I see that this catagory has been slow moving lately and I wanted to start a new thread with a different direction. I would like to get everyone's opinion (even the people that have never suffered with addiction). What do you think about your state's peer assistance/recovery program? Do you think it is too harsh or not harsh enough? What state are you in, and do you know the rules or guidelines of your states recovering nurses program?
I just want to get a general view of nurses' education on the matter. I have noticed lately in my hospital that the nurses do not know that there is a recovery program out there. They don't know that there are options and many are scared to report someone, especially if it is their friend. They are scared to report themselves if they need help.
I know that there are more impaired nurses out there than any of us want to admit. I think that if we were educated more on the matter, we could get a better grasp on the situation.
I admire your attitude and again, hope that this ends up well for you. I am sorry for being such a bulldog and in looking back, did not need to respond as I did.
I left nursing for a long list of reasons, but to sum it up, nursing was not healthy for me, emotionally and for my recovery. It took over 2 yrs for me to actually walk away, and I discussed it with a therapist, my family, my support network and my SO. I did not know about the OIG exclusioin when I did so, and intended to work in the HC field using my experience...
I too was blessed with nurses supporting me in early recovery and am positive that not only was it a God thing, but that without those people I would never have recovered. I remain passionate about helping other nurses new to recovery and have several ideas tht would help, but don't have the ability to actually put them into action.
I also think that there are areas where the BON's could improve, but since all states have individual regulations, have not gotten involved with this. I would support any nurse who wanted to take action and am encouraged to actually see someone who is willing to attempt this. If you want to toss some ideas out to me I am open to helping you out.
All is good here...I hold no ill will toward you. I have been tough on a few people in the past too. Sometimes it's what a person needs to get something through their head! What is the OIG exclusion??
Well, for starters, here in Tennessee we have no face to face meetings with our case managers from TNPAP on any regular basis. I met my case manager 6 years ago when I signed my contract. Haven't seen her since. We have our nurse support groups but they are not our advocates, per se. They don't have any say in any decisions that TNPAP makes. All I have to compare to is the pharmacist's peer program here. If a pharmacist is caught diverting, working under the influence or self reports their license is suspended by the Board of Pharmacy. They then, after finishing with the recommended treatment, go before the Board and plead their case. They don't need a lawyer because their advocates are right beside them. The advocates for TPRN are other pharmacists in recovery who volunteer for the position. It is a service they perform for their fellow recovering pharmacists. They are present at the caduseus (sp) meetings with the other pharmacists every week. Paperwork is turned in directly to them. Their advocates ARE their peers. Not so with TNPAP.
TNPAP on the other hand has five paid case managers and decisions are made by the case manager and the director of TNPAP. I don't KNOW these people and they don't KNOW me. Sorry, but I want someone who knows me to make a judgement call about me and my life. Personally I think TPRN works very well. It seems more of them stay in recovery compared to nurses. If nurses had to plead their case in front of the BON to get their license reinstated they might think twice before making the choice to relapse. I know that if someone is going to relapse they have relapsed in their mind long before they pick up and there is no stopping someone who is determined to use. But there has got to be a better system. A system that makes the recovering nurse feel more a part of than like they are being punished. To me TNPAP is puntative in many ways. It is not set up that way but it IS that way a lot of times. After six years with TNPAP I have seen, heard and experienced a lot.
Specializes in Impaired Nurse Advocate, CRNA, ER,.
If nurses had to plead their case in front of the BON to get their license reinstated they might think twice before making the choice to relapse. I know that if someone is going to relapse they have relapsed in their mind long before they pick up and there is no stopping someone who is determined to use.
Read some of the work done by Terence Gorski. He's one of the leading authorities on relpase and relapse prevention. Also, much of the brain studies done over the past 5 - 10 years are showing that "triggers" can, and do, happen below the awareness of many recovering individuals. As a result, the changes associated with active use have a chance to get revved up again and unless something is done to short circuit this process, using is almost inevitable.
