Inconsistencies in Recovering Nurses

[Jon12309]

I would like to preface this article by saying I am in no way shape or form intending to spark a debate about if nurses in recovery from substance abuse should be afforded the opportunity to return to practice, but rather how wrong I think it is to have found how inconsistent the path of returning to practice may be.

As a recovering nurse, I find myself spending a lot of time in nurse support groups, AA/NA, and IOP programs. Some nurses struggle/struggled with alcohol use disorder, marijuana abuse, opiate use disorder, etc. Some nurses in groups also have legal battles stemming from drug diversion of opiates. The lack of consistency in regards to the ability or inability to return to practice is quite baffling. By this, I mean that there is a wide array of ways nurses are punished and sometimes not punished for diversion and it DRASTICALLY affects the nurses ability to get back to practice through state sponsored diversion programs. For example, I spoke to a nurse practitioner who while a trauma RN diverted absurd amounts of opiate medications. The penalty for this nurse essentially boiled down to the attorney general allowing him to stay in practice with stipulations, no suspension, and if he complied with the state diversion program (from a licensing standpoint, not criminal diversion) then they would essentially "turn their heads" on the criminal matter. He went on to complete that requirement without any consequences other than a 3 year prescribing restriction as a NP with his DEA license. Another nurse I know used to take waste from her hospital and was charged with felony possession of a controlled substance and a type A misdemeanor for theft. This nurse was offered criminal pretrial diversion (meaning no criminal record if she complies) in her county and allowed to participate in the licensing diversion program for the state with a suspension period followed by probation until she completed her monitoring agreement. Another nurse received two felony counts and can get probation to knock down her charges to just a class A misdemeanor. In her county, there is no pretrial diversion for level 6 felonies.

Given these crimes of drug diversion, how can it possibly be allowed to have such a wide range of punishments or lack of punishments for the same crime? All the nurses I know never intended to become addicted to substances when they signed up for nursing school and walked down that treacherous path. I also know all these nurses are the type to take recovery extremely seriously as the possibility of having a future rides on compliance so they jump through any hoop required to get back to their profession. I strongly feel it is not fair for the attorney general's office be selective in criminal prosecution and the county in which the diversion was committed to have life altering consequences. There must be some type of consistency in the punishment as we are talking about someone or someone and their families livelihood. Again, I'm not here to discuss addiction as a moral deficiency vs a disease, but rather how the punishment is handled.

What do you think?

[catsmeow1972, BSN, RN]

In regards to the legalities (I'm not discussing the various BON ‘alternative to discipline' programs' being that that is a whooollllee ‘nother topic) I think it reflects the way such things are handled in society as a whole. Various prosecuting attorneys may see the case as ‘just another file to be dealt with' and could not possibly care less what the implications to the persons livelihood are, whether that livelihood is a medical professional and they were diverting opiates or they were unemployed and dealing crack on the street corner. There is also the point as to whether the nurse has an attorney or is dependent on an overworked public defender. We as professionals tend to be able to scrape up the money to retain an attorney and also likely do not have any previous record. Then you have the prosecuting attorneys who are disgusted and appalled at what they are looking at and wish to nail the person to the wall and see them as another Pablo Escobar.

Ultimately, the end comes down to the ability and willingness of the prosecutor and defense attorney's ability to ‘cut a deal' so to speak.

In no jurisdiction, county or state, will you find standard sentencing guidelines for this or any other crime, regardless of who the defendant is and whether they diverted from a workplace or sold crack on the street corner. It just doesn't work like that.

[dirtyhippiegirl, BSN, RN]

You should read some of Bryan Stevenson's works. What you're describing stretches to all corners of the justice system.

[SpankedInPittsburgh, DNP, RN]

Yeah,

From what I see there are two distinct different systems in place. The criminal justice system is widely inconsistent with punishments dealt out to different defendants charged with any number of crimes. I've personally known people who have been sentenced for decades-long punishments based on the "three strikes and your out" felony laws for possession of very small amounts of crack cocaine. Essentially giving a life sentence in jail to a crack head. On the other hand if a defendant is well-defended very little if anything happens to him / her for literally murder (think OJ).

Here on the other hand the monitoring board applies the same sentence to all offenders. The person with a DUI years before she became a nurse gets the same punishment as the nurse who was actively diverting opiates at work for a long period of time or was high at work to the detriment of the patients in their care. Worse yet are the people with mental health issues who get sucked into these kangaroo courts or the nurse who seeks treatment and trusts a medical professional only to reported for issues that have not affected her work performance at all.

At least in a criminal court you need some level of objective proof that a crime occurred. Not so with the BONs. Being Nursing rumor and innuendo become facts if the original lie is repeated often enough. I was in monitoring for about a year with a woman who was reported to the BON by an abusive ex-husband for drug abuse with zero proof offered. In fact she worked at two jobs with regular drug tests and never failed a single one. She was in grad school which required drug testing both upon starting her studies and at the behest of clinical site with all clean tests. Upon receipt of the allegations she took hair, urine and blood tests that all came up clean. It didn't matter. The BON took the word of a convicted wife-beater over an outstanding nurse with years of service and clean tests in. She was placed in the one-size-fits-all program and lost her ICU job, her place in NP school and just about everything she owned. A simple travesty. Any reason to draw blood and inflict pain to any nurse is good enough for witch hunting Nazis.

[Persephone Paige, ADN]

I am very familiar with the discrepancies. And although I have seen a pattern with regards to doctors vs nurses ( I guess the prescribers get afforded all the cushy deals ) because they are harder to replace than nurses. I haven't been able to identify a specific 'pattern' in nurses ( who gets it worse ). And I honestly think it comes down to who gets hold of the case ( a hard ass or a softie ).

[SpankedInPittsburgh, DNP, RN]

The docs here have an entirely different system. Ours lasts 3 years. Theirs 5. Their system is driven my medical diagnosis and treatment plans from physicians. Ours is one size fits all. I was inpatient with a doc and we got to be friends. The most important difference in my opinion is that he went right back to his practice after rehab. It took me 11/2 years to get my job back