12-Step Coercion - page 5

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

  1. by   tommyperkins
    Quote from mjlrn97
    To the OP: Okay, if you don't want people 'coerced' into attending AA or NA meetings, what would you suggest they be mandated to do?
    Inasmuch as someone may be mandated to AA for breaking a rule, I would suggest that they be mandated to not breaking that rule again. That's what I call a second chance, not religious coercion, which is in itself rule breaking by the coercers.

    Quote from mjlrn97
    And why so judgmental toward the boat builders and topless dancers and factory workers---do they have nothing of value to offer, simply because they occupy a lower position on the socioeconomic food chain than you do?
    I think you have me mixed up with someone else. I assume OP stands for original poster and that is me. However, you should read the messages more carefully. I never brought this up. I'm a topless dancer myself, not professional but when I sing in the shower I sometimes dance too.
  2. by   Havin' A Party!
    Quote from tommyperkins
    ... I'm a topless dancer myself, not professional but when I sing in the shower I sometimes dance too.
    Hahahahahahahahahaha!

    Guess I'm a topless and bottomless singer then.
  3. by   NP2BE
    Quote from tommyperkins
    Inasmuch as someone may be mandated to AA for breaking a rule, I would suggest that they be mandated to not breaking that rule again. That's what I call a second chance, not religious coercion, which is in itself rule breaking by the coercers.


    I think you have me mixed up with someone else. I assume OP stands for original poster and that is me. However, you should read the messages more carefully. I never brought this up. I'm a topless dancer myself, not professional but when I sing in the shower I sometimes dance too.

    Well, its not a puishment, its a way to get help, and it helps more people than it hurts, Im all for it
  4. by   tommyperkins
    Quote from NP2BE
    it helps more people than it hurts
    I disagree. I believe it hurts more people than it helps.
  5. by   Big Bab's
    Quote from vwgirl
    I agree that there should be other options; random hair sampling would be one. (Not urine, 'cause if you really are an addict, a fake clean urine is too easy to score!) But what are the demands that the 12 step program places? In my decade in NA nothing has ever been demanded of me, not to share, not to show up, not even to stop using. Things are suggested, as these are the things that have been proven to work with previous addicts, but whether I took these suggestions was, and is, totally up to me. Or did you mean the demand by the BON of having to attend the meeings? I'm not being sarcastic, just genuinely curious.

