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Call to action! Nurses in Monitoring Programs

Activism Article   (7,188 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 5 of Call to action! Nurses in Monitoring Programs. If you want to start from the beginning Go to First Page.

JadedCPN has 13 years experience as a BSN, RN and specializes in Pediatrics, Pediatric Float, PICU, NICU.

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58 minutes ago, ArmyRntoMD said:

Addiction is a choice not a disease.  

Ahhh this explains so much.

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

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You have no control over a disease. A patient with pneumonia, or cancer doesn’t make a daily choice that is the result of their condition. 

The first step is admitting responsibility. As long as “it’s not their fault it’s an illness not a choice” is the slogan, it takes their autonomy to change their poor coping mechanisms.

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JadedCPN has 13 years experience as a BSN, RN and specializes in Pediatrics, Pediatric Float, PICU, NICU.

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On 1/7/2020 at 4:56 PM, ArmyRntoMD said:

You have no control over a disease. A patient with pneumonia, or cancer doesn’t make a daily choice that is the result of their condition. 

The first step is admitting responsibility. As long as “it’s not their fault it’s an illness not a choice” is the slogan, it takes their autonomy to change their poor coping mechanisms.

Addiction IS defined as a disease by many reputable medical organizations including the American Medical Association. 

There are many diseases that are impacted/triggered by lifestyle choices, such as diabetes type II or lung cancer from smoking. Doesn’t make them any less of a disease even though people’s choices may have impacted it. Same with addiction.

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

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How is drug addiction comparable to say diabetes? Sure poor diet and lack of exercise can make one more prone to it, but you will not become an addict if you don’t take these substances. I may get diabetes, heart disease, or lung cancer no fault of my own. I guarantee you I won’t wake up one day and find myself addicted to smack unless I made a conscious effort to stick a needle in my arm. 

There’s a difference in “choices may have impacted it” and “directly caused it.”

In addition, it’s not very likely that those other diseases will affect patient care. It’s not a punishment that they shouldn’t be a nurse but simply that patients come first. No one has a “right” to any job. 

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Gingernurse81 has 8 years experience and specializes in Psych, Addiction/Recovery.

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JadedCPN, there's no need to debate this person. Maybe someday they will have the unfortunate opportunity to have their mind changed. Strange to say I hope they don't have to be in that position. However, it's pretty evident there's no budging here, and to keep arguing is wasted effort.

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

314 Posts; 714 Profile Views

I’ve been in that situation. I had a junkie girlfriend when I was in the army. Wealthy, daughter of a multi millionaire, (actually a nursing student who luckily never made it), who I found out was addicted to both heroin and coke. Glad I found out somewhat early on. I’m just so glad she didn’t give me something. Something how stupid we are when we’re young. Young lads out there- if she tells you “yeah my parents are super over protective and drug test me because they don’t trust me”, it isn’t because her parents are psycho. They most likely have a reason. 🤣

So it isn’t like it’s something I haven’t experienced.

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

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On 1/7/2020 at 5:22 PM, ArmyRntoMD said:

How is drug addiction comparable to say diabetes? Sure poor diet and lack of exercise can make one more prone to it, but you will not become an addict if you don’t take these substances. I may get diabetes, heart disease, or lung cancer no fault of my own. I guarantee you I won’t wake up one day and find myself addicted to smack unless I made a conscious effort to stick a needle in my arm. 

There’s a difference in “choices may have impacted it” and “directly caused it.”

In addition, it’s not very likely that those other diseases will affect patient care. It’s not a punishment that they shouldn’t be a nurse but simply that patients come first. No one has a “right” to any job. 

You are of course entitled to you own opinion which is exactly what you are espousing. Please be sure to qualify you comments as such. There is a plethora of Evidence based research on the disease model of addiction. This is why it is recognized by the AMA, the APA and listed in the DSM 5.

Hppy

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

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Please lets not lose sight of the purpose of this forum which is to bring about sensible reform to a program effecting the lives of many nurses and their families.

Thank You 

Hppy

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AnnaFender specializes in ER Trauma.

