While working on an orthopedic unit of an acute care facility, the nurse's level of suspicion regarding substance dependency would be heightened if a peer made which of the following comments?
1. "Why don't you go to lunch and I'll give your client something for pain."
2. "I went out with my friends last night and got so drunk on two drinks."
3. "I think Mr. Mathews in room 212 is a drug abuser, because he's always asking for something for pain."
4. "I have a urinary tract infection, and I've had to go to the bathroom every 20 minutes."
1
Rationale: The nurse who frequently offers to administer narcotics to other nurses' clients raises the suspicion of possible substance dependency, but this is not conclusive proof, and should not be acted upon until further information is obtained that indicates substance use. The nurse who felt drunk after two drinks is unlikely to have a problem, because tolerance increases with repeated use. The nurse talking about Mr. Mathews has broken client confidentiality, and needs more education about pain management, but does not cause suspicion about substance dependency. Urinary tract infections do cause frequent trips to the bathroom, and it is unlikely someone going to the bathroom every 20 minutes is taking a narcotic that frequently.
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