    I can only speak for myself here...The program that I was mandated to by the state board requires me to 1) call in every morning by 11am to listen to a recording to see if it is my day for a UA, we are required to do 24 per year (some people are required to do more for various reasons, but 24 is the standard), along with the UAs come the cost of them, for me its $35.00 each, but I am lucky and have a lab that does the collection for me for free, in other states the price tag is MUCH higher and they have to do more of them.....2) I am FORCED to attend at least 3 12 step meeting per week, after inpatient rehab I had to do 90 meetings in 90 days, for me the meetings are the worst, it goes against all my beliefs, its blasphemis and I despise going to them, what DOES work for me is Rational Recovery but that is not an option that I am allowed, other programs they could let choose from are RR, Smart Recovery, Women in Recovery, and I know there are more that I am forgetting.....3) I am required to have a work site monitor who sends a monthly report on my "progress"......4) I have to do a monthly self report as to how I think I'm doing.....5) a monthly calendar showing meetings I've attended, when, where, topics...etc....6) I'm am required to have a sponsor and be at that persons mercy and beck and call....7) A monthly monitoring fee........anyway these are the big parts of it, I'm sure theres small stuff I'm forgetting.....other states require much much more than this....Now here's an interesting tidbit, if your monthly payment is late, its considered a "level 1 relapse behavior" and can be reported to the BON, so let me get this straight!?!...If I can't afford the bill, that means I'm relapsing?!?!?!?!!......What kind of logic is that?!?!.....Honestly, the only part I can't stand about my program is the meetings, I hate them I absolutely hate them...BUT that's MY choice!!....If it works for somebody else GReat!!!!...but we should have some choices of other programs than AA/NA, period.....the emphasis with alternative programs should be on TOTAL ABSTINENCE for mood altering substances and it shouldn't matter HOW you maintain that abstinence, the fact that you DO maintain it should be enough......and how do they monitor your abstinence??...thru bodily fluid testing or hair if you like......The kicker here is that the program I'm in is considered VERY progressive and new, it is a cake walk compaired to other states.....Anybody here from Ohio???.....Ohio is a prime example of a BON and government that considers "impaired nurses " to be garbage, and that's not my wording its THEIR's!!!!!!......Anybody else wanna tell what their program requirements are??...Maybe it would help people not in a program to understand it better, just a thought......Anywho, does that help as far as the "big picture" and what other things we are required to do??.....If I've offended anyone I apologize, but can you see why we get as upset and as angry as we do??...I'm not trying to justify anyones bad behavior but maybe this will help explain it........It's very frustrating to feel that your control has been stripped and now somebody in a far away town is running my life....Thanks for listening.
  6. by   Big Bab's
    Oops!!....forgot to say that this monitoring is a 5 year contract.....EEK!!....that seems like forever!!....well 2 1/2 years to go!!
  7. by   Quailfeather
    Someone posted earlier, asking for options other than mandated 12-step attendance. There are many secular organizations available to recovering people. One poster has already mentioned Rational Recovery. There is also S.M.A.R.T. Recovery, Secular Organization for Sobriety (SOS), Lifering Secular Recovery, and Women for Sobriety to name a few. These alternatives should be offered to recovering nurses instead of the one-size-fits-all approach taken by state boards. Although I do not personally subscribe to the disease concept of addiction, the nursing boards do. They openly describe addiction as a disease that is chronic, progressive, and ultimately fatal if not treated. Yet the "treatment" that they mandate is religious conversion. As Tweety has already pointed out, AA is not a religion, per se, but it is a religious program. God, "higher power", or "spiritual" is mentioned in seven of its twelves steps. Alcohol is only referred to in the first step. Recovery, treatment, and abstinence are not addressed in any of the steps.

    As nurses, we are taught to treat each patient holistically. We are also expected to respect the autonomy and self-determination of our patients. Yet if a nurse falls victim to addiction, whether their drug of choice is vodka or vicodin, they are all herded into the same program. Even Bill Wilson, the founder of AA, realized that one approach may not suit everyone. In his address to the New York Medical Society on Alcoholism in 1958, he stated:
    "Your President and other pioneers in and outside your Society have been achieving notable results for a long time, many of their patients having made good recoveries without any A.A. at all. It should here be noted that some of the recovery methods employed outside A.A. are quite in contradiction to AA principles and practice. Nevertheless, we of AA ought to applaud the fact that certain of these efforts are meeting with increasing success."
    Address to the New York City Medical Society on Alcoholism, April 28, 1958. Online at http://www.historyofaa.com/billw/med1958.htm

    AA is not the only road to recovery. As a matter of fact, more people sober up and recover outside the rooms of AA. AA Trustee and Harvard Prof. George Vaillant, MD, admitted this in an interview in May 2001 for AA's news magazine, the Grapevine:
    "... it doesn't hurt at the level of GSO for AA to have humility and understand that 60 percent do it without AA."
    Complete interview in The Grapevine, May 2001, online at http://www.aagrapevine.org/archive/i...Interview.html

