12-Step Coercion - page 10

the following presentation was given at the may 21, 2004 open forum of the north carolina board of nursing meeting:... Read More

  1. by   VivaLasViejas
    Quote from chris_at_lucas
    The OP's question was does this guy have a case, I think.

    Not really: he has two choices though--he can give up his license or do something acceptable to the court (charged with enforcing the law, intended to protect the public), to demonstrate the probability that he is a safer nurse today and will probably continue that path.

    Choices. Most of the time when we engage in behaviors which, by virtue of a privilege (nursing license is not a right, mind you, any more than a driver's license!), endanger the public, we are (and should be) cooked.

    I don't agree that pure punishment is the answer--but I do think protecting the rest of us should be paramount.

    Some of us have no business being nurses, for a variety of reasons. Eliminating a means by which the public can be protected and the impaired professional can resume providing safe service to the community based on whether it is religious, spiritual or whatever is assinine.

    That nurse should be grateful for a chance to keep his license and continue his life in relative dignity and privacy. All he has to do is suit up, show up, sit down and shut up. Pretty simple program.

    Meantime, where did he work again? Because I sure don't want to be taken care of by him!
    Well said, Chris! That's exactly the point I was trying to make sometime back, but the folks with axes to grind have been so strident in their opposition to these groups, and so firm in their conviction that AA, NA et. al are worthless and/or dangerous, that I've long since given up on this thread. It's not worth the time or energy to try to reach someone whose mind is totally closed. Good try, though.......better luck next time.
  2. by   Lemonhead
    Quote from 3rdShiftGuy
    So it's not just whimpy nurses not standing up for their rights, it's a lot of people. I think it's because people are so humbled that they want what is offered (such as keeping their nursing license, getting out of jail, etc.) that they just shut up and go along with it. Just a thought.
    I agree with you. Unfortunately, many nurses--and the public in general, have no clue as to federal rulings, case law, Constitutional Rights, etc because they've not been in a position to HAVE to understand them. And when we ARE in that position--we are so intimidated, ashamed and vulnerable, we just "do what we gotta do" to get through the system. It took me 4 years to past the point of believing I was "getting what I deserved" and understanding that I/we were NOT being treated fairly.

    It's a shame because the flip side of that--you have folks that just "play the game" to make it and may never find the help that they truly need.
    That's why it's paramount, in my opinion, that as nurses we not only educate out patients, we educate ourselves and each other. There are too many nurses that just voluntary surrender their licenses because they don't understand the system and their own rights. Why should nurses be excluded from every other US citizen when it comes to rights? Why should we forfeit our property right and in some cases, our freedom, because we made the same mistake that a judge made, but because he has the legal knowledge to protect himself, he makes it...it's not right, REGARDLESS OF WHAT WE'VE DONE WRONG. There should absolutely be consequences..but equality is key--or should be anyhow....
  3. by   elkpark
    Of course we have a right to due process, etc., in the restriction or revocation of our licenses, but what the "not a right" crowd (myself included) are saying is that you don't have an absolute right to have the license, regardless. There are many restrictions put on the licenses (not just nursing; professional licenses of any variety) by which you must abide, or lose the license. For instance, I can't ignore my state's Nurse Practice Act and do any crazy thing I feel like doing to patients, and keep my license. I can't practice impaired and keep my license. In states with continuing education requirements, you can't ignore the CE requirements and keep your license. You can't just demand a nursing license without going to school and passing the NCLEX, because you have a "right" to have a license. It is a privilege which is earned by meeting (and continuing to meet) requirements set by the licensing board under statutory authority granted it by the state.

    The comparison to property rights is a good one. We have a right to due process protections relative to real property that we have purchased, but we have no constitutional right to have the property ... You have to purchase the property in the first place; you have to pay property taxes; you may have local covenants or requirements about the condition in which you keep your property; there are all sorts of local, state and federal laws about what you can and can't do with your property. If you fail to pay your property taxes, there is a process which the local or state government must follow to take your property from you, but, if you keep not paying your taxes, eventually you will lose your property. If the government decides that it wants your property and invokes eminent domain, you have a right to challenge the process and to be compensated for the goverment taking your property away from you, but you don't get to say no to the government and keep your property.

