12-Step Coercion

hypnotic_nurse · Jun 15, 2004

Thanks Elk. You said that MUCH better than I could have. :)

Havin' A Party!, ASN, RN · Jun 15, 2004

... After it is earned, a license to practice a profession is seen as a "property right." As a result, the nurse has protections when a governmental entity, such as the board of nursing, takes an action that threatens an individual's constitutional rights...
Excellent point!

Havin' A Party!, ASN, RN · Jun 15, 2004

Actually, I believe it's the lack of same that keeps them out of trouble. They never SAID they were health care providers or psychiatric or mental specialists...

Quite true, Ratched.

Only thing that doesn't jive is that our society repeatedly touts that alcoholism is a disease. Well if that's the case, then how does it logically justify the willy-nilly turn over of these medically sick people to non-licensed plain folks?

Seems a little inconsistent.

vwgirl · Jun 15, 2004

Quite true, Ratched.
Only thing that doesn't jive is that our society repeatedly touts that alcoholism is a disease. Well if that's the case, then how does it logically justify the willy-nilly turn over of these medically sick people to non-licensed plain folks?
Seems a little inconsistent.

Perhaps because the medical folks don't tend to get too far in treating alocholic/addicts, since most doctors today receive about as much training in addictionology as they do in caring for patients with polio, even tho the disease of addiction if taking thousands of lives every day. And then again, there is the money thing, but someone else has hashed that over already.

Havin' A Party!, ASN, RN · Jun 16, 2004

Perhaps because the medical folks don't tend to get too far in treating alocholic/addicts, since most doctors today receive about as much training in addictionology as they do in caring for patients with polio, even tho the disease of addiction if taking thousands of lives every day. And then again, there is the money thing, but someone else has hashed that over already.

Yup.

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Don't all the various points made on this thread make everyone a bit uncomfortable / uneasy at how inadequately the various underlying issues are presently being addressed? It's a mess.

1) Few, if any, options recognized by some BONs;

2) "Forcing" concepts that are substantially religion-based;

3) Lack of licensed, healthcare personnel involvement;

4) Are we truly regarding alcoholism a disease?

5) All the other individual points raised here.

Guess we really don't care. And, so consequently, give it a low priority in the great scheme of things.

Headhurt, ADN · Jun 16, 2004

Now...I get to toss my hat into the ring. If you don't like it, just take it as my own personal opinion and leave it at that. I am not going to change my mind, and I am not going to change yours. That being said...

I spent my community health rotation in a homeless shelter which provided an intense recovery program for those who wanted to access it. The whole experience gave me a lot of insight into AA and other recovery programs, especially since I grew up with a volatile alcoholic family. But I am not here to lament my own personal journey. We have all walked hard roads, but there is always someone else out there who has it worse than you.

While a lot of their literature makes references to "God" or a "Higher Power"...neither of them are the true reason for the program. They are not out to preach to the masses and convert people. The idea is that something is provided that will turn their focus away from the addiction, and give them something more positive and less destructive to focus on. If AA were to put a pink rock as their focal point, everyone would think they were nuts for one thing, no one would attend the meetings as no one can associate with a pink rock. "God" and "Higher Power" are terms most everyone can associate with, regardless of their personal beliefs. For some people, God is that focus because it is what they know; for others it is Buddha, or Allah, or a doorknob, or maybe it is a pink rock. Whatever your focal point is, it gets you to stop thinking about that drink, or that hit...which is the intended purpose.

As for turning your nose down at someone who may not be a trained professional in terms as a mentor. Think of this...most addicts are more willing to open up to someone they know has been through what they have been through, rather than someone who is a trained expert just because they have a peice of paper that says they are. Think of Weight Watchers. Everyone who works there has been through the program...and people listen to them because they were successful. But also remember that even Weight Watchers doesn't work for everyone.

