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Call to action! Nurses in Monitoring Programs

Activism Article   (7,258 Views | 62 Replies | 818 Words)
by hppygr8ful hppygr8ful (Guide) Guide Writer Expert Nurse

hppygr8ful has 15 years experience and specializes in Psych, Addictions, Elder Care, L&D.

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Do you have any input regarding individualized standardize programs in substance abuse monitoring programs?

Many Nurses who suffer from addictions to alcohol and other substances are currently in monitoring programs all over the country. On their face these programs serve to protect the safety of the consumer as well as provide the impaired nurse with a path to return to safe practice. You are reading page 3 of Call to action! Nurses in Monitoring Programs. If you want to start from the beginning Go to First Page.

77Mercy has 25 years experience as a ADN, ASN, BSN, RN and specializes in Public health, recovery.

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Ok. I am not understanding your rationale for the different monitoring levels. Also why inpatient or outpatient treatments? Why aa or celebrate recovery? I would like to see some reliable, non biased research that proves that these treatment actually help people who use substances. Also I would like to see some science based research that proves that nurses who use substances are all a danger to society. What if the nurse works in a public health office and does paperwork all day? Is she really putting society at risk if she used drugs when she was on a leave of absence? What about the nurse who does research and gets a dwi- who is she putting at risk? Why does she need to go to inpatient treatment for 1000.00 dollars a day because a cd evaluator who spoke with her for one hour recommended it? Also should the nurse who was raped by a AA member be forced to go to an AA support group every month? These are all true scenarios that have happened and I could tell you more. I think your plan is as well thought out as the states’s plan and I ask you to Realize that your plan is built on a lot of assumptions that have no merit and are just the same old ideas as always. The state does not own nurses. Nurses who use substances are not necessarily a danger to anyone but for some reason this idea that they are continues to flourish with no proof and people continue to be as ignorant as they have always been. Think outside the box and give me some good science based rationale for your ideas, then I will take you seriously. 

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hppygr8ful has 15 years experience and specializes in Psych, Addictions, Elder Care, L&D.

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Thanks for your feedback - Understand the formula I proposed is just a work in progress and always open to suggestions. I also believe that there are nurses out there who have and do use substances in a non problematic or addictive way that pose little or no danger to the public. I choose to use AA/celebrate recovery as they are currently the only modalities accepted by the BON. I do not however think that AA or other forms of 12 step flagellation are the only means one can use against addiction. In fact less than 15% of the people in the rooms of AA ever achieve lasting sobriety.

Still the BONs actually don't care about any one nurses recovery. Their mandate is to protect the public from impaired nurses. The DWI example you cited is an example of what the BONs call impaired judgement. Their reasoning is that if a person has the bad judgement to drive under the influence they might well try to perform their nursing job under the influence. 

I also don't think the majority of people with substance abuse disorder need pricey in-patient programs and while I will not dispute the scenario of someone being raped by a person they meet in AA my experience is that most of the folks there are not violent. Still if such a thing happened to someone then they should receive some type of accommodation to their prescribed recovery program.

My point is that there are currently no accommodations or individualization allowed in BON programs so thinking about change is a good thing. 

 

Hppy

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hppygr8ful has 15 years experience and specializes in Psych, Addictions, Elder Care, L&D.

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On 10/25/2019 at 5:02 PM, 77Mercy said:

Ok. I am not understanding your rationale for the different monitoring levels. Also why inpatient or outpatient treatments? Why aa or celebrate recovery? I would like to see some reliable, non biased research that proves that these treatment actually help people who use substances. Also I would like to see some science based research that proves that nurses who use substances are all a danger to society. What if the nurse works in a public health office and does paperwork all day? Is she really putting society at risk if she used drugs when she was on a leave of absence? What about the nurse who does research and gets a dwi- who is she putting at risk? Why does she need to go to inpatient treatment for 1000.00 dollars a day because a cd evaluator who spoke with her for one hour recommended it? Also should the nurse who was raped by a AA member be forced to go to an AA support group every month? These are all true scenarios that have happened and I could tell you more. I think your plan is as well thought out as the states’s plan and I ask you to Realize that your plan is built on a lot of assumptions that have no merit and are just the same old ideas as always. The state does not own nurses. Nurses who use substances are not necessarily a danger to anyone but for some reason this idea that they are continues to flourish with no proof and people continue to be as ignorant as they have always been. Think outside the box and give me some good science based rationale for your ideas, then I will take you seriously. 

I am actually looking for some evidence based longitudinal studies to prove disprove the efficacy of AA/12 step programs. 

I didn't mind going so much until my BON started mandating which kind I went too such a one big book study, one open discussion , one women's stag etc....

