment and collecting the data at only one site. CONCLUSIONS: Fever management is an integral aspect of paediatric nursing. For its consistent rational management, nurses must have appropriate knowledge and positive attitudes. This highlights the need for continuing education in fever management.