American Society for the Prevention of Suicide:
800-273-8255
800-273-8255
American Association of Nurse Anesthetists Peer Assistance Hotline:
800-654-5167
800-654-5167
Anesthetists In Recovery Hotline:
215-635-0183
215-635-0183
National Suicide Prevention Hotline:
1-800-784-2433
1-800-784-2433
Jack Stem 513-833-4584
Founder and CEO jack@jackstem.com
Founder and CEO jack@jackstem.com
“Lighting the way to hope.”
Should a recovering nurse return to practice?
An excellent question. The short answer is, yes, if they have a solid recovery program and a reentry agreement that specifies the reentry process in detail.
Visit the Department of Health and Human Services for information on your rights as an individual recovering from chemical dependence.
Know Your Rights
Please remember, this not legal advice or insurance advice. This information is intended to get you to think about things that haven’t occurred to you as you consider returning to work. The longer you are able to stay away from the work that may have been involved in your substance abuse and addiction, the better...PROVIDED you are working a solid plan of recovery. Also, returning to work without a plan and safety nets makes no more sense than skydiving without a reserve parachute.
Returning to work will require a solid program of recovery plus additional safety measures. One of the things most people aren't ready for is the effects of "cues", some of which can be quite intense. Your reaction to these cues are not something you can control since they occur in the limbic system of our primitive brain. When I returned everything seemed fine until I popped that first vial of fentanyl! I began sweating, felt some nausea, and became light headed. No one in the OR noticed, but it really threw me for a loop! So be very aware that these cues will happen and the feeling will pass. You are not weak or have a poor program because you feel these things. Cues can be sounds, smells, places, people, things, etc. Have a plan in case the cue(s) is/are overwhelming. If your boss is open to have you back, then she might be a good person to go to when the cues happen. As time goes on they become less intense and less frequent, but they can happen even after 20+ years of recovery. Never get lazy with your program.
Here are the safety nets I strongly recommend:
An excellent question. The short answer is, yes, if they have a solid recovery program and a reentry agreement that specifies the reentry process in detail.
Visit the Department of Health and Human Services for information on your rights as an individual recovering from chemical dependence.
Know Your Rights
Please remember, this not legal advice or insurance advice. This information is intended to get you to think about things that haven’t occurred to you as you consider returning to work. The longer you are able to stay away from the work that may have been involved in your substance abuse and addiction, the better...PROVIDED you are working a solid plan of recovery. Also, returning to work without a plan and safety nets makes no more sense than skydiving without a reserve parachute.
Returning to work will require a solid program of recovery plus additional safety measures. One of the things most people aren't ready for is the effects of "cues", some of which can be quite intense. Your reaction to these cues are not something you can control since they occur in the limbic system of our primitive brain. When I returned everything seemed fine until I popped that first vial of fentanyl! I began sweating, felt some nausea, and became light headed. No one in the OR noticed, but it really threw me for a loop! So be very aware that these cues will happen and the feeling will pass. You are not weak or have a poor program because you feel these things. Cues can be sounds, smells, places, people, things, etc. Have a plan in case the cue(s) is/are overwhelming. If your boss is open to have you back, then she might be a good person to go to when the cues happen. As time goes on they become less intense and less frequent, but they can happen even after 20+ years of recovery. Never get lazy with your program.
Here are the safety nets I strongly recommend:
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Full disclosure of your history to your employer and immediate supervisor
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Initial supervision tapered off over time and frequent employee evaluations to document your progress
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Appropriate and timely random drug screens throughout your clinical career (they are YOUR documented proof of your sobriety so be sure to obtain copies for your records. Maintain this documentation for your own protection for as long as you have access, even beyond any formal contract with a monitoring program)
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A thorough monitoring program with a written contract (the board of nursing will have one between you and the board. You might want to consider an additional one with your employer. This would be an excellent sign of your willingness to do whatever it takes to assure them safety is a concern for all involved.
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Insurance (Malpractice, Health, and Disability). Are any of these available to you as part of the group? Do not be surprised if you do not qualify, but seek it out as an individual policy that the group will consider purchasing for you in the future after a realistic probationary period.
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I strongly recommend you seek your own professional liability in addition to that supplied by an employer. If you would relapse or be accused of relapsing and face additional investigations by the board, etc., attorney fees would be covered by your policy and probably NOT by your employer's policy. Talk to a qualified insurance agent who deal with nursing liability policies.
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I also strongly suggest you retain an attorney familiar with the board of nursing, the practice of nursing, and administrative law. A criminal defense attorney doesn't have this type of experience in most instances. Contact The American Association of Nurse Attorneys (TAANA) for information and referrals in your area. Here's the link to their web site: http://www.taana.org/. Many nurses think they can't afford an attorney. My question is...can you afford to NOT have an attorney? If you say or do the wrong thing, even innocently, it could prolong the time until the board allows you to return, or you could permanently lose your license.
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At least 3 support group meetings/week. Most contracts with professional monitoring services require a 12 step format. The addition of a nurse support group to these three meetings is strongly recommended. Contact the board of nursing or state nursing association to see if they have a list of nurse support groups.
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A sponsor...preferably a recovering nurse with at least 2 years of continuous recovery. A nurse isn't required but they certainly have a better understanding of what you'll be experiencing.
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Do NOT venture into any workplace that does not fit your needs. Your initial reentry worksite will be THE avenue to the resumption of your career. If the employer is not willing to work within the confines of a reentry contract, this is not the place for you. Risking relapse and terminating any opportunity to reenter the field is too high a price to pay for accepting a working arrangement that puts your recovery at risk.
Also remember that you may be working within the confines of two contracts and they need to be congruent enough to be manageable. Your existing contract with a monitoring agency like an alternative program or the Board of Nursing should not conflict in any way with your employment contract. If there are any questions at all on how these two sets of expectations will be managed by you, it needs to be well understood and IN WRITING for your own protection; and NEVER assume anything! You and your documented drug screens will be your best defenders from this point forward.
Read "The Top Ten Relapse Dangers"
Does your hospital have a policy on substance abuse and chemical dependency? If so, I'd be happy to review it to see what they have to say about all of this. A bad policy leads to bad decision by your management.
Please feel free to call me anytime, now or in the future.
513-833-4584
One day at a time my friends!
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