My boss explained that at our facility, we intend to have it work this way: you must tell the supervisor what you think. You have to have actual objective events to say something. He or she will then have the responsibility to ask the nurse to do an impromptu drug test. Refusal results in the DON getting involved and I am sure, a possible firing. Acceptance, and a subsequent negative test, results in employee health getting involved and asking the nurse if they are having issues that they could help with, and no report is made to the BON. I do not know if refusal of a drug test results in a report, and that's all I've heard on the subject other than reading the text of the proposal.
However, all of this seems like common sense to me; if I work with an impaired nurse I will speak up. I think what it will do is reiterate that nurses are mandated reporters and that includes of other nurses... then it states of course, if the impaired nurse is a patient, the nurse(s) caring for that person don't have to report. I think. Really I am not sure what the point of it all is.