This is one of the reasons why being an integral part of a group of recovering folks who really get to know each other over time are probably one of the best preventions to relapse available. While the person who is beginning the process of relapse isn't likely to be aware of the subtle changes in thinking taking place, their close-knit recovering "community" will begin to detect the subtle changes in thinking and behavior and can intervene. Is it any wonder one of the earliest signs of impending relapse is the person begins to "disappear" from meetings and recovery related events?
I also agree that it's almost impossible to stop someone who is determined to use again. But it also can be short circuited in many instances if the recovering individual has established a solid base of recovery and has friends in recovery who know them well and spend more than a little time with them.
It's relationships in recovery that make for one of the strongest tools against relapse.
Specializes in Impaired Nurse Advocate, CRNA, ER,.
Their advocates ARE their peers. Not so with TNPAP.
Oh man! You have REALLY hit on something here! I am unaware of ANY board of nursing that has a recovering nurse on the disciplinary committee or involved in investigations of complaints about impaired nurses, or have input into the development and implementation of alternative programs. Too many nursing associations drop the ball as well. It's one of the reasons I started my peer advocacy for impaired nurses educational/advocacy efforts...because no one really does this in the nursing community with one major exception, the American Association of Nurse Anesthetists!
The AANA has an excellent peer assistance program (it's been around for 26+ years!). They have a network of State Peer Advisors (SPA) who provide help for any SRNA or CRNA who is impaired by addiction, other emotional/psychiatric conditions, or physical problems. The contact information for the SPAs is listed on the AANA web site so the impaired provider can contact them directly, or they can call the hotline, which is manned 24/7/365. Most of these peer advisors are available for educational programs for anesthesia departments, training programs, and any group seeking assistance (including nursing programs, nursing departments, other specialty groups, high schools, etc.). We assist with interventions, establishing policies and procedures, and conduct research about the disease in our colleagues. We also develop close contacts with treatment facilities who have treatment programs for health care professionals. This allows us to help those who contact us get into treatment. All of this is voluntary and completely free for AANA and state association members.
This past Thursday was a perfect example of how well this system works.
My fellow SPA and I gave a 2 hour presentation regarding chemical dependence to the nurse anesthesia program in our town 7 weeks ago. Thursday morning I received a phone call fom one of the students who heard our presentation. The student was "intervened" upon by a couple of their classmates. They encourage the student to call me to seek assistance. To their credit, the student DID make that call! By 8:00 pm (less than 12 hours since the call) we had the student admitted to a leading treatment facility in the US, made contact with the students parents, and notified the program director (who is a strong supporter of our efforts) of the days events.
I will be meeting with the students who got the ball rolling on Monday in order to "debrief" them and let them know, in no uncertain terms, they saved the life of their colleague by doing exactly what needed to be done.
It's my hope, and one of my goals, to assist nursing associations in following the lead of the AANA in assisting nurses (including students) who develop this disease.
If you look at the way this disease has been "handled" by health care professionals and our culture, it's clear what we've been doing isn't working. If we ever hope to improve the addiction and/or recovery rate in this country we have to change our approach! Very few nurses (including boards of nursing) understand the purpose of alternative programs. Unfortunately the mismanagement of several state programs have pushed peer assistance back several years. Because of poor funding, inadequate staffing, and poor training for that staff, these programs are doomed to fail from the very beginning. The press focuses and sensationalizes the failed programs and rarely mentions the programs with a good track record.
Things have got to change or more and more of our colleagues will destroy their lives and their careers, and put patients and colleagues at risk for harm.
"I am unaware of ANY board of nursing that has a recovering nurse on the disciplinary committee or involved in investigations of complaints about impaired nurses, or have input into the development and implementation of alternative programs."
