Treatment options for impaired nurses
Impairment exists on a continuum from minimal to severe. It may be barely perceptible to us, yet our colleague may be endeavoring to mask and compensate for his/her stress, chronic pain, mental or physical illness or substance use disorder (SUD).
Alternative-to-discipline (ATD) programs for impaired nurses are available in most states. The mission of these programs is to protect the public from unsafe nursing care through the voluntary cessation or restriction of practice by the impaired nurse. ATDs are confidential, therapeutic, nonpunative programs that offer the nurse a structured assessment, treatment and monitoring plan that facilitates successful rehabilitation and return-to-work.
Acceptance into an ATD program usually requires that the nurse:
- Acknowledge impairment.
- Authorize the release of participant information. to allow monitoring by the appropriate state agencies.
- Voluntarily restrict, suspend practice or surrender license as recommended by the program or Board of Nursing.
- Enter and comply in good faith with an approved therapeutic rehabilitation program.
- Agree to a non-negotiable contract that requires completion of the ATD program in lieu of disciplinary action.
Some of the services that an ATD offers the nurse include:
- Assessment to verify the type and extent of impairment
- Referral for detoxification or further medical evaluation as needed
- Referral to treatment programs
- Development of a participant centered return-to-work plan that includes: random drug tests, continuing care (support groups), and ongoing consultation with the nurse's supervisor
Treatment program modalities
The SAMHSA website lists major support groups along with an opportunity on the website to locate the support group close to home. https://findtreatment.samhsa.gov/locator/link-focSelfGP
Alcoholics Anonymous (AA)
Recovery from alcohol addiction through a 12-step program including regular attendance at group meetings.Cocaine Anonymous (CA)
Recovery from cocaine addiction through a 12-step program including regular attendance at group meetings.Crystal Meth Anonymous
Recovery from crystal meth addiction through a 12-step program including regular attendance at group meetings.Dual Recovery Anonymous
Recovery from joint chemical dependence & emotional/psychiatric illness through a 12-step program including regular attendance at group meetings.Marijuana Anonymous
Recovery from marijuana addiction through a 12-step program including regular attendance at group meetings.Narcotics Anonymous (NA)
Recovery from drug addiction through a 12-step program including regular attendance at group meetings.SMART Recovery®
4-Point Program® helps people recover from all types of addictive behaviors by teaching how to change self-defeating thinking, emotions, & actions.Al-Anon Family Groups
Helps family and friends recover from the effects of someone else's drinking through a 12-step program including regular attendance at group meetings.Nar-Anon
Helps family and friends of addicts recover from the effects of living with an addicted relative or friend.
*(Florida nurse must visit and explore the Intervention Project for Nurses web site and then return to the RnCeus course)
State alternative to discipline programs run by State Boards of Nursing:
Alabama Voluntary
Disciplinary Alternative Program (VDAP)
Arizona State Board
of Nursing Chemically Addicted
Nurses Diversion Option (CANDO)
California Board of
Registered Nursing Diversion Program
Colorado Nursing Peer Health
Assistance Program/Nurse Alternative to Discipline Program
Connecticut (Health Assistance Intervention Education Network)
Delaware's Voluntary Treatment
Option for Chemically Dependent or Impaired Professionals
District of Columbia Committee on Impaired Nurses
Illinois
Professionals Health Program or Illinois Peer Assistance
Network for Nurses (PANN)
Kansas Kansas Nurses Assistance Program (KNAP)
Kentucky Board of
Nursing KARE for Nurses
Program
Louisiana State Board of Nursing Recovering Nurse Program
Maryland Board of
Nursing Rehabilitation
Program
Massachusetts Board
of Nursing Nursing
Substance Abuse Rehabilitation Program (SARP)
Michigan's Health Professional Recovery Program
State of Minnesota's Health Professionals Services Program
Mississippi Recovering Nurse Program
Montana Board of
Nursing Nursing Assistance
Program (NAP)
Nebraska Department
of Health and Human Services Nebraska Licensee
Assistance Program
Nevada Board of Nursing Alternative Program for Chemically Dependent Nurses
New Jersey Board of Nursing Recovery
& Monitoring Program
New Mexico Board of
Nursing Diversion
Program for Chemically Dependent Nurses
North Carolina
Board of Nursing Alternative Program
for Chemical Dependency
Ohio State Board of
Nursing Alternative Program
for Chemically Dependent Nurses
Oklahoma Board of
Nursing Peer Assistance
Program
Pennsylvania
Department of State Professional Health
Monitoring Programs
Rhode Island Specific
program subject to board approval
South Carolina's Recovering Professional Program
South Dakota's Health Professionals Assistance Program
Tennessee Tennessee Professional Assistance Program (TnPAP)
Texas Texas Peer Assistance Program for Nurses (TPAPN)
Utah Recovery Assistance
Program (URAP)
Virginia Department
of Health Professions Health
Practitioners Monitoring Program
Washington Washington Health Professional
West Virginia West Virginia Restore
Wisconsin Professional
Assistance Procedure
Wyoming State Board of Nursing Nurse Monitoring Program
Slightly different programs for impaired nurses
Hawaii Specific program subject to board approval
Georgia GNA Peer Assistance Program – in conjunction with Georgia Nurses Association – staffed with volunteer nurses
Maine Medical Professionals Health Program – For physicians and other healthcare worker
New York Office of
the Professions, Professional
Assistance Program (PAP)
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