When the Helper Needs Help - Supporting Nurses and Midwives with Drug and Alcohol Concerns

Introduction

Nurses and midwives dedicate their careers to supporting the health and wellbeing of others. However, the pressures associated with healthcare work can sometimes impact their own wellbeing. Exposure to trauma, emotional demands, workplace stress, fatigue, shift work, and personal challenges can contribute to increased reliance on alcohol or other substances as a way of coping.

Drug and alcohol concerns can affect nurses and midwives at any stage of their career. They can occur across all areas of practice and are not limited by experience, seniority, personal circumstances, or professional role.

Seeking support early is an important step towards wellbeing, recovery, and maintaining safe and sustainable practice.

Understanding Drug and Alcohol Concerns

Drug and alcohol use exists along a continuum. For some people, substance use may be occasional and not cause concern. For others, use may gradually become a way of managing stress, emotions, sleep difficulties, or difficult experiences.

A nurse or midwife may recognise concerns when they notice:

• Increasing reliance on alcohol or other substances to cope
• Using substances to manage stress, anxiety, distress, or sleep
• Difficulty cutting down or controlling use
• Feeling unable to relax or function without alcohol or substances
• Increased tolerance or experiencing cravings
• Changes in mood, relationships, health, or daily functioning
• Concerns raised by family, friends, or colleagues
• Attending work affected by alcohol or other substances

Recognising these changes is not about judgement—it is an opportunity to seek support.

Why Nurses and Midwives May Be at Increased Risk

Healthcare professionals often work in environments that involve significant emotional and psychological demands.

Exposure to Trauma and Distressing Events

Nurses and midwives may regularly experience:

• Patient deterioration and death
• Traumatic injuries or unexpected outcomes
• Workplace aggression or violence
• Moral distress when unable to provide the care they would like
• Cumulative exposure to suffering and grief

Over time, these experiences can impact wellbeing, particularly when there is limited opportunity to process or recover.

Workplace Stress and Burnout

High workloads, staffing pressures, workplace conflict, changing expectations, and emotional exhaustion can affect coping capacity.

Some healthcare professionals may find themselves using alcohol or substances as a way to switch off after work, manage difficult emotions, or create distance from stressful experiences.

Shift Work and Fatigue

Irregular hours and disrupted sleep patterns can affect mood, physical health, and resilience. Some people may turn to substances in an attempt to relax, sleep, or manage exhaustion.

When a Nurse or Midwife Reaches Out for Support

Contacting a peer support service about drug or alcohol concerns can feel overwhelming. Many nurses and midwives worry about:

• Being judged or labelled
• The impact on their career or registration
• Losing the respect of colleagues
• Concerns about confidentiality
• Feeling shame or embarrassment

A supportive conversation provides an opportunity to explore what is happening, understand the person’s circumstances, and identify appropriate supports.

Peer support is not about diagnosing, investigating, or determining blame. It is about listening, acknowledging the person’s experience, and supporting them to identify their next steps.

A Peer Support Response

A compassionate peer support approach involves:

Listening Without Judgement

Creating a safe space where a nurse or midwife can talk openly about their experiences is often the first step.

Helpful responses may include:

"Thank you for trusting me with this. It sounds like things have been really difficult."

"Many healthcare professionals experience periods where they need additional support."

"Let's explore what support might be helpful for you from here."

Understanding the Person’s Story

Drug and alcohol concerns are often connected with other factors, including:

• Workplace stress
• Trauma exposure
• Relationship difficulties
• Grief and loss
• Mental health challenges
• Sleep disruption
• Burnout or compassion fatigue

Understanding the broader context helps identify meaningful support options.

Encouraging Early Support

Early support can prevent concerns from escalating. Encouraging a nurse or midwife to seek appropriate assistance is an important part of maintaining wellbeing.

Support options may include:

• Peer support services
• Employee assistance programs
• General practitioners and healthcare providers
• Alcohol and other drug services
• Psychological support
• Workplace wellbeing resources
• Professional support programs

Supporting a Colleague Who May Be Struggling

Nurses and midwives may notice changes in a colleague before the person seeks help.

Possible indicators may include:

• Increased absenteeism or lateness
• Changes in mood or behaviour
• Reduced engagement with colleagues
• Declining confidence or performance
• Concerns about reliability or safety

If you are concerned:

• Choose an appropriate private time to talk
• Approach with compassion rather than assumptions
• Focus on observed changes
• Ask how they are going
• Encourage support-seeking
• Maintain professional boundaries

A simple conversation can be the first step towards someone getting help.

Professional Responsibility and Support

Concerns about alcohol or drug use can create anxiety about professional obligations. Nurses and midwives may fear consequences before understanding what support is available.

The priority of a supportive response is to encourage safe practice, wellbeing, and early intervention.

Seeking help demonstrates insight, responsibility, and commitment to providing safe care.

Recovery and Returning to Wellbeing

Many healthcare professionals experience challenges with alcohol or other substances and go on to recover and continue meaningful careers.

Recovery may involve:

• Understanding personal triggers
• Developing healthier coping strategies
• Accessing appropriate treatment and support
• Rebuilding confidence and wellbeing
• Strengthening protective factors and relationships

Recovery is a process, and support can make a significant difference.

Key Messages for Nurses and Midwives

• Drug and alcohol concerns can affect anyone, including healthcare professionals.
• Seeking support early is a strength, not a weakness.
• Nurses and midwives deserve the same care and compassion they provide to others.
• Peer support offers a confidential opportunity to talk, reflect, and identify pathways forward.
• Supporting a colleague begins with compassion, curiosity, and connection.

Remember

You do not need to wait until things become overwhelming before reaching out for support.