Having a nursing license (much like a driving license) is a privilege...not a right. If a notorious DUI offender was released on the streets after just paying a fine and no treatment, we would be screaming to the government. Afterall, they are taking our lives into their hands when they get behind the wheel of a car. Why should our nursing license be so different? I agree with the poster who said drug screening was not enough. I do agree that more options should be available to those who are mandated to seek treatment in terms of what that treatment is..but I feel (and it is my opinion, remember?) that mandatory treatment should not be an option when it comes to getting your nursing license back.

Big Bab's · Jun 16, 2004

It is a privilege which is earned by meeting (and continuing to meet) requirements set by the licensing board under statutory authority granted it by the state.

Yes!!!, BUT!!, If the "requirements" are things like, forced attendence to religious meetings then thats UNCONSTITUTIONAL!!!.....and keep in mind the circuit courts have ALREADY RULED THAT THE 12 STEPS ARE INDEED RELIGIOUS!!!.....and these alternative programs do this ALL THE TIME, they only offer 12 step programs and that's not right and its illegal.

Big Bab's · Jun 16, 2004

Yup.
-------------------------------
Don't all the various points made on this thread make everyone a bit uncomfortable / uneasy at how inadequately the various underlying issues are presently being addressed? It's a mess.
1) Few, if any, options recognized by some BONs;
2) "Forcing" concepts that are substantially religion-based;
3) Lack of licensed, healthcare personnel involvement;
4) Are we truly regarding alcoholism a disease?
5) All the other individual points raised here.
Guess we really don't care. And, so consequently, give it a low priority in the great scheme of things.

You nailed it Larry!!!.....Now if the people with the authority to do something about it could "get it" maybe we'd get somewhere..its sooooo frustrating!

Big Bab's · Jun 16, 2004

Now...I get to toss my hat into the ring. If you don't like it, just take it as my own personal opinion and leave it at that. I am not going to change my mind, and I am not going to change yours. That being said...
I spent my community health rotation in a homeless shelter which provided an intense recovery program for those who wanted to access it. The whole experience gave me a lot of insight into AA and other recovery programs, especially since I grew up with a volatile alcoholic family. But I am not here to lament my own personal journey. We have all walked hard roads, but there is always someone else out there who has it worse than you.
While a lot of their literature makes references to "God" or a "Higher Power"...neither of them are the true reason for the program. They are not out to preach to the masses and convert people. The idea is that something is provided that will turn their focus away from the addiction, and give them something more positive and less destructive to focus on. If AA were to put a pink rock as their focal point, everyone would think they were nuts for one thing, no one would attend the meetings as no one can associate with a pink rock. "God" and "Higher Power" are terms most everyone can associate with, regardless of their personal beliefs. For some people, God is that focus because it is what they know; for others it is Buddha, or Allah, or a doorknob, or maybe it is a pink rock. Whatever your focal point is, it gets you to stop thinking about that drink, or that hit...which is the intended purpose.
As for turning your nose down at someone who may not be a trained professional in terms as a mentor. Think of this...most addicts are more willing to open up to someone they know has been through what they have been through, rather than someone who is a trained expert just because they have a peice of paper that says they are. Think of Weight Watchers. Everyone who works there has been through the program...and people listen to them because they were successful. But also remember that even Weight Watchers doesn't work for everyone.
Having a nursing license (much like a driving license) is a privilege...not a right. If a notorious DUI offender was released on the streets after just paying a fine and no treatment, we would be screaming to the government. Afterall, they are taking our lives into their hands when they get behind the wheel of a car. Why should our nursing license be so different? I agree with the poster who said drug screening was not enough. I do agree that more options should be available to those who are mandated to seek treatment in terms of what that treatment is..but I feel (and it is my opinion, remember?) that mandatory treatment should not be an option when it comes to getting your nursing license back.

