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  1. Josie Bellings Case Study  


    Two months ago, you saw Josie, a 34-year-old nurse, to whom you prescribed escitalopram 10 mg daily and alprazolam 0.5 mg, three times a day as needed for anxiety.

    Today, Josie, her mom, and her boyfriend, Robs, present for a follow up visit. Josie reports, “My anxiety isn’t really any better. I haven’t been able to come in to work for the past three days. I ran out of my alprazolam and I cannot even think about going to work without it. Tell her, Robs, what it’s like.”

    “Yesterday,” Robs says, “Josie couldn’t get through the day, so um, yeah, she took some of my mom’s alprazolam yesterda–.”

    Josie’s mom interrupts to ask, “But why did you even give her that drug? With her history of alcohol addiction! She’s been alcoholic since she was in her early 20s. And did she tell you her dad also had problems with addiction?”

    “Addiction?” Robs asks Josie’s mom. “Are you worried about addiction to this drug?”

    He turns to you, agitated. “Did you know Josie’s sometimes taking up to seven pills a day? At least that I know of. Is that overusing or addiction?”

    Josie starts crying. “But I can’t function without alprazolam. Robs, you know how hard nursing has been ever since orientation ended. I love my job but I just want to feel normal. And the alprazolam makes me feel that way. Please….” she pleads.

    Based on the initial letter of your last name, from your perspective as Josie’s psychiatric nurse practitioner, address the following in your initial post. Question 5 should be answered by everyone.
    G–L: How does alprazolam work? What makes the medication so addictive?
    Everyone: Are there any special considerations for Josie because she is a registered nurse? What are the rules and regulations in your state for impaired nurses? Include the link to online information.


Subject Nursing Pages 5 Style APA


Josie Bellings Case Study

This paper discusses Josie’s case study by answering how alprazolam functions and why Josie became addicted to it.  The areas covered in the paper are how alprazolam works and what makes it addictive, special considerations for Josie as a registered Nurse, and rules and regulations in Florida for impaired nurses.

How Alprazolam Works and What Makes it Addictive

Alprazolam is utilized in treating anxiety and panic disorders, and it functions by reducing abnormal elation in the brain. Another brand name for alprazolam is Xanax, a benzodiazepinethat operates on the brain and nerves to generate a calming effect (Ait-Daoud et al., 2018). Alprazolam functions by boosting the impacts of a particular natural chemical in the body called gamma-aminobutyric acid (GABA). When a person experiences extreme anxiety, the brain raises specific nerve signals that trigger sentiments of uneasiness. During this moment, the brain generates a varying quantity of chemical signals, rising brain action, sensations of fear and anxiety, and limiting the capability to calm the mind. Alprazolam functions by producing a calming impact by affecting the effects of GABA, a naturally- stirring chemical in the brain. Alprazolam works by attaching to these receptors and fueling its signals.  

There are two main routes for the development of alprazolam addiction. The first way is when a person chooses to use alprazolam for recreational objectives and ultimately develops an addiction. Some individuals use alprazolam as a party drug for its sedative impacts (Ait-Daoud et al., 2018). The second method is when persons get an alprazolam prescription like in Josie’s case for legitimate medical motives, managing their anxiety. However, a danger when it comes to alprazolam is mixing it with another substance. Alprazolam and alcohol are a precarious combination.  A person like Josies with alcohol addiction leads to overdosing because both substances are central nervous system depressants. Hence they slow down the body’s processes such as movement and breathing.

Special Considerations for Josie as a Registered Nurse

Josie has special considerations because, under the Florida Mandatory Reporting Law, all certified nurses must report any supposed impairment to the IPN or the health department. Suppose the impaired nurse reports herself or reported by others only to the IPN and consents to engage in the IPN and fruitfully finishes the program. In that case, the treatment is held in secret and not notified to the health department, so no disciplinary action is taken (Smith & Greene, 2015). So, Josie’s psychiatric nurse practitioner should report her to the IPN monitoring program. The benefit of IPN is that it takes prompt action in eliminating a possibly unsafe nurse from the practice instead of the conventional investigation and castigate procedure that can take months and might only happen after actual harm has occurred. For a nurse, the ability to get assistance whereas retaining her license and upholding the likelihood of returning to the workplace gives a substantial motivation, as does the capacity to preserve their names from being made public.

Rules and Regulations in Florida for Impaired Nurses

The Florida Nurse Practice Act outlines the standards for the extent of nursing practice in a broad spectrum of care.  Florida State was the first state to provide a program targeted mainly at meeting the complex needs of nurses suffering from substance abuse through a Florida Intervention Project for Nurses (IPN). It does not fall under the board of nursing (BON) domain, and a nurse might successfully finish the program minus the board being informed. Nurses who partake in the IPN will get a systematic system that comprises evaluations, treatment interventions, and continuing monitoring (Lockwood, 2018). Only when the nurse declines to engage or displays no progress is that an ensuing report is filed to the Department of Health. If a nurse is found culpable three separate times of drug abuse breaches, he or she will lose their license permanently.

In conclusion, this paper has effectively discussed Josie’s case study by covering three areas including the functioning and addictive nature of alprazolam, special considerations for a registered nurse, and regulations and rules governing impaired nurses in Florida.




Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A review of alprazolam use, misuse, and withdrawal. Journal of addiction medicine12(1), 4.

Lockwood, W (2018). Florida Nursing Laws and Rules.https://www.rn.org/courses/coursematerial-10013.pdf

Smith, L. L., & Greene, M. (2015). Florida Intervention Project for Nurses: A national model for ADP and nurse assistance. Journal of addictions nursing26(3), 159-162.https://floridasnursing.gov/help-center/who-may-make-a-report-to-the-intervention-project-for-nurses-ipn/













Appendix A:

Communication Plan for an Inpatient Unit to Evaluate the Impact of Transformational Leadership Style Compared to Other Leader Styles such as Bureaucratic and Laissez-Faire Leadership in Nurse Engagement, Retention, and Team Member Satisfaction Over the Course of One Year

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