Advertisement

Psychosocial Factors Associated With Alcohol Use Among Nurses: An Integrative Review

      Background

      Understanding alcohol use among nurses may inform interventions related to the coping mechanisms nurses use for workplace stress and trauma. Alcohol use can be caused by a variety of factors and has serious implications on a nurse’s personal health and professional practice. Understanding psychosocial factors and preventive measures may assist in the development of interventions to improve coping mechanisms and reduce the incidence of alcohol misuse.

      Purpose

      To review the psychosocial factors and preventive measures associated with alcohol use among nurses.

      Methods

      For this integrative review, systematic searches were conducted in CINAHL, PubMed, PsychNet, and ProQuest Central. Included studies were peer-reviewed and addressed alcohol use among nurses in the United States. Articles were appraised using methods-specific tools indicated by the Whittemore and Knafl framework. Data were extracted and themes identified using constant comparison.

      Results

      Of 6,214 nonduplicate articles screened, 78 were selected for full-text review and 13 were included after application of inclusion criteria. Synthesis resulted in four themes: (1) occupational stress and trauma, (2) workplace characteristics, (3) mental health implications, and (4) protective factors. The data show that workplace stress and trauma contribute to alcohol use among nurses. Night shifts, rotating shifts, and shift length are factors related to alcohol use, as are mental health problems such as anxiety, depression, trauma, and suicide. Protective factors that reduce alcohol use among nurses include faith, resilience, and perceived organizational support.

      Conclusion

      Alcohol use among nurses presents challenges for the nursing profession and regulatory bodies with specific and interrelated phenomena related to the role and identity of nurses. A better understanding of these factors through research will facilitate a healthier nursing workforce that is better prepared to take on the rewards and challenges of a nursing career.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Nursing Regulation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Accreditation Council for Graduate Medical Education. (2021). ACGME Common program requirements. Retrieved December 7, 2022, from https://www.acgme.org/globalassets/PFAssets/ProgramRequirements/CPRResidency2021.pdf

      2. American Association of Colleges of Nursing. (2021). The essentials: Competencies for professional nursing education.

      3. American Nurses Association. (n.d.). Healthy nurse, healthy nation. Retrieved May 21, 2022, from https://www.nursingworld.org/practice-policy/hnhn/

      4. Carpenter, H. 2013, December 11 Learn about the five constructs of the healthy nurse. American Nurse Today. Retrieved May 21, 2022, from https://www.myamericannurse.com/learn-about-the-five-constructs-of-the-healthy-nurse/#:~:text=ANA%20defines%20a%20HealthyNurse%20as,spiritual%2C%20personal%20and%20professional%20wellbeing

      5. Centers for Disease Control and Prevention. (2022, April 19). Alcohol and public health: Frequently asked questions. Retrieved September 13, 2022, from https://www.cdc.gov/alcohol/faqs.htm

        • Choflet A.
        • Davidson J.
        • Lee K.C.
        • Ye G.
        • Barnes A.
        • Zisook S.
        A comparative analysis of the substance use and mental health characteristics of nurses who complete suicide.
        Journal of Clinical Nursing. 2021; 30: 1963-1972https://doi.org/10.1111/jocn.15749
        • Clayton M.
        • Rolland M.
        • Bosanquet J.
        Alcohol and why we should care for the public’s health.
        Gastrointestinal Nursing. 2015; 13: S10-S15
      6. Code of Federal Regulations. (n.d.). Flight time limitations and rest requirements: One or two pilot crews. Code of Federal Regulations. Retrieved December 7, 2022, from https://www.ecfr.gov/current/title-14/chapter-I/subchapter-F/part-91/subpart-K/subject-group-ECFRc17623c0e0be17e/section-91.1059

        • Collins R.L.
        • Gollnisch G.
        • Morsheimer E.T.
        Substance use among a regional sample of female nurses.
        Drug and Alcohol Dependence. 1999; 55: 145-155https://doi.org/10.1016/s0376-8716(98)00193-8
      7. Critical Appraisal Skills Programme. (n.d.-Qualitative checklist. Retrieved May 22, 2022, from https://casp-uk.net/images/checklist/documents/CASP-Qualitative-Studies-Checklist/CASP-Qualitative-Checklist-2018_fillable_form.pdf

