Study indicates high rate of ‘intentional’ drug-related deaths among nurses
More nurses die from deliberate drug overdose than any other health care professionals, according to a landmark new study.
Researchers from the Department of Forensic Medicine at Monash University examined more than 400 drug-related deaths of Australian healthcare workers between 2003 and 2013.
It included medical practitioners, paramedics, nurses, dentists, psychologists, pharmacists and vets.
Lead author Jennifer Pilgrim found the highest number of deaths was among nurses — 62 per cent of the deaths — followed by medical practitioners, at 18 per cent.
Most of the nurses were women, and the doctors male.
“Drug-caused deaths among healthcare professionals in Australia commonly involve females in their mid-40s, with a diagnosis of mental illness, personal and professional stress and the intent to self-harm,” the study found.
Intentional self-harm was the main cause of death, and mental illness was common, with depression diagnosed in almost half of those who died.
But taking into account the number of people employed in different parts of the health sector, veterinarians were most at risk of a fatal overdose.
“Most of these vets involved intentional self-harm where they took an overdose of barbiturates,” she said.
“Until this study, we didn’t know if drug-related overdoses were a problem in Australia.
“Professional and personal stresses were also very common, along with financial problems, relationship problems and workplace stress.”
Drugs obtained illegally through workplace
On average, 37 health care workers died each year from drug overdoses.
Most of the drugs were obtained illegally through the workplace by theft or self prescription.
Dr Pilgrim said the findings raised real concerns about whether enough is being done to monitor health workers for mental health problems and drug use.
“Many healthcare professionals treat themselves or don’t seek treatment at all,” she said.
“It highlights the need for better detection of these problems to provide them with the support they need.”
She said, alarmingly, almost all the healthcare professionals were still licensed to practice at the time of their deaths, despite probable work place impairment.
“How are these potentially preventable deaths not considered workplace incidents?” she asked.
Better oversight needed to prevent more deaths
Researchers say the findings suggest a need to “consider improving the detection and management of drug-addicted and impaired healthcare providers” in Australia to prevent future deaths.
Dr Pilgrim said though overall numbers were small, there was a high death rate among anaesthetists.
“Most of these involved taking the drugs they used for work,” she said.
International research shows many healthcare professionals were afraid to speak up about mental health and substance abuse issues for fear of stigma and losing their jobs.
Healthcare workers face additional risk factors such as stress, long working hours, self-medicating and ready access to controlled drugs.
Listen to the story on The Health Report on ABC RN at 5:30pm today, and 5:30am on Tuesday. Or anytime online at www.abc.net.au/radionational/healthreport.
Filed under: General Problems
This article is just scratching the surface of a much larger problem that runs bone-deep in both medicine and society at large. Run a google search on “doctor suicide” and you’ll come up with thousands of references. But even this dos not tell the whole story.
Multiple factors are involved in the high rates of physician and nurse self-harm. Not least of these in the US is the situational stress imposed by for-profit hospital management teams and insurance company refusal to adequately reimburse the protracted care necessary to manage patients with chronic life-threatening disorders. Doctors see far too many patients, often restricted to a ten-minute consult for each and professionally penalized if they do not meet management expectations. Many of the same factors are likely involved in the 440,000 deaths per year due to errors in US hospital care.
A further factor in younger health care professionals is the long-known abuses of the internship system. Doctors just entering the health professions are subjected to unrelenting stress in 100-hour or longer work weeks often involving 24-hour shifts. Sleep deprivation does well known harms to our practicing young physicians, and hospital managements turn a blind eye to that harm — often continuing to do so after a doctor suicides. Nobody listens.
All of this is complicated by financial and social reality. A third of the US medical dollar is spent in collection systems (insurance company overhead, malpractice law, and other factors that have nothing to do with patient care). We also refuse to embrace the need for preventative care, instead spending most of our health “care” dollars on heroic measures during the last five years of life. A huge portion of our medical care cost is incurred in avoidable disorders: diabetes, heart disease and cancer caused by our high-sugar diets and smoking. We cannot expect to live long and rewarding lives when we daily mistreat ourselves and others by unsustainable life style habits.
The underlying problem in health care provider deaths isn’t lack of oversight. It’s a system that itself is deeply broken in multiple ways.
Most nurses don’t steal drugs from patients. They get them like everyone else. They have many groups with nurses. They really have a tuff time because they work in the health community. Like anyone else having problems an sometimes in serious pain.
They need to be treated with dignity and respect. We all know this don’t we ?