A nurse manager is reviewing a recent client report related to a staff nurse. Which of the following behaviors by a nurse at work might be red flags for a substance use disorder?

A. Crying, sharing personal details of relationship problems, monopolizing conversations: While these behaviors may indicate emotional distress or stress, they are not specific red flags for a substance use disorder. Many factors can lead to emotional behaviors that are not necessarily related to substance use. B. Increased cheerfulness, increased energy, helping other nurses on the shift: Although increased energy might seem positive, it can also be a sign of stimulant use. However, increased cheerfulness and helpfulness alone do not necessarily indicate a substance use disorder and may reflect a temporary mood change. C. Volunteering for overtime on a continual basis, avoiding having a witness to wasting narcotics, needing to be alone in the medication room when preparing medications: These behaviors are significant red flags for a substance use disorder. Continually volunteering for overtime may indicate a desire to be near controlled substances, while avoiding witnesses during narcotic waste and needing solitude in the medication room suggests potential misuse or diversion of medications. D. Increased irritability towards supervisors, outspokenness regarding work issues, increased attendance at staff meetings: While increased irritability and outspoken behavior may raise concerns about the nurse's mood or job satisfaction, they are not direct indicators of a substance use disorder. Increased attendance at meetings may even suggest a commitment to the job rather than a problem.