Impaired Nurses Benefit from Alternative-to-Discipline Approach

Jennifer Thew, RN, June 14, 2017

Nursing organizations advocate for rehabilitating rather than punishing nurses experiencing substance use disorder. 

The American Association of Nurse Anesthetists is endorsing a new position statement that advocates for an alternative-to-discipline approach for nurses and nursing students with substance use disorder.

The position statement Substance Use Among Nurses and Nursing Students, co-authored by the International Nurses Society of Addictions and the Emergency Nurses Association calls for an alternative-to-discipline approach with the stated goals of:

  • Retention
  • Rehabilitation
  • Re-entry into safe, professional practice

The position statement also says drug diversion for personal use should be considered a symptom of a serious but treatable disorder rather than strictly as a crime.

“It’s about education for prevention and fair handling when it happens,” says Lynn Reede, DNP, MBA, CRNA, FNAP, AANA senior director of professional practice. “Education raises awareness and understanding, and at the same time decreases the stigma related to the disease. Treatment of substance use disorder helps keep patients and healthcare professionals safe.”

Recovery is the Goal

A disciplinary approach to impaired practice or drug diversion involves due process with a state board of nursing and suspension or revocation of a nurse’s professional license. There is no offer of a recovery program and the nurse may be terminated and legal charges can be filed.  

Through an alternative-to-discipline program, a nurse does not practice for a specific time while undergoing treatment and establishing sobriety and recovery program. He or she may undergo psychiatric evaluations, specialized treatment like one-to-one therapy and support groups, and random drug screens.  A return-to-work agreement is created and often involves a reduction in hours, limited shifts, and restrictions in assignments with continued treatment and monitoring for periods of up to three to five years. Restrictions are lifted as the nurse demonstrates he or she is making progress.

Alternative-to-discipline programs make it easier for impaired nurses, including nurse anesthetists, to step away from work while they receive treatment, says the AANA in a news release.

“An ATD approach gives Certified Registered Nurse Anesthetists and student registered nurse anesthetists three opportunities: 1) To enter treatment to address their addiction, 2) To work toward lifelong sobriety, and 3) When possible, their eventual return to the workplace,” says Linda Stone, DNP, CRNA, chair of the AANA peer assistance advisors committee.

Jennifer Thew, RN

Jennifer Thew, RN is the senior nursing editor at HealthLeaders Media.

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