Published
For almost 5 years now, my sister has been undergoing an ordeal with her state Board of Nursing because of a complaint lodged by her employer. Long story made short, she had chronic pain, underwent many, many conservative medical therapies, had a 3-level cervical spine fusion, and eventually required use of opioid medications. She was under close supervision of a pain specialist and there were no issues of impairment, drug diversion, or patient safety. She has now spent thousands of dollars on attorney fees (3 attorneys, so far), experienced an unsuccessful mediation, went through a trial that was prosecuted by an Assistant Attorney General (representing the Board), had her license suspended for 9 months (the suspension didn't actually occur until after her pain resolved to a point that she no longer required the pain medication), and is now in a 3-year Peer Assistance Services program for people who have substance abuse and mental issues. In this program she must submit to weekly random urine screens, attend two group therapy sessions per month, and two private counseling sessions per month. Her employer must monitor her and send lengthy reports to Peer Assistance Services. She has received a letter from the federal government stating that because her license was suspended for drug reasons, she is not permitted to work in a facility that receives federal funding (i.e., Medicare or Medicaid) for five years. She is fortunate to have employment, but makes about half the salary she would in other positions for which she is qualified.
That said, it has been very difficult to find information that pertains to the issue of healthcare professionals, management of the healthcare professional's chronic pain, and fitness for work. I just came across the following statement issued by the AANA (American Association of Nurse Anesthetists). I post it below in the event that it can help another "non addicted" nurse who appropriately utilizes prescribed pain medications in her employer/Board dealings. The statement does make a recommendation for a neuropsychological evaluation and written clearance for return to work by the physician. This would mean disclosure to to nurse's employer.
It is my opinion that employers (yes, healthcare providers) and staff/members of the various Board's of Nursing are largely uneducated about this subject. In the interest of protecting the public (an important consideration) they (employers and regulatory agencies) would rather err on the side of conservative, rather than potentially face public outcry in the event that a patient safety situation arise - and then have to explain for their apparent lack of due diligence. Position statements, such as the one cited below, may help to inform and inspire productive conversations and lead to actions that will benefit patients and be fair and supportive to nurses.
AANA Advisory Opinion 5.4
Patient Safety and CRNAs on Drug Therapy Regimens for Pain Management