Originally Posted by CAR1962
I would have never known that each state can determine what exactly is required to get reinstated regardless of what the Americans with Disabilities Act (ADA) says. I understand that licensed individuals are held to a different standard and rightly so, afterall, patients put their trust in us. Thank you for your comments. I appreciate all of them. Keep 'em coming! : )
CAR1962,
The ADA prevents you from being discriminated against because of your diagnosis (chemical dependency). BUT, if you are actively using or have other disqualifying circumstances, the ADA does not apply. The following is from a brochure about the ADA and those with substance abuse disorders:
"WHO IS NOT PROTECTED?
• People who currently engage in the illegal use of drugs are
not protected under these non-discrimination laws, except
that individuals may not be denied health services (including
drug rehabilitation) based on their current illegal use of
drugs if they are otherwise entitled to those services.
• People whose use of alcohol or drugs poses a direct
threat—a significant risk of substantial harm—to the
health or safety of others are not protected.
• People whose use of alcohol or drugs does not significantly
impair a major life activity are not protected (unless they
show they have a “record of” or are “regarded as” having a
substance use disorder—addiction—that is substantially
limiting).
• Remember: people who pose a direct threat to health or safety, or have committed misconduct warranting job discipline, including termination, are not protected."
One of the problems recovering nurses (I'm a recovering CRNA) discover after being diagnosed with this disease is that there is a lack of continuity by the state boards of nursing. What happens in one state can be dramatically different than what happens in another. The only state(s) you need to be concerned with are those in which you hold a nursing license.
The first priority of a nursing board is to protect the public from unsafe nurses. Fortunately, approximately 38 (this changes, so I'm not sure if that number is still accurate) have passed legislation that protects a nurses license if the enter a "diversion" program. This program is as individual as each board of nursing (there are no national guidelines). These programs define what is required to enter the program, complete the program, and what prevents someone from entering the program or to be released from the program.
Generally speaking, most require you to voluntarily surrender your license for a prescribed period of time, be evaluated by an approved clinician, enter an approved treatment program if it is deemed appropriate by the evaluating clinician, complete the program and any aftercare program(s), be randomly screened for controlled substances, attend a specified number of support group meetings (typically AA or NA or something similar), one of which may be a group specific to health care professionals (nurse support groups or caduceus groups), sign a re-entry contract with the board or monitoring service for a specified period of time (2 - 5 years is pretty common).
As someone else pointed out, the board is used to dealing with nurses who are substance "misusers". A recovering physician who is now a board certified addictionologist made a comment at a peer assistance workshop I attended last year. She said addicts never abuse their drugs, they take excellent care of their "lover" (the drug of choice). It's the people around them that get abused. So it is to be expected that the board will "assume" you (me, we) are lying because that is one of the signs of this disease. Looking back over my own struggles with this disease proves her statement to be true. A person with this disease in it's active phase will do whatever it takes to obtain and use their drug of choice. Nothing else matters. Most health care professionals divert from their place of employment, which violates the nurse practice act, and is a felony. Because there are states with legislation to protect the license of an individual who enters treatment and monitoring, more health care practitioners are able to continue to practice their profession safely. Do exactly what the Impaired Professionals Program (IPP) tells you to do and you will eventually get back to practice.
Wisconson's Impaired Professionals Program information can be found here:
http://drl.wi.gov/dept/ipp.htm
Wisconson has the nurse practice act (NPA) available online here:
http://nxt.legis.state.wi.us/nxt/gat...&d=code&jd=top
Chapter 7 of the Wisconson NPA deals specifically with conduct issues and states:
N 7.03 Negligence, abuse of alcohol or other drugs or mental incompetency.
N 7.03 - 2 (b) An act or omission demonstrating a failure to maintain
competency in practice and methods of nursing care;
(It could be argued that using a controlled substance for other than the prescribed reason is a demonstration of nursing incompetence)
N 7.04 Misconduct or unprofessional conduct.
(1) Violating, or aiding and abetting a violation of any law substantially related to the practice of professional or practical nursing. A certified copy of a judgment of conviction is prima facie evidence of a violation;
(2) Administering, supplying or obtaining any drug other than in the course of legitimate practice or as otherwise prohibited by law;
(3) Failing to report to the board or to institutional supervisory personnel any violation of the rules of this chapter by a licensee. (it could be argued you are in violation of this section by not reporting yourself)
I'm not an attorney, so none of this should be seen as legal advice (legal disclaimer). And I no longer practice nursing or nurse anesthesia, nor do I have a nursing license (I voluntarily surrended my license forever because I knew I would die of I returned to clinical practice after several relapses), so none of this medical advice (my non-medical disclaimer).
As a nurse with the chronic, progressive, potentially fatal disease of chemical dependency, it is you responsibility to know as much as possible about the disease and how to remain in recovery. It also your professional responsibility as a nurse to know all there is to know about your practice of nursing and the rules and laws that govern your practice. Use your time away from practice to do those 2 things. Obtain whatever legal and medical advice you need to obtain that knowledge. Think of the colleagues you will be able to help in the future by going through all of this. Some day you will ralize this is the best thing that ever happened to you.
With much love and respect,
Jack
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