Jack, In Massachusetts the SARP board does have members who are themselves in recovery. I always felt they had my best interests in mind. I phoned the head woman many times during my 5 years in the SARP program and she was very helpful. Again, I feel blessed to have been in my state during this process. Massachusetts is very liberal in many ways and their "disease-oriented" attitude did help make the process feel less punitive. And I was clear in my mind that the hoops I had to jump through were the direct result of the "wreckage of my past".
Specializes in Impaired Nurse Advocate, CRNA, ER,.
"I am unaware of ANY board of nursing that has a recovering nurse on the disciplinary committee or involved in investigations of complaints about impaired nurses, or have input into the development and implementation of alternative programs."
Jack, In Massachusetts the SARP board does have members who are themselves in recovery. I always felt they had my best interests in mind. I phoned the head woman many times during my 5 years in the SARP program and she was very helpful. Again, I feel blessed to have been in my state during this process. Massachusetts is very liberal in many ways and their "disease-oriented" attitude did help make the process feel less punitive. And I was clear in my mind that the hoops I had to jump through were the direct result of the "wreckage of my past".
Very Cool! I hope we'll hear from others who have a similar experience. I know that the Michigan alternative program has worked closely with the peer advisors for nurse anesthetists to upgrade the way they deal with CRNAs. It gives me hope the same thing may be possible in Ohio one of these days.
Specializes in Psych, hospice,homecare, admin., Neuro,.
I did not really understand and "get" recovery until this last relaspe when I really started going to NA meetings, got a sponcer, started working the steps and working on me.
This time I got it. I have more than 3 years clean now. I am very thankful to God that I have another chance.
I look at some of the nurses in my "support" group I have to go to each week and know that they are not getting it. Recovery is life changing. You have to want it. My life is better. I am greatful.
One of the greatest rewards for me is seeing the light bulb go on in a recovery persons eyes. You know their soul has begun to awake.
Specializes in Psych, hospice,homecare, admin., Neuro,.
Read some of the work done by Terence Gorski. He's one of the leading authorities on relpase and relapse prevention. Also, much of the brain studies done over the past 5 - 10 years are showing that "triggers" can, and do, happen below the awareness of many recovering individuals. As a result, the changes associated with active use have a chance to get revved up again and unless something is done to short circuit this process, using is almost inevitable.
Excellent author and speaker. I had the privileged of hearing him speak 1988. I am currently in the middle of rereading his book, the information is so vital to my recovery. It is so true that this disease is cunning, baffling and powerful. Knowledge is great but it was not until I developed a relationship with my higher power that I had a chance at emotional sobriety. I was one of the real alcoholics our book talks about and I also have a drug addiction too,{ I think I caught my drug addiction from one of those addicts who come to our AA meetings, I am just kidding of course.}I am so grateful we have a solution and I am living in it.
I have been involved with the michigan HPRP for ablmost 2 years. I was advised to self report. What a mistake. I have never diverted, don't drink, no DUI's. Anyway, I did'nt get an attorney, did'nt think I needed one, and here I am in "the system". Michigan's programs primary purpose is monitoring for protection of the public. Recovery is suggested and your problem. Drops start at one a week along with group therapy and addictionist, weekly and monthly. The case mgrs don't meet face to face and rarely speak with you on the phone. I know several RN's that finished their program without ever talking to their CM! The program is ill run, expensive and from what i've seen gets minimal results. I wouldn't be suprised if Michigan cancelled their HPRP like CA. Many of the providers in the program participate because of the cash up front-no ins hassle of the program. They don't have to worry about compliance if u don't use ins. I've seen so many HIPPA violations and substandard medical providers. They would never survive in a traditional medical setting. Knowing what I know now I would never self report, get help on my own which is basically what I've done anyway, especially if you want to keep working. The HPRP makes working extremely difficult if not impossible! I thought that was part of their purpose!
My career in nursing goes all the way back to 1976 when I entered nursing school. In those long ago times, if a nurse was caught drunk or drugged at work or stealing narcotics from the hospital, their career was pretty much over.
