Discipline for Chemical Dependence Is Just the First Hurdle for Some Nurses

I have received many questions about nurse licensees receiving discipline due to some violation of their respective state's nurse practice act. Most of those questions center on the effect of the discipline and the nurse licensees' ability to obtain a new job, should they decide to look for a position other than the one they had when they were disciplined. One area in which job seeking is particularly difficult is when the violation that leads to discipline is due to chemical dependence of some kind. Miller and other researchers, in their published article, "Hiring Nurses Re-entering the Workforce After Chemical Dependence" (Journal of Nursing Education and Practice, Sciedu Press 2015), identify some of the types of violations that can take place: drug diversion from the employer; a positive drug screen for a substance not documented as being prescribed; illegal use of controlled substances; and the use of habit-forming medications or controlled substances or alcohol impairment. When a state board determines, through its disciplinary process, that a violation has occurred, the board then determines what discipline is appropriate, including whether rehabilitation is available to the nurse and whether a punitive or non-punitive approach is proper. After treatment has been successful and the disciplined, but rehabilitated, nurse, is ready to return to work, a myriad of employer responses to rehiring the nurse must be faced. Some employers believe nurses should be given a second chance to prove the violation was the first and only that will occur with that particular nurse licensee. Others, however, are more cautious and prefer not to hire a nurse who has been disciplined for chemical use/abuse because they are concerned another violation could happen again on their watch. Miller and her colleagues' research questioned administrators and nurse managers about their perceptions and experiences working with rehabilitated nurses recovering from chemical dependency. The responses to this inquiry were interesting, as many themes emerged. They included: demonstrating compassion and concern for the rehabilitated nurse; concern about the assignment of duties; and the importance of the personal values of forgiveness, acceptance, and respect for others. Personal views expressed included believing recovering nurses should be given a second chance and that some interviewed have hired such nurses. These findings are quite different, the researchers suggest, from previous literature that these nurses are not accepted back into nursing practice. Indeed, according to the authors, empathy, the trademark of the profession, often is not applied toward an addicted professional. In addition to empathy, nurse employers and nurse administrators need to keep in mind that chemical use/abuse is a disease that requires treatment. As a result, complying with the mandates of the Americans With Disabilities Act, the Rehabilitation Act of 1976 and any other applicable laws, is necessary in order to provide a second opportunity for a recovering nurse to re-enter the workplace and prove that the discipline imposed for the nurse practice act violation was a one-time event. A resource for you to review is the recently published text about recovering nurses and their re-entry into the nursing workplace, by Karolyn Crowley and Carrie Morgan. "Re-Entry: A Guide For Nurses Dealing With Substance Use Disorders" (2014) is available for purchase as a hard cover or e-book. NOTE: Nancy Brent's posts are designed for educational purposes and are not to be taken as specific legal or other advice. To comment, email [email protected].