    The license is not a right. Due process regarding the restriction or revocation of the license, once you have it, is, but not the license itself.
  4. by   hypnotic_nurse
    Thanks Elk. You said that MUCH better than I could have.
  5. by   Havin' A Party!
    [QUOTE=Lemonhead]
    Quote from chris_at_lucas
    ... After it is earned, a license to practice a profession is seen as a "property right." As a result, the nurse has protections when a governmental entity, such as the board of nursing, takes an action that threatens an individual's constitutional rights...
    Excellent point!
  6. by   Havin' A Party!
    Quote from Nurse Ratched
    Actually, I believe it's the lack of same that keeps them out of trouble. They never SAID they were health care providers or psychiatric or mental specialists...
    Quite true, Ratched.

    Only thing that doesn't jive is that our society repeatedly touts that alcoholism is a disease. Well if that's the case, then how does it logically justify the willy-nilly turn over of these medically sick people to non-licensed plain folks?

    Seems a little inconsistent.
  7. by   vwgirl
    Quote from LarryG
    Quite true, Ratched.

    Only thing that doesn't jive is that our society repeatedly touts that alcoholism is a disease. Well if that's the case, then how does it logically justify the willy-nilly turn over of these medically sick people to non-licensed plain folks?

    Seems a little inconsistent.
    Perhaps because the medical folks don't tend to get too far in treating alocholic/addicts, since most doctors today receive about as much training in addictionology as they do in caring for patients with polio, even tho the disease of addiction if taking thousands of lives every day. And then again, there is the money thing, but someone else has hashed that over already.
  8. by   Havin' A Party!
    Quote from vwgirl
    Perhaps because the medical folks don't tend to get too far in treating alocholic/addicts, since most doctors today receive about as much training in addictionology as they do in caring for patients with polio, even tho the disease of addiction if taking thousands of lives every day. And then again, there is the money thing, but someone else has hashed that over already.
    Yup.

    -------------------------------

    Don't all the various points made on this thread make everyone a bit uncomfortable / uneasy at how inadequately the various underlying issues are presently being addressed? It's a mess.

    1) Few, if any, options recognized by some BONs;

    2) "Forcing" concepts that are substantially religion-based;

    3) Lack of licensed, healthcare personnel involvement;

    4) Are we truly regarding alcoholism a disease?

    5) All the other individual points raised here.

    Guess we really don't care. And, so consequently, give it a low priority in the great scheme of things.
  9. by   Headhurt
    Now...I get to toss my hat into the ring. If you don't like it, just take it as my own personal opinion and leave it at that. I am not going to change my mind, and I am not going to change yours. That being said...

    I spent my community health rotation in a homeless shelter which provided an intense recovery program for those who wanted to access it. The whole experience gave me a lot of insight into AA and other recovery programs, especially since I grew up with a volatile alcoholic family. But I am not here to lament my own personal journey. We have all walked hard roads, but there is always someone else out there who has it worse than you.

    While a lot of their literature makes references to "God" or a "Higher Power"...neither of them are the true reason for the program. They are not out to preach to the masses and convert people. The idea is that something is provided that will turn their focus away from the addiction, and give them something more positive and less destructive to focus on. If AA were to put a pink rock as their focal point, everyone would think they were nuts for one thing, no one would attend the meetings as no one can associate with a pink rock. "God" and "Higher Power" are terms most everyone can associate with, regardless of their personal beliefs. For some people, God is that focus because it is what they know; for others it is Buddha, or Allah, or a doorknob, or maybe it is a pink rock. Whatever your focal point is, it gets you to stop thinking about that drink, or that hit...which is the intended purpose.

    As for turning your nose down at someone who may not be a trained professional in terms as a mentor. Think of this...most addicts are more willing to open up to someone they know has been through what they have been through, rather than someone who is a trained expert just because they have a peice of paper that says they are. Think of Weight Watchers. Everyone who works there has been through the program...and people listen to them because they were successful. But also remember that even Weight Watchers doesn't work for everyone.

    Having a nursing license (much like a driving license) is a privilege...not a right. If a notorious DUI offender was released on the streets after just paying a fine and no treatment, we would be screaming to the government. Afterall, they are taking our lives into their hands when they get behind the wheel of a car. Why should our nursing license be so different? I agree with the poster who said drug screening was not enough. I do agree that more options should be available to those who are mandated to seek treatment in terms of what that treatment is..but I feel (and it is my opinion, remember?) that mandatory treatment should not be an option when it comes to getting your nursing license back.
  10. by   Big Bab's
    It is a privilege which is earned by meeting (and continuing to meet) requirements set by the licensing board under statutory authority granted it by the state.

    Yes!!!, BUT!!, If the "requirements" are things like, forced attendence to religious meetings then thats UNCONSTITUTIONAL!!!.....and keep in mind the circuit courts have ALREADY RULED THAT THE 12 STEPS ARE INDEED RELIGIOUS!!!.....and these alternative programs do this ALL THE TIME, they only offer 12 step programs and that's not right and its illegal.
  11. by   Big Bab's
    Quote from LarryG
    Yup.