And everyone knew this. That's why it had such a deterrent effect. Your license was revoked and you had to find another way to make a living. In addition, nurses with these kind of problems were so stigmatized they wouldn't be able to find another job even if noone had the heart to notify the State Board. People had no sympathy for nurses who did things like this. It was considered flat out disgraceful, a blot on the profession. People almost took it personally. Sure, we had nurses with these problems. But they were truly rare. In the old regime of shame and punishment, few transgressed. Only the worst chose to cross that line.
Then the 80's came along and the thinking changed. Drug abuse was recast as a disease whose sufferers were in need of treatment. Nurses who were drunks and druggies became "impaired nurses" who were called "valuable professionals" who deserved treatment and another chance. And above all, they were not to be judged or stigmatized by their peers. Such sensibilities were felt to be part of the impaired nurses problem and we, their peers, were shamed into abandoning our old attitudes in favor of more enlightened approaches to the problem.
So here we are in the 2010's and from the looks of more than twenty years of enlightened thinking we have done nothing but create a monster. Sure, there are some nurses who come back from the brink. But from what I'm learning, most don't. All over the country, BON's are inundated and backlogged with complaints about impaired nurse practice. They can't find the staff or the funds to manage the caseload. And in the meantime, these nurses migrate from state to state, hide out in nurse registries, and fail to meet the demands of diversion programs. It is a critical, and growing, problem of national scope.
I have no quick, simple answers to offer. I have only to say that I think the situation is just one small part of a large scale retreat in our entire society from knowing the difference between right and wrong and possessing the motivation to act confidently on those convictions whether by exercising self control or calling others to account for their actions.
My career in nursing goes all the way back to 1976 when I entered nursing school. In those long ago times, if a nurse was caught drunk or drugged at work or stealing narcotics from the hospital, their career was pretty much over.
And everyone knew this. That's why it had such a deterrent effect. Your license was revoked and you had to find another way to make a living. In addition, nurses with these kind of problems were so stigmatized they wouldn't be able to find another job even if noone had the heart to notify the State Board. People had no sympathy for nurses who did things like this. It was considered flat out disgraceful, a blot on the profession. People almost took it personally. Sure, we had nurses with these problems. But they were truly rare. In the old regime of shame and punishment, few transgressed. Only the worst chose to cross that line.
Then the 80's came along and the thinking changed. Drug abuse was recast as a disease whose sufferers were in need of treatment. Nurses who were drunks and druggies became "impaired nurses" who were called "valuable professionals" who deserved treatment and another chance. And above all, they were not to be judged or stigmatized by their peers. Such sensibilities were felt to be part of the impaired nurses problem and we, their peers, were shamed into abandoning our old attitudes in favor of more enlightened approaches to the problem.
So here we are in the 2010's and from the looks of more than twenty years of enlightened thinking we have done nothing but create a monster. Sure, there are some nurses who come back from the brink. But from what I'm learning, most don't. All over the country, BON's are inundated and backlogged with complaints about impaired nurse practice. They can't find the staff or the funds to manage the caseload. And in the meantime, these nurses migrate from state to state, hide out in nurse registries, and fail to meet the demands of diversion programs. It is a critical, and growing, problem of national scope.
I have no quick, simple answers to offer. I have only to say that I think the situation is just one small part of a large scale retreat in our entire society from knowing the difference between right and wrong and possessing the motivation to act confidently on those convictions whether by exercising self control or calling others to account for their actions.
It is obvious that you don't see addiction as a disease and instead see it as a personal weakness, which is your right and I respect your right to have this opinion, but disagree with it
I also really question where your facts come from, as far as the success rate, the funding defecits, and the ability to state hop with BON involvement.
