ReEntry Back into the Workplace

[Jon12309]

What type of universally systemic approach should be given to nurses with a history of discipline due to drug diversion?

As a recovering nurse, I have seen and heard many stories in my short journey back into my intended career path. I am also baffled by several aspects of the downfall and reintegration of a recovering nurse. I've seen, with specifically narcotic diversion, a wide array of penalties and pathways back to the profession. For simplistic reasons, let's just say a nurse took opiate pills and/or intravenous opiate medications. Some nurses are arrested on the spot and charged with two level 6 felonies and a class A misdemeanor. The plea deals and outcomes from this range from being booked and decided on one level 6 felony, to pre trial diversion and dropping of all criminal charges. Then comes the licensing board. You are afforded the opportunity to join an alternative to discipline program which mandates an assessment as well as some type of rehab program. With the likely suspension of license and later probation, comes the "blacklisting" of your name in the National Practitioners Data Bank. Your public litigation files will forever be viewable to any who want to dig into your history. You must also disclose your litigation documents to all future employers and interviews for jobs/furthering education applications.

Some people think all nurses who commit drug diversion should go to prison just like everyone else. They think the punishment should be maximized as medical professions, we are held to a higher standard. What I don't think people understand, is how tough the road back to practice is. You see opportunity, what you don't see is the financial and emotional toll of facing everyone from that day forward. I for one, can tell you the road back in tough. Everyone has their own reasons for doing what they did. Some nurses truly have been addicted your years. Some just started slipping drugs to take an edge of some part of their personal lives. I hardly knew of anyone who joined the profession just to gain access to drugs, nor did anyone want to end up in the monitored lifestyle.

Monitoring program-drug tests 16x42x3 years=$2,016

IOP Treatment Deduectable-$2,000

Board Attorney=$4,100

Criminal Attorney (If applicable)-$1,500-$4,000 (local quotes)

Lost Wages- 1 Year Suspension $60,000-$100,000 2 Year $120,000-$200,000

Possible Restitution if applicable

This is all the financial consequences. Many nurses have to leave the profession temporarily and take a huge pay cut, I managed to find myself a $45,000 job during downtime.

The emotional toll is greater. You have to face pretty much everyone from that day forward and explain why you aren't working where u used to or why you don't drink anymore. You have to make the public appearances at the board hearings and settlement conferences. You have to disclose your documents to everyone forever onward. You may not be able to apply for any type of advanced practice degree with the stamp of a disciplinary history (Good luck selling yourself to an interview panel, can be done though). Some are arrested and plastered on the local news. People will act different around you like if they say or do something, you will snap and

off on some huge relapse bender, when really it's not like that. For some it may, but the point is people will always see you differently. Only you really know what happened, how to make it not happen, and what the reality of it all is. Some people lose their families/friends/homes/cars from the loss of employment and getting behind on bills.

The question is, what do you think should happen to nurses who divert? Some say, punish them to the ends of the Earth, some say you make them go to an ATD program. Some say you arrest them too. Should they be afforded another opportunity, or should there be a one strike you're out system?

[missmollie, ADN, BSN, RN]

To answer your question, I believe everyone deserves one second chance. Addicts in recovery are often told to not put themselves in situations where the temptation is great. Nurses have access to narcotics, and it is difficult to keep from that situation. This is the problem, but I do think the monitoring program works and and only works because of how much a nurse has to lose. I am sorry you are going through this, and I wish you the best of luck in your future endeavors.

[catsmeow1972, BSN, RN]

I do not belive that there can be a universal systemic approach. We are talking about human beings here, not cars that need an engine overhaul. States all run thier programs differently. Regardless, there are many people that get wrapped up in 'the monitoring lifestyle' as you call it in ways that have zero to do with nursing practice. Yet, they are punished the same way.

In your tally of the financial aspect you failed to factor in the reality that many that are forced down this toilet of so called ATD programs (I say so called, because once you are in you find out that it's really an alternative to punishment and an expensive one at that) lose thier insurance and either have no way to pay for this forced rehab which may or may not be necessary or if they are lucky enough to retain some kind of insurance, it is useless because the programs force you to see thier choice of evaluators and go thier choice of rehabs, all of which are likely cash only. Good luck affording $30,000 for that when you are barred from working.

The boilerplate, universal contracts that are issued, at least in my state with stipulations that may or may not be appropriate are what comes from efforts at a "universally systemic approach." That approach winds up doing serious harm to the ones (like myself) that are caught in the dragnet of this mindset. That dragnet is now cast far and wide and sweeps up people into monitoring and licensing issues for so much more than diversion issues and throws the 'punishment' for diversion at them.

Additionally, we are a profession that is taught to treat addiction as a disease. Why then do we seek to punish our own for a disease?

[Jon12309]

What I meant was more along the lines of it should become a universal thing where there are criminal charges or not along with the hefty cost of the ATD programs. I've met many nurses who got 2 or 3 initial felony charges for a couple norcos, then one guy who gets pretrial diversion for one felony. Some people's lives get ruined and some don't by the criminal aspect. Yes, there is a universal like approach when it comes to states administrative disciplinary programs. It shouldn't be that some get plastered on the news and some shouldn't. Some people's consequential paths are more fostering to a recovery than others. I think no criminal charges for one person and then another person charges and news publicity make it ten fold worse. Throw the likelihood of some type of underlying mental health issue (commonly depression) into the equation with publicity, and now I bet your depression is way worse. I just think across he entire spectrum it should be handled in a more consistent fashion.

[allnurses Admin Team]

Duplicate threads merged.

[catsmeow1972, BSN, RN]

If it's a from a purely municipal/criminal justice standpoint that you are coming, the fact that the person is a doctor, nurse, lawyer or Indian chief I don't think matters to the detective or district attorney that is prosecuting the case. That is one of the determining factors in felony etc. charges. Another is that when a facility encounters a nurse and a diversion issue, some are content to fire and instruct the person to report themselves to thier respective program. They've then done thier part. Others want the police called and the person frog marched out in handcuffs. So municipally, there will never be any consistency, in my opinion.