    -------------------------------

    Don't all the various points made on this thread make everyone a bit uncomfortable / uneasy at how inadequately the various underlying issues are presently being addressed? It's a mess.

    1) Few, if any, options recognized by some BONs;

    2) "Forcing" concepts that are substantially religion-based;

    3) Lack of licensed, healthcare personnel involvement;

    4) Are we truly regarding alcoholism a disease?

    5) All the other individual points raised here.

    Guess we really don't care. And, so consequently, give it a low priority in the great scheme of things.


    You nailed it Larry!!!.....Now if the people with the authority to do something about it could "get it" maybe we'd get somewhere..its sooooo frustrating!
  12. by   Big Bab's
    Quote from Headhurt
    Now...I get to toss my hat into the ring. If you don't like it, just take it as my own personal opinion and leave it at that. I am not going to change my mind, and I am not going to change yours. That being said...

    I spent my community health rotation in a homeless shelter which provided an intense recovery program for those who wanted to access it. The whole experience gave me a lot of insight into AA and other recovery programs, especially since I grew up with a volatile alcoholic family. But I am not here to lament my own personal journey. We have all walked hard roads, but there is always someone else out there who has it worse than you.

    While a lot of their literature makes references to "God" or a "Higher Power"...neither of them are the true reason for the program. They are not out to preach to the masses and convert people. The idea is that something is provided that will turn their focus away from the addiction, and give them something more positive and less destructive to focus on. If AA were to put a pink rock as their focal point, everyone would think they were nuts for one thing, no one would attend the meetings as no one can associate with a pink rock. "God" and "Higher Power" are terms most everyone can associate with, regardless of their personal beliefs. For some people, God is that focus because it is what they know; for others it is Buddha, or Allah, or a doorknob, or maybe it is a pink rock. Whatever your focal point is, it gets you to stop thinking about that drink, or that hit...which is the intended purpose.

    As for turning your nose down at someone who may not be a trained professional in terms as a mentor. Think of this...most addicts are more willing to open up to someone they know has been through what they have been through, rather than someone who is a trained expert just because they have a peice of paper that says they are. Think of Weight Watchers. Everyone who works there has been through the program...and people listen to them because they were successful. But also remember that even Weight Watchers doesn't work for everyone.

    Having a nursing license (much like a driving license) is a privilege...not a right. If a notorious DUI offender was released on the streets after just paying a fine and no treatment, we would be screaming to the government. Afterall, they are taking our lives into their hands when they get behind the wheel of a car. Why should our nursing license be so different? I agree with the poster who said drug screening was not enough. I do agree that more options should be available to those who are mandated to seek treatment in terms of what that treatment is..but I feel (and it is my opinion, remember?) that mandatory treatment should not be an option when it comes to getting your nursing license back.

    My issue isn't so much with an AA/NA member giving some well intended advice but with the fact that alot of alt. programs require the participants to have regular written reports from their "approved sponsor", and these programs grade alot of a nurses progress by these letters, now don't you think thats a bit too much power to put into the hands of someone with NO proffesional experience??...and heaven forbid you should make your sponsor angry!!....then theirs the issue of, if my "sponsor" is reporting to the BON all the time, exactly how much "rigorous honesty" am I gonna practice around them??...what if I inadvertently said something that THEY see as "a sign of relapse"??.....I probably wouldn't feel real free to talk to this person about EVERYTHING.......I personally don't use the 12 steps, but even if I did I've have HUGE issues with this, its a big conflict of interest, not to mention the fact that it totally invalidates the whole "anonymous" part of AA/NA for both the nurse AND the sponsor.....just some of my thoughts
  13. by   odatrn
    I wish the anger and frustration would be addressed to the powers that mandate people to attend the 12 step programs. I have said it before, going to say it again: I don't want to be part of a meeting where there are people who are forced to be there. I cannot say it more plainly: If you don't want to be there, I don't want you there. I am not there to help someone get back their licenses, whether it be drivers, medical, or legal. I am there for me. If I can pass this message onto others, and practice these prinicples in all my affairs, all the better.


    So all of the anger, and rhetoric about the religous part of the program? I understand you feel. Take it to the Boards who are putting you at the meetings. Give them all of these arguments, and figure out a compromise. But place the responsibility for what has happened where it belongs: On the Board that decided the course of action, and the chosen behavior that sent people to them in the beginning.

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