    Addicted nurses deserve the right, just as anyone else, to recovery options. That way they can make an informed consent by choosing the option that fits best with their personal and philosophical beliefs. The boards do have the right and responsibility to mandate abstinence and monitor compliance, but they go beyond their ethical scope when they dictate how a nurse is to achieve that abstinence. Recovery is a very personal journey. Nurses should be allowed to chose their own path while maintaining their accountability through drug testing and self/peer reports. If said nurse's integrity becomes compromised because they are not making an honest recovery effort, then the board is obligated to terminate them from the program and take action against their license. Those, I believe, are fair options.
    Last edit by Quailfeather on Jun 10, '04
  8. by   Tweety
    Quote from Big Bab's
    .....Ohio is a prime example of a BON and government that considers "impaired nurses " to be garbage, and that's not my wording its THEIR's!!!!!!......Anybody else wanna tell what their program requirements are??...
    Are you saying they used the words "impaired" or "garbage"? Here in Florida they use the word "impaired" as well I think. My spouse's part time job is with the Intervention Project for Nurses here in Florida (I think that's what's it's called) and the requirements sounds pretty similar to yours. He says they don't mandate AA meetings, but mandate some sort of meeting, I'll have to ask him again the number of meetings required a week.

    The problem being when Florida says you must attend 3 meetings a week, if you don't live in a major metropolitan area, there aren't going to 3 alternative type meetings a week, and in some areas only AA is available. Tough issue. Spouse says you just gotta take what you need and leave the rest.

    I don't think though that drug testing alone is good enough. I have to say I agree with the mandated meetings of the persons choice. A lot of people can quit addiction through will power alone, and drug testing can prove that, but I still think in the best interest of patient safety that person needs a recovery program beyond just drug testing.

    Quailfeather, excellent post.
  9. by   vwgirl
    Quote from Big Bab's
    I can only speak for myself here...The program that I was mandated to by the state board requires me to 1) call in every morning by 11am to listen to a recording to see if it is my day for a UA, we are required to do 24 per year (some people are required to do more for various reasons, but 24 is the standard), along with the UAs come the cost of them, for me its $35.00 each, but I am lucky and have a lab that does the collection for me for free, in other states the price tag is MUCH higher and they have to do more of them.....2) I am FORCED to attend at least 3 12 step meeting per week, after inpatient rehab I had to do 90 meetings in 90 days, for me the meetings are the worst, it goes against all my beliefs, its blasphemis and I despise going to them, what DOES work for me is Rational Recovery but that is not an option that I am allowed, other programs they could let choose from are RR, Smart Recovery, Women in Recovery, and I know there are more that I am forgetting.....3) I am required to have a work site monitor who sends a monthly report on my "progress"......4) I have to do a monthly self report as to how I think I'm doing.....5) a monthly calendar showing meetings I've attended, when, where, topics...etc....6) I'm am required to have a sponsor and be at that persons mercy and beck and call....7) A monthly monitoring fee........anyway these are the big parts of it, I'm sure theres small stuff I'm forgetting.....other states require much much more than this....Now here's an interesting tidbit, if your monthly payment is late, its considered a "level 1 relapse behavior" and can be reported to the BON, so let me get this straight!?!...If I can't afford the bill, that means I'm relapsing?!?!?!?!!......What kind of logic is that?!?!.....Honestly, the only part I can't stand about my program is the meetings, I hate them I absolutely hate them...BUT that's MY choice!!....If it works for somebody else GReat!!!!...but we should have some choices of other programs than AA/NA, period.....the emphasis with alternative programs should be on TOTAL ABSTINENCE for mood altering substances and it shouldn't matter HOW you maintain that abstinence, the fact that you DO maintain it should be enough......and how do they monitor your abstinence??...thru bodily fluid testing or hair if you like......The kicker here is that the program I'm in is considered VERY progressive and new, it is a cake walk compaired to other states.....Anybody here from Ohio???.....Ohio is a prime example of a BON and government that considers "impaired nurses " to be garbage, and that's not my wording its THEIR's!!!!!!......Anybody else wanna tell what their program requirements are??...Maybe it would help people not in a program to understand it better, just a thought......Anywho, does that help as far as the "big picture" and what other things we are required to do??.....If I've offended anyone I apologize, but can you see why we get as upset and as angry as we do??...I'm not trying to justify anyones bad behavior but maybe this will help explain it........It's very frustrating to feel that your control has been stripped and now somebody in a far away town is running my life....Thanks for listening.
    ...only because my sponsor has NEVER made me feel like I am at her "mercy or beck and call"; I know some sponsors can be rough, I guess I am just lucky I got a good one. But it's not like being married you know, you can always pick a new one (I've been dumped by a sponsee before, and it was beat, but for the best in the end.) What do you find blasphemous in the meetings you go to? (I'll conceed there is a lot of profanity....)
  10. by   BabyRN2Be
    Quote from loerith
    "The focus is on stopping drinking. Period."
    A relative has been involved in AA and this person has stated that if you wanted, a door knob could be your higher power if you wish. Not necessarily a force in the universe. Since I'm not in AA, I'm unsure of other things. As loerith said, the focus is stay clean and sober, not a matter of "God" in your life.
  11. by   Tweety
    Quote from BabyRN2Be
    A relative has been involved in AA and this person has stated that if you wanted, a door knob could be your higher power if you wish. Not necessarily a force in the universe. Since I'm not in AA, I'm unsure of other things. As loerith said, the focus is stay clean and sober, not a matter of "God" in your life.