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I find your monitor program idea still too overbearing.  A UDS doesnt test for alcohol so if a person gets arrested for a DUI for the first time they have to deal with the legal aspect outside of their job which will most likely require monitoring ordered by the court and substance abuse counseling. For the love of God if this happened outside of work unrelated to their practice, leave them alone.  The expense and time commitment ordered by the judge is only going to push a person over the edge if they have to be scrutinized by the board too while at work!  Only if someone is obviously impaired on the job or a serious error causing injury occurs should you order a drug screen and send them home and based on those results order random drug screens for no more than 6 months.  And so is requiring more than 30 days of counseling.  3 yrs is ridiculous.  If they are involved in criminal activity related to their practice then automatic suspension of license for up to 1 yr and termination by the employer.  If the criminal activity occurred outside of work, Order monthly self report info to the board regarding conviction of the crime.  If convicted depending on crime order counseling to be completed within a certain time random drug screens not to exceed twice a month while still being allowed to work.  Also, if crime occurred on job pay a fine. What I'm saying is The board of nursing oversteps the criminal justice system when a nurse is facing legal issues unrelated to their job, and makes it difficult to make a living and satisfy board requirements.  This only encourages dishonesty in my opinion and creates mental health issues. I understand wanting to protect the patients we serve but what rights do the nurses have to be protected from the board of nursing and the financial strain of paying for all of these things? Also if nurses satisfy board requirements why would you continue to penalize nurses for future career prospects by disclosing their health information? Last time I checked it's not illegal to have a substance abuse problem. So if a crime has not been committed why would you permanently label them? Those records should be sealed once requirements are satisfied

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AnnaFender specializes in ER Trauma.

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Also, I do agree addiction is a choice.  But the fact remains not everyone has the same circumstances in life nor does everyone have exceptional coping skills.  When a police officer or veteran takes their own life or becomes an alcoholic typically they are offered treatment because their lives are important, but it seems like the nursing boards are only interested in ordering constant correction and scrutinizing without investing time in poor working conditions, or empathy for the circumstances one may be creating stress and poor coping.  Usually chronic substance abuse is directly related to some sort of trauma or painful experience and not to intentionally be some irresponsible good time seeker.  So when you say go to AA meetings for the next 3 to 5 yrs.  That doesnt really address somebody getting their *** beat at home by their husband or a chronically I'll parent or child they may be caring for etc.  Where is the empathy fir nurses that we expect nurses to show for others?

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

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2 hours ago, AnnaFender said:

I find your monitor program idea still too overbearing.  A UDS doesnt test for alcohol so if a person gets arrested for a DUI for the first time they have to deal with the legal aspect outside of their job which will most likely require monitoring ordered by the court and substance abuse counseling. For the love of God if this happened outside of work unrelated to their practice, leave them alone.  The expense and time commitment ordered by the judge is only going to push a person over the edge if they have to be scrutinized by the board too while at work!  Only if someone is obviously impaired on the job or a serious error causing injury occurs should you order a drug screen and send them home and based on those results order random drug screens for no more than 6 months.  And so is requiring more than 30 days of counseling.  3 yrs is ridiculous.  If they are involved in criminal activity related to their practice then automatic suspension of license for up to 1 yr and termination by the employer.  If the criminal activity occurred outside of work, Order monthly self report info to the board regarding conviction of the crime.  If convicted depending on crime order counseling to be completed within a certain time random drug screens not to exceed twice a month while still being allowed to work.  Also, if crime occurred on job pay a fine. What I'm saying is The board of nursing oversteps the criminal justice system when a nurse is facing legal issues unrelated to their job, and makes it difficult to make a living and satisfy board requirements.  This only encourages dishonesty in my opinion and creates mental health issues. I understand wanting to protect the patients we serve but what rights do the nurses have to be protected from the board of nursing and the financial strain of paying for all of these things? Also if nurses satisfy board requirements why would you continue to penalize nurses for future career prospects by disclosing their health information? Last time I checked it's not illegal to have a substance abuse problem. So if a crime has not been committed why would you permanently label them? Those records should be sealed once requirements are satisfied

Actually the UDS administered in monitoring does check for alcohol metabolites and can detect if you drank several days prior!

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

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My situation: Nurse who after 7 years of being sober relapsed and immediately went on a leave of absence in hopes of getting back on track. This nurse never once came to work impaired and worked a desk job as a PHN. One day into her LOA she was reported by her Nurse practioner who was also having an affair with her husband. Yes- her husband was having an affair with her NP. She was immediately contacted by the health professional service program and did not agree to all the conditions of the HPSP therefore she was reported to the board of nursing and after meeting with them her license was suspended for a year. She is now sober  but has not went back to nursing as she does not want to participate in the monitoring program. 

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