Need feedback: Medicalization..raising awareness and potential study? - page 2

by medisec 3,106 Views | 15 Comments

I have been compelled by the narratives and stories I read in this forum esp about the medicalization of nurses and nursing students with disabilities, and the marginalization of those nurses with bipolar and other mental health... Read More


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    Quote from Laurie52

    This just doesn't seem putative or discriminatory to me. They are asking about either mental or physical illnesses. They are not asking you to foretell the future, they are asking if at this time, are there any issues. Why is this not reasonable? I was talking to an anesthiologist recently and he said that in our state that he had to undergo mandatory drug testing simply because the incidence of abuse is so high in this speciality. Any profession that holds the public trust is held to higher standards. If I had to undergo drug testing I wouldn't care. Inconvenient perhaps but seriously just a blip on my radar.

    I realize that we have both had different life experiences, I'm not trying to be critical but just offering a different view.
    Why does one who has a chronic mental health problem; is managing it successfully, have to undergo the SAME program as one who has a documented diversion problem; undergo drug testing, attend NA and AA for a mental health problem???

    I didn't know that having a mental health illness equaled a substance abuse disorder.

    That is unreasonable IMHO...it goes into the stereotype that most people with mental health issues abuse drugs; most of us are educated to utilize critical thinking and the nursing process; I would not have an issue with the BON making sure nurses with chronic mental health illness have access to counseling, and other factors to ensure success; but try are NOT doing that.

    That was Viva's point.

    OP, I think it's valuable that you do this proposal; I look forward to hearing more about your plans.
    VivaLasViejas and canigraduate like this.
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    So far I think I might get the to ahead to do the study, although it will take a while to get IRB approval through my university...maybe by the semester's end?? I will keep everyone posted, but I do appreciate the interest and hope to get some great feedback when I do get the green light.

    In the meantime, I am focusing on the narrative analysis of some of the threads concerning this topic and how nurses diagnoses of "bipolar" are medicalized as "addicts" - which two of my professors thought was just mind boggling. One of them is a disability studies specialist in the field and he kept asking if that is legal, how that violates privacy, especially when a employer asks in your new hire paperwork disclosure of meds and mental health history. Is that when and where they determine you have to participate in a monitoring program? The available literature is very sketchy, mostly about actual "addicts."
    Anyway, I did want to find out, and Viva I might have email you separate since you have been sharing detailed knowledge of this topic...
    Is the monitoring at the discretion of individual hospitals, the state and/or a combination of that and the BON? I ask because it is very difficult to find specific information about this other than the BON website, which even there it says monitoring is voluntary?? and/or is it at the discretion of the hospitals' hiring policy as to how long a nurse with bipolar needs to go through such as program? and who pays for it? I hope to gain a little more insight, especially since most research in this field refer to older studies that include interviews and observations, nothing too recent.
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    The costs of these programs are borne by the nurse, of course. Which is interesting considering that it's very difficult to find a nursing job as it is, let alone with stipulations. I honestly don't know how people do it.

    I should mention that at least in my state, one can 'self-refer' to the HPMP, although I'm pretty sure it's safe to state that the vast majority are mandated either because the nurse has been brought to the attention of the BON, or has self-disclosed her/his addiction or mental illness on the license application. The length of time one must stay in the program varies, but it's a minimum of two years here.

    There is a separate track for nurses with mental health issues, although it's amazingly similar to the one for addicts/nurses who have diverted etc. meaning you still have to submit to periodic observed UDS (they seem to think psych patients are automatically guilty of substance abuse), daily call-ins, and counseling by THEIR staff. Frankly, if they offered the counseling services only, I think a lot more nurses would self-disclose, because the rest of it is just harassment IMHO. I can see the benefit of counseling, because not everyone has their own therapist or psychiatrist, and it is harder for those of us with emotional dysregulation and mood disorders to cope with the stresses inherent in our work.

    But the punitive approach is what's in vogue, and that's what drives nurses underground and forces them, essentially, to lie. That can't be good for either the nurse or the public the BON is trying to protect.
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    Viva, can I ask what state you are in? I know you mentioned Texas, where I am, is very strict. I'd like to look into some other states and see if I can dig a little deeper for information....or if anyone could chime in who is from another state for a heads up about policy??
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    I'm in Oregon. Ours is called the Healthcare Professionals Monitoring Program (HPMP). You can Google it or follow the link from the state BON website.
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    Sorry I've been a bit MIA but dissertation work and teaching simultaneously, especially this semester, has been very time consuming. I just wanted to give a shout out and thank you to those of you who provide some responses and gave voice to some of the issues regarding the monitoring program. I am working on the editing stages of hopefully a publishable article based on ethical practices of health professionals in the workplace regarding disclosure/nondisclosure, monitoring and marginalization of nursing professionals with disabilities, AND a summarized version of the research I worked on this past fall based on some of your input has been accepted for an ethics panel/presentation at a conference on medicine and technologies in May. So your voices/concerns, in this respect, will be represented in another type of public forum.
    I am still hoping to continue the research by documenting oral histories or personal accounts from some of you have expressed interest in telling your story. I need to see if I need IRB approval first...usually with narrative oral histories, and because this is a publicly open forum, oral histories may be exempt from the process. Will keep you all posted but if anyone else is interested
    VivaLasViejas and Esme12 like this.


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