Nurses with substance use disorder (SUD) present challenges to the nursing profession and patients. With increased recognition of SUD as a disease, alternative-to-discipline (ATD) programs have emerged as a more contemporary, nondisciplinary approach to managing SUD in health professionals and have been implemented by many state boards of nursing (BONs).
The aim of this analysis was to explore the components and requirements of state nurse monitoring programs to determine the similarities and differences across programs.
A document analysis was performed on U.S. monitoring program materials in August 2017. Participation was requested from all U.S. BONs with ATD programs, and 27 programs (69%) provided materials. Results: Twenty-one program components and requirements emerged from the review. Many program components and requirements were found in at least 50% of the program documents, including (a) an alcohol/drug abstinence requirement (85%), (b) use of mood-altering medications for psychiatric/medical conditions while participating in a program (70%), (c) use of Alcoholics Anonymous/Narcotic Anonymous/12-Step program as an acceptable group meeting (62%), and (d) restricted hours and shifts (59%).
Wide variation exists in the components of nurse SUD monitoring programs. There is a lack of consistency and uniformity among nurse monitoring programs, and additional investigation is needed to determine the essential components and requirements that would lead to positive outcomes for nurses with SUD.
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Kathleen Russell, JD, MN, RN, is Associate Director, Regulation, National Council of State Boards of Nursing, Chicago, Illinois.
© 2020 National Council of State Boards of Nursing. Published by Elsevier Inc. All rights reserved.
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