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."
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.