Is it wise to enter alternative-to-discipline programs for substance use disorders?

A reader said she submitted a statement that she was reported to her board of nursing for an apparent substance use disorder.

After a hearing, the board recommended that to maintain her license, she would need to get into a treatment program sponsored by the board. The reader responded to the board she did not want to voluntarily participate in the treatment program. She wonders what will happen next.

As I discussed in my blog, “Should Nurse Accept Reprimand Offer from Board of Nursing,” boards have the authority to propose professional disciplinary options to nurse licensees. Although it is always best not to be in a situation where you have to make the choice to accept a professional discipline, in most instances the recommendation from the board requires careful, thoughtful consideration.

If an offer is reasonable based on your specific circumstances, and your attorney counsels you that the offer is the best option for you, you should accept your attorney’s advice.

In this instance, it sounds as though participating in a treatment program will allow the reader to keep her license, which is a critical point. By not accepting the offer to get into treatment, she will continue with her substance use disorder and will most likely face a possible suspension of her license and need to petition the board for reinstatement at a future time when she is “clean and sober.”

The reader did not indicate the type of treatment program in which the board was requiring her to participate. She did state she would be able to keep her license if she did enroll in the program. If so, the program may well be an alternative-to-discipline program.

What are alternative-to-discipline programs?

Alternative-to-discipline programs are used by boards of nursing to help nurse licensees receive needed treatment and maintain an unencumbered professional nursing license. They provide a “non-punitive, nondisciplinary and usually confidential approach” to the nurse licensee. Treatment and after-care are included in alternative-to-discipline programs.

The “confidential” approach is a crucial benefit of an alternative-to-discipline program that offers this protection. A board of nursing disciplinary action is accessible to the public through the board’s reporting mechanisms and is reported to the National Practitioner Data Bank and other banks.

However, successfully completing an alternative-to-discipline program and its aftercare requirements allows the nurse licensee to obtain treatment confidentially, no (reported) discipline occurs, and the nurse can return to nursing practice and safely provide care to patients.

Alternative-to-discipline programs vary from state to state. Variability includes how the alternative-to-discipline program is administered (e.g., by the state board or another state agency), eligibility and continued nursing practice during treatment.

Alternative-to-discipline programs have been highly successful in treating nurses with substance use disorders. Moreover, the long-term recovery rate for nurse licensees undergoing treatment in these programs is high. Last, but by no means least, the public is protected because the nurse licensee is practicing unimpaired.

Boards of nursing that administer alternative-to-discipline programs include Delaware, Iowa, Maryland, Michigan and North Carolina. To check if your state board offers these …read more

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