    But to stay clean and sober one must turn their life over to a higher power. Some people have such a problem with that it obscures everything else. They should be respected enough not to have it mandated that they go exclusively to AA, but be offered alternatives.

    On the other hand, as my spouse says, you take what you need and leave the rest. Some people can overlook the God stuff, do their time, and even learn a little bit. To others it's so offensive, even as tommyperkins says harmful. With all due respect to tommyperkins, I don't think one size fits all, AA has been a miracle is too many countless lives to be harmful 100% of time. There are plenty of people who have tried everything and AA was the only thing that's helped them. But one size doesn't fit all for nurses who make mistakes with Pyxis, or who get a DUI, or take some morphine during times of extreme stress. (Could I be anymore on the fence with this. LOL)
    Last edit by Tweety on Jun 10, '04
  12. by   elkpark
    I certainly agree that it would be nice if professionals were offered more options than just AA in impaired professional programs, but the reality remains that the BON is making the decisions. We are all licensed and practice on the say-so of the licensing board.

    No one is being "forced" to go to AA -- you choose to do that if you want to keep/regain a license to practice nursing. But you always have the option of just choosing to go into another line of work ...
  13. by   tommyperkins
    Quote from elkpark
    i certainly agree that it would be nice if professionals were offered more options than just aa in impaired professional programs, but the reality remains that the bon is making the decisions. we are all licensed and practice on the say-so of the licensing board.

    no one is being "forced" to go to aa -- you choose to do that if you want to keep/regain a license to practice nursing. but you always have the option of just choosing to go into another line of work ...

    as a state agency, a board of nursing is bound by certain laws. and they are violating the constitution in a very serious way if they attach an ultimatum of attending religious exercises as a requirement for holding a license to practice nursing. as i have said before, they are violating the religion clauses of the first amendment as well as the religious test clause of article vi, section 3 of the constitution. this is not the first time you have denied that boards force people to go to aa. it sounds like you want to play a game of semantics with the word "force". as i pointed out before the federal appeals court used the word "forcing" in their opinion in the warner case. do you also deny that boards coerce people to go to aa or that they compel people to go to aa? you also never answered my previous question, "do you deny that a license to practice nursing is a public trust?" (see post #13 of this thread).[/size]



    it appears that you believe the boards are above the law when you say, "but the reality remains that the bon is making the decisions." i repeat, the board is not above the constitution. they can no more demand a religious test than they can demand a racial test. they cannot attach unconstitutional conditions to a public trust. they cannot deny a license to a person because of their chosen religious faith and they cannot deny a license to someone because of their race. they cannot coerce people into aa because aa is a religious organization. they cannot even promote aa, let alone coerce people into aa.[/size]



    now read the first quote from my presentation--justice blackmun's concurring opinion in lee v weisman:



    http://www.angelfire.com/journal/forcedaa/ncbon.html

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