Hppy

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Hi Hppy:

I think your ideas for reforming the system are super compared to what we have now and I truly appreciate your efforts at reform.  However, I have some random thought on the subject.

First, I also have noticed a dearth of research on the subject of whether these "treatments" for substance abuse work.  I think this may be because the "treatment" was never based on science to begin with.  If I remember in science you test and retest a hypothesis until proven or disproven until you start treating patients with a proposed remedy.  In the recovery industry (from what I've seen all 12 step based) we started with the notion that a drunk guy going through DTs had a vision from God.  All else followed that.  The clinical manual (Big Book) isn't based in science and really nothing has proven that this stuff works any better than quitting on your own from what I've seen and read.

I can understand the lack of clinical research into AA/NA/whatever A because essentially this is a group of folks who get together voluntarily and have a core value of anonymity.  I've been to hundreds of AA meetings now and most are held together by 5-10 diehards and true believers who have made AA the very center of their life.  Outside of that core you have a mass revolving door of people who come and go with most staying for a few meetings.  What happens to them?  Who Knows but I doubt very much they are "cured" of anything.

What I cannot understand is the recovery industry.  These folks pass this stuff off as science and are backed by billions of public, insurance and private dollars yet cannot prove that their "treatment" works at all.  Further, I think this industry would dry up and blow away if it wasn't for the individuals who are forced into programs by courts, employers, spouses...  Where are the studies from this well funded industry that there "treatment" works.

We are so far in the weeds in this instance that we have placed a superstition as a cornerstone for treating people afflicted with substance abuse issues with little or no scientific backing

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ArmyRntoMD has 6 years experience as a BSN, RN and specializes in Critical Care.

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Are we hurting that bad for nurses that we need to have ones working that have drug issues? 

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Nurses are human.  I think you will find the same percentage of them with human frailties as the rest of the public to include politicians, business folks, police officers .... and everyone else.  We are supposed to be in the business of helping folks heal from affliction.  Should that not count for our own?  People make mistakes and simply throwing them away isn’t an answer especially for a profession whose cornerstone value is supposed to be compassion and caring

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catsmeow1972 has 15 years experience as a BSN, RN and specializes in OR.

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On top of agreeing with Spanked, I am inclined to think people with even the most minimal knowledge of these programs are aware that they cast thier net far and wide and sweep up folks across the spectrum of humanity. Yes, people with ‘drug issues’ but also those with psychiatric issues that have nothing to do with nursing practice and those who may have made a one time dumb decision, sometimes even before the thought of being a nurse entered their head.  All of these folks are dumped into a program that has ONE modality...that of the addict on the verge of relapse. People are crammed into one-size-fits-all contracts and forced through treatment services that are mostly cash up front and do more harm than good. People are forced into these situations where they must pay and pay or forfeit that which they worked so hard for.
while the need for the existence of monitoring programs cannot be disputed as there are people that benefit and there are people who should not be practicing but making such a simplistic assumption that all in these programs have ‘drug issues’ and therefore should be stripped of their livelihood is cold and inhumane and not in keeping with the idea that we are supposed to be a caring profession.

This kind of thinking is precisely why changes are needed.

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ArmyRntoMD has 6 years experience as a BSN, RN and specializes in Critical Care.

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Of course they should have a livelihood. I’m just not sure in the field of nursing. 

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Rose_Queen has 15 years experience as a BSN, MSN, RN and specializes in OR, education.

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3 hours ago, ArmyRntoMD said:

Of course they should have a livelihood. I’m just not sure in the field of nursing. 

People can change and reform. You may be surprised at how many of your coworkers past and present may have had a brush with programs such as these. Such a rigid viewpoint generally doesn't jive with reality.

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hppygr8ful has 15 years experience and specializes in Psych, Addictions, Elder Care, L&D.

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Well statistically the 1 out of ten nurses suffers from or is in recovery from a substance use disorder. I have been clean and sober for 20 years and have been a nurse for just as long. This type of program while onerous most likely saved my life and made me the nurse I am today (one who is compassionate to those with dependence and addiction issues!)

Hppy

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ArmyRntoMD has 6 years experience as a BSN, RN and specializes in Critical Care.

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As long as they don’t have the ability to access narcotics and are drug tested I have no problem. 

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Who are “they”?  Is it any nurse that failed a random drug screen for weed in a state it’s legal?  Is it the nurse with mental health issues who may have self medicated?  Is it the nurse who got a dui on an off night?  Is it the nurse whose ex said she had a substance abuse problem with no proof?  Is it the nurse who self admitted to a detox program to get off of sleeping meds after years of working nights with no instanced at work?  

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