ATTITUDE

The attitude held toward addiction interferes with the very spirit of nursing. It is hard to change the widespread attitude around addiction. We are not responsible for the attitudes we were raised with, but we can change them through education. We can then conduct our practice from an informed stance, offering the best we have to our patientsor our fellow nurses. Do we blame the cardiac patient or the diabetic for their illness? No, but we ask them to follow specific guidelines and take responsibility for the management of their disease and recovery. It is unethical to have a prejudicial attitude toward any disease or patient.

The need for change

The present system fails because there is no mandate for treatment and no standards for impaired nurses in Connecticut.

Current System

* Is a disciplinary model

* Punitive

* Process is slow-can take up to a year from the time of discovery until probation takes effect.

* Lacks confidentiality-everything is a matter of public record

* Fear of disclosure and licensure issues prevent the nurse from seeking treatment

* Is not recovery oriented

* "Captures" nurses only identified by diversion-- offers little/no help for the nurse addicted to street drugs/alcohol

* Places NO constraints on the license initially

* There is no assessment of the nurse's fitness to return to work, readiness to end probation and no positive guidance or direction for the recovering nurse.

* Inconsistent and unenlightened monitoring once probation is in effect

Thirty-seven other states have alternative to discipline programs that are extremely effective in helping the impaired nurse maintain their health, their life and their profession.

Alternative to Discipline Program

* A contracted agreement

* Confidential and non-threatening

* Ensures public safety by encouraging recovery

* Early identification is key

* Immediate entry into treatment

* Agreement not to work until cleared by program

* Safe return to practice

* Highly structured monitoring by a diverse team of addiction professionals using a case management model

* Mandatory attendance at structured recovery nurse support groups

* Identification of relapse behaviors in the early stages, with appropriate counseling and guidance

* Completion of mandatory relapse prevention modules before consideration for release from contract

What should you do if you suspect that a nurse is impaired?

* Document any behavioral changes along with corroborated evidence to support your suspicions.

* Notify your Nurse Manager or Director of Nursing.

* If appropriate, refer the nurse to "Nurses for Nurses"

It is essential to remember that denial is the hallmark of addiction and is the basis for the rationalizations that keep the addict-nurse continuing with addictive thinking and behaviors. EDUCATION is what is needed to stop the enabling and help the thousands of our peers whom are at risk for this lethal disease. This is an opportunity for all of us to participate in the metamorphosis of our contemporaries and uphold the Code of Ethics for Nurses. Take a stand to unify our profession and provide for our own. Be a part of the spirit that is nursing.

Addicts are not "bad" people trying to get good ..They are sick people trying to get well.

by Dede Dwyer, RNC

Patricia Holloran, RN

Karen Walsh, BSN