RELATED ARTICLE: American Nurses Association's (ANA's) stance on substance abuse.

The ANA Code of Ethics encompasses compassion, conscience, commitment, and competence in caring for patients, patients' family members and others. The code of ethics aLso describes a nurse's personal and professional growth. (1) The intention of the code is "to safeguard the client and the public when health care and safety are affected by the incompetent, unethical, or illegal practice of any person." (2(p481)) It is every nurse's responsibility to acknowledge the needs of an impaired nurse and to help him or her regain fuLl professional capacities. An impaired nurse could have difficulty remaining accountable to himself or herseLf and to others for his or her actions. (2(p48L,48M)), (3) In 1982, the ANA passed a resolution to create nondisciplinary, peer-assisted programs for nurses across the country, thereby taking a less punitive and more reparative stance with nurses who abuse substances. (4)

(1.) "ANA unveils Bill of Rights for RNs," The American Nurses Association, http://nursingworld.org/tan/01sepoct/billrigh.htm (accessed 18 Aug 2005).

(2.) J M Supples, "My colleague, my friend: The impaired nurse," Nursing Management 21 (August 1990) 481, 48L, 48M.

(3.) P D Blair, "Report impaired practice--STAT," Nursing Management 33 (January 2002) 24-26, 51.

(4.) S Trossman, "'Nurses" addictions: finding alternatives to discipline," American Journal of Nursing 103 (September 2003) 27-28.

RELATED ARTICLE: Communication across state lines.

Many nurses are licensed to practice in more than one state. Individual states handle their nurse practice act and proceedings differently, so the question that arises is how to handle nursing issues when the nurse in question crosses state tines. Are issues that have been reported to the state board of nursing in the initial state shared with the new state's board of nursing and next employer? Some states have entered into interstate compacts using the mutual recognition mode[ as adopted by The National Council of State Boards of Nursing (NCSBN). A national competence assessment examination (ie, National Council Licensure Examination [NCLEX]), which is the same in every state, theoretically allows states to accept nursing licenses of other states. In an interstate compact, the state hiring the nurse recognizes the standards set forth by the nurse's state of residence and voluntarily accepts the RN's License to practice in the other state. A nurse, therefore, is able to work in two or more states without applying for licensure in each state. (1)

A major concern regarding these agreements is the ability to track disciplinary actions within a state and to disseminate that information to the board of nursing in the state in which the nurse currently practices. A centralized, national data bank would allow jurisdictions to access this informarion to ensure the safety of its citizens. (2) Licensing boards that are a part of a national registry that sharing databases across state tines, therefore, would help ensure patient safety. (1) The NCSBN coordinates state boards of nursing through NURSYS, a statewide data system that collects nurse license information from participating states and makes them available to health care facilities and the public. Currently, 27 boards of nursing contribute data. (1)

A prospective employer should perform a thorough, pre-employment evaluation process to help prevent potential problems in hiring employees. The prospective employer should contact past employers and question them regarding the candidate's

* tardiness,

* absences,

* work ethic,

* performance evaluations, and

* rehire status.

If the past employer states that they would not rehire the candidate, the prospective employer should ask why.

The prospective employer should contact the state board of nursing for issues previously reported. The prospective employer also should contact references provided by the potential employee to provide a well-rounded picture of the candidate. Although there is a need to balance the hiring facility's right to know with the individual's right to privacy, "health care workers must take the extra step to ensure the public's trust and confidence," (3)(p16) while not discriminating against recovering nurses. Hiring processes should be reformed so that honest and accurate information about employees can be obtained.

Editor's note: NCLEX is a trademark and NURSYS is a registered trademark of the National Council of State Boards of Nursing, Chicago.

(1.) S Trossman, "Nurses' addictions: Finding alternatives to discipline," American Journal of Nursing 103 (September 2003) 27-28.

(2.) D M Flook, "The professional nurse and regulation," Journal of PeriAnesthesia Nursing 18 (June 2003) 160-167.

(3.) C Dunbar, "Verifying nurses" backgrounds: How much should we know?" Nursing Spectrum (Jan 26, 2004) 16-18.