To Recovering RN, The Michigan program functions at about the same level as your program. I feel their success rate is poor and for the cost it needs to be totally rehabilitated. This will be my mission when I complete my program. Their is so much inconsistency. I see RN's who are using out there working or at the most getting a one day suspension versus RN's who have been compliant and C & S for near two years with restrictions so severe or suspensions so they cannot work. The program is broken. Michigan contracts out their services so you get a new group of CM's every three years. In my first year I had three CM's. You NEVER meet with your CM. This is intentional. They provide only a PO BOX address, on purpose.(so no reason to send mail certified) This is comparable to a social worker never meeting the clients she/he is working with. For the money we pay it's outrageous. I find it hard to believe that you can effectively evaluate a client without ever meeting with them. Mid-Michigan is devoid of quality care for addicted health professionals. My sponsor and I started an additional cadeceus group each month just to have more choices of meetings to attend for medical professionals. I agree, our addiction is not our CM's concern, but performing their jobs and providing the services they are contracted to do is. Our job is to remain C & S and provide proper documentation of such to the HPRP, they can at least monitor the paperwork as they are contracted to do. I'm guess I'm still glad we have the option of HPRP and I hope we don't end up like California. With the rate of relapse I see in our little Mid-Michigan group of 20 people, the program probably has the same rate of success as the previous poster quoted 1-2%!! (at best) However, I'm determined to be in the 1%!! I'm just saying the program is very ineffective and for the cost I feel much better care could be provided. Alot of providers are making good money providing poor quality care through the guise of the HPRP and addiction treatment. It's worth a try to change it for us nurses! We're worth better than what we're getting!:redpinkhe Sorry to ramble.
Jack, Congrats on 14 yrs.! You are an awesome inspiration to us all. I hope to do in Michigan what you are doing in Ohio. Lord knows we need it, especially in Mid-Michigan. Thanks so much for all you do. I would love to get an online AA/NA group for recovering nurses.
I'm just saying the program is very ineffective and for the cost I feel much better care could be provided. Alot of providers are making good money providing poor quality care through the guise of the HPRP and addiction treatment. It's worth a try to change it for us nurses! We're worth better than what we're getting!:redpinkhe Sorry to ramble.
RecoveringRN
11 Posts
All is good here...I hold no ill will toward you. I have been tough on a few people in the past too. Sometimes it's what a person needs to get something through their head! What is the OIG exclusion??
Well, for starters, here in Tennessee we have no face to face meetings with our case managers from TNPAP on any regular basis. I met my case manager 6 years ago when I signed my contract. Haven't seen her since. We have our nurse support groups but they are not our advocates, per se. They don't have any say in any decisions that TNPAP makes. All I have to compare to is the pharmacist's peer program here. If a pharmacist is caught diverting, working under the influence or self reports their license is suspended by the Board of Pharmacy. They then, after finishing with the recommended treatment, go before the Board and plead their case. They don't need a lawyer because their advocates are right beside them. The advocates for TPRN are other pharmacists in recovery who volunteer for the position. It is a service they perform for their fellow recovering pharmacists. They are present at the caduseus (sp) meetings with the other pharmacists every week. Paperwork is turned in directly to them. Their advocates ARE their peers. Not so with TNPAP.
TNPAP on the other hand has five paid case managers and decisions are made by the case manager and the director of TNPAP. I don't KNOW these people and they don't KNOW me. Sorry, but I want someone who knows me to make a judgement call about me and my life. Personally I think TPRN works very well. It seems more of them stay in recovery compared to nurses. If nurses had to plead their case in front of the BON to get their license reinstated they might think twice before making the choice to relapse. I know that if someone is going to relapse they have relapsed in their mind long before they pick up and there is no stopping someone who is determined to use. But there has got to be a better system. A system that makes the recovering nurse feel more a part of than like they are being punished. To me TNPAP is puntative in many ways. It is not set up that way but it IS that way a lot of times. After six years with TNPAP I have seen, heard and experienced a lot.
Well, there's a start anyway!...lol!