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Second Chances: Nurses in Recovery

One in five RNs may face addiction issues during their careers, says the American Nurses Association.

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Coming on Board

Pennsylvania is one of the most recent states to join the alternative-to-discipline movement.

In spring 2009, the Pennsylvania Nurse Peer Assistance Program (PNAP) was created to help nurses with drug and alcohol addiction.

PNAP includes referrals to treatment programs and counselors, monitors nurses' progress, and acts as both support and advocate for nurses, according to Kathie Simpson, RN, executive director of operations of PNAP.

"Alcohol or drug addicted nurses were once considered by many to be pariahs, banished from the profession, receiving little help and less sympathy," Simpson wrote. "Slowly over the past 25 years, attitudes have changed and the focus is now on treatment and rehabilitation."

Before PNAP was created, nurses with addiction issues were directed to the state's Professional Health Monitoring Programs, which was seen by many to be punitive-based. The Disciplinary Monitoring Unit - which can suspend or revoke an RN's license - continues to be directly involved if the addicted nurse injured a patient or committed fraud.

PNAP was created with a dual purpose: to help the nurse individually, and ensure licensed nurses are practicing safely.

When a nurse contacts PNAP, they work with trained peer counselors to create a plan for recovery. The plan can include inpatient treatment, outpatient treatment, 12-step programs, peer counseling, random drug tests and more.

PNAP has been operating for less than 18 months and more than 1,000 nurses have been referred to the program - less than 1 percent of the state's nursing workforce. But nursing leaders fear other nurses with addiction issues may exist.

"We really want to get the word out now about PNAP," Simpson said. "We want nurses with substance abuse issues to get help now. We want them well and back to work caring for patients in Pennsylvania."

Going Forward

Alternative-to-discipline programs are not foolproof. In New Jersey, for example, a few of the 1,000-plus participants have relapsed during the 5-year monitoring period. When that happens, the 5-year time clock simply starts again, Cole said.

There are many success stories of nurses "graduating" out of monitoring programs and regaining control of their lives.

Annie is one of them.

"I went into recovery with my heart and soul," she said. "I really wanted to learn why this happened twice and what I could do to make sure it didn't happen again."

During her 5-year monitoring period, Annie learned how to treat addiction as a disease. She accepted she was an addict and that she needed to be constantly vigilant. But this time, she wasn't alone.

"RAMP helped me not to be ashamed of my disease and to own it," Annie said. "My addiction is part of me, but it doesn't define me."

She's used her time in recovery well: earning a master's degree and finding a new position in nursing continuing education at a community college. Although it is not mandatory, Annie still goes to therapy and 12-step meetings.

Her next project - with the blessing of Cole - is to start a support group for RAMP graduates.

"This is just one more way to help me continue my recovery in a positive light," Annie said. "Hopefully others will feel the same way."

Lyn A.E. McCafferty is a contributor to ADVANCE.


Second Chances: Nurses in Recovery

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I had been a nurse over 30 years. I have been in recovery for 5 years now. In the state that my license was suspended was in MI, and my other RN are no longer valid due to the suspension in MI the states were VA and NY due to my name on a national data base. My licenses had been inactive in those to states. I am an alcoholic and had never diverted, never did anything to hurt patients and had never came to work intoxicated. This suspension was due to not be able to stop attending the substance abuse program because I could no longer attend the program due to financial hardship. I had three mos left in this program to complete it. My addiction doctor and therapist wrote numerous letters to this organization stating they felt I was doing very well and requested I be released by the program. This organization told me I could not be released bec I had two dilute urines. I have dilute urine at times as I am on a diuretic, which my internist wrote them and told them these meds could cause dilute urine. The MD in charge of the program said that that was impossible.I feel I had been treated unfairly and was in this program with health professionals, almost killed patients and diverted. I am in a pickle. I do NOT want to go back into nursing .I have the fear of applying for any jobs, esp medical which is what I am staying away from applying for jobs. I had hired a lawyer in MI but was unable to pay her. I know they would find out this info(employers). What would you suggest? Thx for reading this long letter . My therapist told me that if the employer will not hire me bec of my condition that I probably not want to work with that employer anyway.

Cyrisse RussellMarch 21, 2014
Albany, NY



Being nurse working in a high stressful environment, I have experienced the negative attitudes of some of my co-workers towards nurses in recovery. As well, witness a very talented and excellent nurse leave the profession due to lack of support from colleagues and administration. I am currently working on a research paper on recovering nurses leaving the field because of this lack support. Reading these comments have helped me further understand this problem! Any additionally input from my fellow colleagues is welcomed.
Thanks
Deb

Debby ,  RNJanuary 22, 2014



Addiction is a medical diagnosis. So, for the clinical instructors who have been so unempathetic: What about a nurse with diabetes? This nurse could have a complication of the disease and put the patient in danger. A nurse with a seizure disorder could have a seizure while providing patient care and pot a patient in danger. My point is that employers are not permitted to ask those questions during the application process and I know many who have prexisting conditions and are hired and supported by the employer. I am a good nurse and although my employer did not support me, they can't take away my self worth. Why don't the instructors advocate for better teaching about addiction in nursing schools?

Molly October 28, 2013
PA



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