Diversion- what are we missing?

Published

I am in a Masters program, taking a course on effective leadership, and one of our recent topics has been dealing with a staff member you suspect is abusing narcotics. At the same time, I have a dear friend and fellow nurse who has battled an addiction for several years. I really knew nothing about diversion despite my 7-8 yrs of nursing experience (I know,shame on me) until I befriended this lady and she decided to share her experience. So I am writing a paper for this class on what I think could make this program more effective- or should i say more helpful. I have to say so far what i have read in research articles and heard from my friend is pretty horrible- the BRN's idea of diversion seems to be punitive and nothing else. I would like to ask any of you willing to help me out to please let me know your experiences with this. Anonymous of course, but I want to hear from nurses who have been through or are going through the diversion process nationwide, and what you think could be done differently. I posted on another forum that my friend was pretty much shown the door with no follow-up from anyone in our facility- is this what we nurses do to each other? Aren't we in the business of healing the whole person? Any input would be sincerely appreciated.

I am curious. How does one fail a diversion program because of a paperwork problem?

When I applied to graduate I didn't read the instructions carefully. I was supposed to supply character reference letters and didn't see the part about them being on letterhead. I was accused of writing the letters myself.

Up Vote Up Vote ×
Just my opinion

I don't believe that addiction is a disease. So, I think if you steal or divert drugs, you are not only committing a crime, but putting patient's lives in danger. I have no compassion in that respect. None whatsoever.

Zero tolerance is the only way to fix that. I don't want to work with drug addicts.

You already do, I guarantee it. You just don't know who they are.

Up Vote Up Vote ×
Actually, CA does have a diversion program. It is sanctioned by the BON and if completed successfully results in NO record of report or participation. Is it a good one? I don't think so. I participated in that and failed because of a paperwork problem, and ended up going through probation by the BON for 3 years. When first confronted by the BON the nurse is given the option of probation (public) or diversion (private). Because of the shame involved most nurses new in recovery will choose the private route. If I had known in the beginning what I knew when I failed the diversion program, I would have opted for probation.

The one for the pharmacist though is peer ran. It does not involve the pharmacy board unless the pharmacist is a danger to others and refuses help. But the board has no initial knowledge of participation.

Up Vote Up Vote ×

I agree Pattycake, stealing and theft are crimes. People need to be accountable for there actions and face penalties if they break the law. I also agree with you on the patient safety statement, however, I beg to differ with you when you say addiction is not a disease. Addiction is a chronic disease that the addicted person must "treat daily " if they are to remain clean. We don't judge diabetics if they don't manage their disease properly and end up in the hospital; we need to have compassion for people addicted to drugs and advocate and do the best we can for them when they are under our care. As far as addicted nurses they deserve to go through rehab like everyone else and have a shot at getting their license back. Thanks for listening. :twocents:

Up Vote Up Vote ×
Specializes in Med Surg, Tele, PH, CM.

if employers are basically terminating a nurse for diversion and not reporting it, i'm not understanding this.

but once it's reported and proven, the BON is extremely involved in their recovery process.

it's a long, hard road back to nursing.

but i do not agree that the BON (or anyone else) should be held responsible for taking the first step to getting help.

i'm just not following the logic on that one.

leslie

My guess is that the BON has no clue that this person is practicing nursing. Many employers will fire someone for diversion without even reporting it. In most states, this is illegal, but the firing institution simply does not want to get involved with recovery. I worked with a nurse who was discovered to be diverting demerol- emptying the tubex and refilling it with Compazine. It was later learned that his previous employer had fired him for the same thing and never reported it. The responsible manager was later reported to the BON and her license was suspended for a year. The nurse was referred to a Program, which he completed sucessfully. After being clean for a year, his license was reinstated and he is now working as a discharge planner - doing very well. The problem is that not everyone is successful with recovery. If that's the case, that person does not belong in nursing....

Up Vote Up Vote ×
Specializes in Lie detection.
Thanks so much for responding..I'm afriad you are the only one so far who has responded to my post. Maybe no one agrees with us? Or is this still a taboo topic? I would love to get some more input on this subject, because you have confirmed what I suspected- this diversion program is NOT working as it should. Turning our back on the addicted nurse/person is not the fix. They just move on to another facility, and get in trouble all over again.

Programs vary from state to state. Some states are more punitive, some are very strict, some lenient, etc. It's getting better but very slowly. Many people still have the a mindset that addiction is NOT a disease and addicts should be able to "chin up" and stop. I used to think like that as well until I became an addict. Thinking back to when I literally COULD NOT stop myself from using, well, that wasn't the real me. It was a disease, one that affects your brain first so you rationalize that everything you are doing is ok. It is much more difficult than the idea of "just stopping".

Thankfully, I got myself to recovery but many nurses need a push. I think compassion goes much further than slamming doors. I KNOW that I would have gotten help much sooner if just ONE person had shown a little understanding. Yes, the patients need to be protected but we can do that while getting a nurse some help. The two are not mutually exclusive.

Up Vote Up Vote ×
Specializes in Psych/Rehab/Family practice/Oncology.

TazziRN. Thanks for answering my question re the paperwork, sorry I just saw it. Why in the world didn't they give you a chance to produce the reference letters on letterhead, if you had done everything else right to get to the point of graduation? So did you have to start the whole thing over?

Up Vote Up Vote ×

I will admit that I too, have little tolerance for drug abuse. I do enjoy a glass of wine(for the flavor more than the effects..... the effects are the reason I only drink a glass LOL)

But..... It is a real health issue, and as such, deserves to be addressed and TREATED!!! I do think that one time, and you should lose your license. But treatment should be REQUIRED.

Just recently at the one facility I work at as an LPN(agency) an LPN was dismissed for stealing meds.... don't know the outcome, but would hope that she is required to attend recovery program.

F

Up Vote Up Vote ×
TazziRN. Thanks for answering my question re the paperwork, sorry I just saw it. Why in the world didn't they give you a chance to produce the reference letters on letterhead, if you had done everything else right to get to the point of graduation? So did you have to start the whole thing over?

If you fail the diversion program in CA, you are never eligible for it again. I had to go through the state's probation program which was essentially the same thing in theory, for three years. I say "in theory" because the diversion program was (it could be better now, I don't know) one of the most confusing things I'd ever participated in. Case manager turnover was high, and with each new CM the rules changed. Some of the baseline rules made little sense. At the nurse support group we were required to attend, confusion was a common complaint and we were often asking each other "What did your CM tell you?"

The state program made much more sense. I always knew what was expected of me and if I didn't understand something my monitor explained it until I got it. Their goal is to return the nurse to level of safe practice.

All in all it took me 10 years before I was finally free of any monitoring program. I have 13 years, 10 months, and 27 days sober.

Up Vote Up Vote ×
Specializes in Rehab, LTC, Peds, Hospice.
If you fail the diversion program in CA, you are never eligible for it again. I had to go through the state's probation program which was essentially the same thing in theory, for three years. I say "in theory" because the diversion program was (it could be better now, I don't know) one of the most confusing things I'd ever participated in. Case manager turnover was high, and with each new CM the rules changed. Some of the baseline rules made little sense. At the nurse support group we were required to attend, confusion was a common complaint and we were often asking each other "What did your CM tell you?"

The state program made much more sense. I always knew what was expected of me and if I didn't understand something my monitor explained it until I got it. Their goal is to return the nurse to level of safe practice.

All in all it took me 10 years before I was finally free of any monitoring program. I have 13 years, 10 months, and 27 days sober.

That's wonderful! :yeah:

Up Vote Up Vote ×
+ Join the Discussion