        • Davidson J.E.
        • Ye G.
        • Parra M.C.
        • Choflet A.
        • Lee K.
        • Barnes A.
        • Harkavy-Friedman J.
        • Zisook S.
        Job-related problems prior to nurse suicide, 2003–2017: A mixed methods analysis using natural language processing and thematic analysis.
        Journal of Nursing Regulation. 2021; 12: 28-39https://doi.org/10.1016/S2155-8256(21)00017-X
        • Davis M.A.
        • Cher B.A.Y.
        • Friese C.R.
        • Bynum J.P.W.
        Association of US nurse and physician occupation with risk of suicide.
        JAMA Psychiatry. 2021; 78: 651-658https://doi.org/10.1001/jamapsychiatry.2021.0154
      8. Federal Motor Carrier Administration. (2021, November 10). Hours of service (HOS). https://www.fmcsa.dot.gov/regulations/hours-of-service

        • Foli K.J.
        • Forster A.
        • Cheng C.
        • Zhang L.
        • Chiu Y.-C.
        Voices from the COVID-19 frontline: Nurses’ trauma and coping.
        Journal of Advanced Nursing. 2021; 77: 3853-3866https://doi.org/10.1111/jan.14988
      9. Foli, K. J., Reddick, B., Zhang, L., & Krcelich, K. (2020). Substance use in registered nurses: “I heard about a nurse who....” Journal of the American Psychiatric Nurses Association, 26(1), 65–76. https://doi.org/10.1177/1078390319886369

        • Foli K.J.
        • Thompson J.R.
        The influence of psychological trauma in nursing.
        Sigma Theta Tau. 2019; (International)
        • Foli K.J.
        • Zhang L.
        • Reddick B.
        Predictors of substance use in registered nurses: The role of psychological trauma.
        Western Journal of Nursing Research. 2021; 43: 1023-1033https://doi.org/10.1177/0193945920987123
        • Humeniuk R.
        • Ali R.
        • Babor T.F.
        • Farrell M.
        • Formigoni M.L.
        • Jittiwutikarn J.
        • de Lacerda R.B.
        • Ling W.
        • Marsden J.
        • Monteiro M.
        • Nhiwatiwa S.
        • Pal H.
        • Poznyak V.
        • Simon S.
        Validation of the alcohol, smoking and substance involvement screening test (ASSIST).
        Addiction. 2008; 103 (https://10.1111/j.1360-0443.2007.02114.x): 1039-1047
        • Hurley S.
        • Edwards J.
        • Cupp J.
        • Phillips M.
        Nurses’ perceptions of self as role models of health.
        Western Journal of Nursing Research. 2018; 40: 1131-1147https://doi.org/10.1177/0193945917701396
      10. Jordan, T. R., Khubchandani, J., & Wiblishauser, M. (2016). The impact of perceived stress and coping adequacy on the health of nurses: A pilot investigation. Nursing Research and Practice, 2016, Article 5843256. https://doi.org/10.1155/2016/5843256

        • Matthias-Anderson D.
        • Yurkovich E.
        Work reentry for RNs after substance use disorder treatment: Implications for the nursing profession.
        Journal of Nursing Regulation. 2016; 7: 26-32https://doi.org/10.1016/S2155-8256(16)32318-3
        • Monroe T.B.
        • Kenaga H.
        • Dietrich M.S.
        • Carter M.A.
        • Cowan R.L.
        The prevalence of employed nurses identified or enrolled in substance use monitoring programs.
        Nursing Research. 2013; 62: 10-15https://doi.org/10.1097/NNR.0b013e31826ba3ca
        • National Institute of Alcohol Abuse and Alcoholism
        Alcohol alert: The link between stress and alcohol.
        Alcohol Research: Current Reviews. 2012; 34
      11. National Institute of Alcohol Abuse and Alcoholism. (n.d.). Drinking levels defined. Retrieved May 26, 2022, from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking.

