Substance abuse and the nurse manager: ethical and legal issues

Nurse managers have a pivotal role in intervening in situations of substance abuse among employees. This article addresses ethical and legal dimensions of chemical impairment from the perspective of the nurse manager. The value of a rehabilitative rather than a punitive approach to the chemically impaired nurse is emphasized. Ethics of care and relevant legal considerations, including the Americans With Disabilities Act, are explored through case analysis. Covenantal relationships offer a framework for examining the responsibilities of the nurse manager with respect to the community, employer, the actual or allegedly chemically impaired nurse, and one's self.