U01: Substances and Studying

College students today face intense pressure, pressure to fit in, to maintain relationships, to make their parents proud, to succeed, etc.  Sometimes the pressure can be too much, and students turn to various vices and/or give into different temptations.

Consider Marie, the nursing student who is taking a full course load while trying to work full time and balance a social life.  She is used to academic success and strives to maintain A’s and B’s at any cost.  The pressure she puts on herself, the pressure she feels from her parents, etc., gets to be too much for her at times and she finds herself giving into temptation all around her.  Marie often studies with a group of her classmates, however, sometimes this provides a whole new avenue for Marie to give into temptation.  One of Marie’s classmates uses stimulants such as Ritalin to help her stay awake and study.  Another classmate in the study group finds that having two nights a week to go out and binge drink is her only way of coping with the intense stress and pressures of nursing school.  These temptations are increasingly difficult for Marie to avoid.

Marie has also struggled with an opioid addiction in the past.  Towards the end of high school, Marie suffered a shoulder injury which led to surgery and months of opioid pain medication.  Marie’s teammates began using opioids around the same time.  This was a period of Marie’s development where her friends and her social surroundings were how she identified herself.  Let’s consider Marie’s experiences with regards to Erik Erikson’s developmental theory.  Unfortunately, because she identified with these less than positive behaviors and friendships, she did not develop a strong sense of self.  As she entered young adulthood, as with most other people, she desired intimacy and relationship with others.  But, “intimacy with other people is possible only if a reasonably well integrated identity” (Sharkey, 1997), is developed in the adolescent stage of Identity vs Identity Confusion.

So where does that leave Marie now?   Well, she has a history of substance use as a vice.  To avoid pain, she used opioids.  To connect with teammates or friends, she continued her opioid use until it became substance abuse.   Marie’s vice is drugs and/or alcohol.  She lacks a strong will to avoid these substances, especially in times where the pressure is intense.

Marie’s study group adds an element of temptation in the sense that her classmates are turning to their own individual vices.   This creates an environment of temptation that is exponential since the individuals all struggle with similar vices.

One of the nursing classes the group is enrolled in has an element of clinical hours.  The students are expected to complete ten clinical hours on Thursdays.  Marie and her classmates were up most of the night, Wednesday, using Ritalin and other substances to keep them going.  They report to clinical on Thursday morning at 7am and one of the clinical instructors notices their appearance and general affect.  The instructor begins to wonder if the girls are hungover, still under the influence, or just too tired for clinical.  It would seem this instructor has several options.  She could do nothing at all, thus potentially opening the patients, other students, and Marie and her friends up for liability since the group is clearly struggling.  On the other hand, she can trust her suspicion and could ask the students to leave clinical, go to student health, get drug-tested and only return when not apparently under the influence.  Or, she can use this as an opportunity to positively influence this group of students by still asking them to be drug tested but also providing some guidance as far as goal-setting goes so that these students perhaps do not feel the need to turn to substances to succeed in nursing school.  Ultimately, as their leader in this situation, the instructor is the person with the influence and the opportunity to determine the direction this group will go (PSU, 2018).  The instructor could consider her own personal values as well as those of the nursing school.  She must consider both what is right or wrong as well as what is in the best interest of Marie and her study group, the other students, as well as the patients and nursing school in general.



PSU. (2018). PSY533: L01 Ethical Leadership. Retrieved from https://psu.instructure.com/courses/1913945/pages/l01-ethical-leadership?module_item_id=25041756

PSU. (2018). PSY533: L02 Vices and Temptations. Retrieved from https://psu.instructure.com/courses/1913945/pages/l02-vices?module_item_id=25041767

Sharkey, W. (1997). Erik Erikson. Retrieved from https://web.archive.org/web/20171007080115/http://www.muskingum.edu/~psych/psycweb/history/erikson.htm#Theory

One Comment

  1. Peggy Smith Bush September 23, 2018 at 2:21 PM #

    U01: Blog Comment Reply

    Good afternoon Rachel,

    I found your blog comment interesting and timely. While neither drugs nor alcohol are among my own list of vices, I recognize the temptation and sympathize. Like nursing school and nursing itself, law school and the practice are competitive and stressful – different stress but a significant issue. I suppose what the Instructor does is, of course, important for the patients – and Marie. Certainly, she has an obligation to the patients and I would trust that she would follow the proper channels for making sure that nobody on her watch is impaired while they are working. On another level, as a leader it is incumbent upon the Instructor to offer guidance and assistance – please note I did not say that the Instructor was responsible for “fixing it” – that is something that is likely beyond her or any other leader’s immediate control.

    Because of your blog comment, I read an article regarding what leaders in nursing can do to help outside of the disciplinary action that would either be mandatory or advisable. The article, Emerging from the darkness and stepping into the light: Implementing an understanding of the experience of nurse addition into nursing education, Journal of Nursing Education and Practice, 2014, was helpful to me in trying to put the stresses of your scenario into a context. (Burton, K.L., 2014). If you have not read it, you might find it at least comforting as to the thoughts which are discussed. In a nutshell, what caught my attention were the similarities that I see between this article regarding nursing versus the articles regarding attorneys. They are not all that different in many ways – and that raises, I believe an even bigger concern of the apparent increase in drug and substance abuse in young people and how it often begins in college.

    As with the attorney statistics and articles I have read, most are applicable to both: “(1) fear is a significant part of the experience of being a nurse who is addicted, (2) shame and guilt are felt by nurses who are addicted, (3) poor coping: addicted nurses report having underdeveloped coping skills (they sure didn’t teach those in law school), (4) addicted nurses feel an increased need to control their environments, and (5) a core problem inherent in nurses who are addicted is a belief that addition would never happen to them.” (Burton, K.L, 2018). The article discussed how nursing schools, “have and continue to be challenged to integrate substance abuse and addition content into both their undergraduate and graduate curricula.” (Burton, K.L., 2018). With so many similarities between young people in two very distinct industries, I propose that it is not the industry but the societal atmosphere in which we live that is at the core of these very serious issues.

    Thank you for a nicely done blog comment – I enjoyed it. Have a nice evening, Peggy

    Burton, K.L., (2018). Emerging from the darkness and stepping into the light: Implementing an understanding of the experience of nurse addition into nursing education. Journal of Nursing Education and Practice, 2014, Vol. 4, No. 4. Retrieved from: http://www.sciedu.ca/jnep and retrieved from: https://sciedu.ca/journal/index.php/jnep/article.

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