My issue isn't so much with an AA/NA member giving some well intended advice but with the fact that alot of alt. programs require the participants to have regular written reports from their "approved sponsor", and these programs grade alot of a nurses progress by these letters, now don't you think thats a bit too much power to put into the hands of someone with NO proffesional experience??...and heaven forbid you should make your sponsor angry!!....then theirs the issue of, if my "sponsor" is reporting to the BON all the time, exactly how much "rigorous honesty" am I gonna practice around them??...what if I inadvertently said something that THEY see as "a sign of relapse"??.....I probably wouldn't feel real free to talk to this person about EVERYTHING.......I personally don't use the 12 steps, but even if I did I've have HUGE issues with this, its a big conflict of interest, not to mention the fact that it totally invalidates the whole "anonymous" part of AA/NA for both the nurse AND the sponsor.....just some of my thoughts :)

odatrn · Jun 16, 2004

I wish the anger and frustration would be addressed to the powers that mandate people to attend the 12 step programs. I have said it before, going to say it again: I don't want to be part of a meeting where there are people who are forced to be there. I cannot say it more plainly: If you don't want to be there, I don't want you there. I am not there to help someone get back their licenses, whether it be drivers, medical, or legal. I am there for me. If I can pass this message onto others, and practice these prinicples in all my affairs, all the better.

So all of the anger, and rhetoric about the religous part of the program? I understand you feel. Take it to the Boards who are putting you at the meetings. Give them all of these arguments, and figure out a compromise. But place the responsibility for what has happened where it belongs: On the Board that decided the course of action, and the chosen behavior that sent people to them in the beginning.

tommyperkins · Jun 16, 2004

I will note that the relapse rate is horrendous almost regardless of which method of getting clean one chooses. Trust me, we professionals aren't doing so much better.

Does that horrendous relapse rate also include those who have been through formal addiction treatment? When you say "we professionals" are you talking about nurses in general or are you talking about treatment professionals? Are you a treatment professional?

Lemonhead · Jun 16, 2004

Of course we have a right to due process, etc., in the restriction or revocation of our licenses, but what the "not a right" crowd (myself included) are saying is that you don't have an absolute right to have the license, regardless. There are many restrictions put on the licenses (not just nursing; professional licenses of any variety) by which you must abide, or lose the license. For instance, I can't ignore my state's Nurse Practice Act and do any crazy thing I feel like doing to patients, and keep my license. I can't practice impaired and keep my license. In states with continuing education requirements, you can't ignore the CE requirements and keep your license. You can't just demand a nursing license without going to school and passing the NCLEX, because you have a "right" to have a license. It is a privilege which is earned by meeting (and continuing to meet) requirements set by the licensing board under statutory authority granted it by the state.
The comparison to property rights is a good one. We have a right to due process protections relative to real property that we have purchased, but we have no constitutional right to have the property ... You have to purchase the property in the first place; you have to pay property taxes; you may have local covenants or requirements about the condition in which you keep your property; there are all sorts of local, state and federal laws about what you can and can't do with your property. If you fail to pay your property taxes, there is a process which the local or state government must follow to take your property from you, but, if you keep not paying your taxes, eventually you will lose your property. If the government decides that it wants your property and invokes eminent domain, you have a right to challenge the process and to be compensated for the goverment taking your property away from you, but you don't get to say no to the government and keep your property.
The license is not a right. Due process regarding the restriction or revocation of the license, once you have it, is, but not the license itself.

Say what??? You're talking sideways here. "It is a right, it isn't a right, it is a right"....well, you're wrong. A property right is a property right according to the US Constitution, regardless of what the property is. And a professional license IS indeed a property right and cannot be taken without due process. In the message that I posted earlier, it clearly stated that ONCE earned, as in completing nursing school, this license becomes a property right. You've insinuated that I'm suggesting that we can take a jaunt to the local Walmart and pick up our license and have protection. You also state that my "comparison to property rights is a good one", it is NOT a "comparison"...a professional license IS a property right, not "compared" to one...

Can you back up your statements? I think you've thrown a bit of legal rhetoric out there to confuse the reader. Bottom line, a professional license IS a property right with all of the same protections as any other property right. And yes, I'm talking about the nursing license that I "earned" via nursing school and state board exams...

I'd appreciate if you could show some documentation to back up your comments.