        • Pollard M.S.
        • Tucker J.S.
        • Green Jr., H.D.
        Changes in adult alcohol use and consequences during the COVID-19 pandemic in the US.
        JAMA Network Open. 2020; 3: e2022942https://doi.org/10.1001/jamanetworkopen.2020.22942
      12. Quick J.C. Tetrick L.E. Handbook of occupational health psychology. (2nd ed.). American Psychological Association, 2014
        • Reinert D.F.
        • Allen J.P.
        The alcohol use disorders identification test (AUDIT): A review of recent research.
        Alcoholism: Clinical and Experimental Research. 2002; 26: 272-279
        • Ross C.A.
        • Jakubec S.L.
        • Berry N.S.
        • Smye V.
        “A two glass of wine shift”: Dominant discourses and the social organization of nurses’ substance use. Global Qualitative.
        Nursing Research. 2018; 5, Article 2333393618810655https://doi.org/10.1177/2333393618810655
        • Shivani R.
        • Goldsmith R.J.
        • Anthenelli R.M.
        Alcoholism and psychiatric disorders: Diagnostic challenges.
        Alcohol Research & Health. 2002; 26: 90-98
        • Smiley R.A.
        • Ruttinger C.
        • Oliveira C.M.
        • Hudson L.R.
        • Allgeyer R.
        • Reneau K.A.
        • Silvestre J.H.
        • Alexander M.
        The 2020 National Nursing Workforce Survey.
        Journal of Nursing Regulation. 2021; 12: S1-S96https://doi.org/10.1016/S2155-8256(21)00027-2
        • Stovall M.C.
        • Firkins J.
        • Hansen L.
        • Dieckmann N.F.
        • Van Ryn M.
        Personality traits and traumatic outcome symptoms in registered nurses in the aftermath of a patient safety incident.
        Journal of Patient Safety. 2021; 17: e1652-e1659https://doi.org/10.1097/PTS.0000000000000740
        • Strobbe S.
        • Crowley M.
        Substance use among nurses and nursing students: A joint position statement of the Emergency Nurses Association and the International Nurses Society on Addictions.
        Journal of Addictions Nursing. 2017; 28: 104-106
      13. Substance Abuse Mental Health Services Administration. (n.d.). Alcohol misuse. Retrieved November 21, 2022, from https://www.samhsa.gov/data/taxonomy/term/91

        • Thomas K.
        • Nilsson E.
        • Festin K.
        • Henriksson P.
        • Lowén M.
        • Löf M.
        • Kristenson M.
        Associations of psychosocial factors with multiple health behaviors: A population-based study of middle-aged men and women. International Journal of Environmental Research and Public Health, 17(4), Article 1239. 2020; https://doi.org/10.3390/ijerph17041239
        • Trinkoff A.M.
        • Selby V.L.
        • Han K.
        • Baek H.
        • Steele J.
        • Edwin H.S.
        • Yoon J.M.
        • Storr C.L.
        The prevalence of substance use and substance use problems in registered nurses: Estimates from the Nurse Worklife and Wellness Study.
        Journal of Nursing Regulation. 2022; 12: 35-46https://doi.org/10.1016/S2155-8256(22)00014-X
        • Trinkoff A.M.
        • Storr C.L.
        Substance use among nurses: Differences between specialties.
        American Journal of Public Health. 1998; 88: 581-585https://doi.org/10.2105/ajph.88.4.581
        • Trinkoff A.M.
        • Storr C.L.
        Work schedule characteristics and substance use in nurses.
        American Journal of Industrial Medicine. 1998; 34: 266-271https://doi.org/10.1002/(SICI)1097-0274(199809)34:3<266::AID-AJIM9>3.0.CO;2-T
        • U.S. Nuclear Regulatory Commission
        (Nuclear power plant staff working hours)
        • von Elm E.
        • Altman D.G.
        • Egger M.
        • Pocock S.J.
        • Gøtzsche P.C.
        • Vandenbroucke J.P.
        The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies.
        International Journal of Surgery. 2014; 12: 1495-1499https://doi.org/10.1016/j.ijsu.2014.07.013
        • Witkoski Stimpfel A.
        • Goldsamt L.
        • Liang E.
        • Costa D.K.
        Work organization factors associated with nurses’ stress, sleep, and performance: A pre-pandemic analysis.
        Journal of Nursing Regulation. 2022; 13: 4-12https://doi.org/10.1016/S2155-8256(22)00085-0
        • Witkoski Stimpfel A.
        • Liang E.
        • Goldsamt L.A.
        Early career nurse reports of work-related substance use.
        Journal of Nursing Regulation. 2020; 11: 29-35https://doi.org/10.1016/S2155-8256(20)30058-2
        • White A.M.
        • Castle I.P.
        • Powell P.A.
        • Hingson R.W.
        • Koob G.F.
        Alcohol-related deaths during the COVID-19 pandemic [Letter].
        JAMA. 2022; 327: 1704-1706https://doi.org/10.1001/jama.2022.4308
        • Whittemore R.
        • Knafl K.
        The integrative review: Updated methodology.
        Journal of Advanced Nursing. 2005; 52: 546-553https://doi.org/10.1111/j.1365-2648.2005.03621.x