PARTICIPANT ORIENTATION COURSE

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1 a monitoring and recovery program for nurses PARTICIPANT ORIENTATION COURSE C R E AT E D B Y R O B I N A. L E W I S, E d D, M S N, F N P - B C, R N R E V I S E D B Y S A N D R A H U D S O N, R N, B S N, C M H P

2 Epidemiology World Health Organization (WHO) reports that alcohol and illicit drug use amounts to 5.4% of the total burden of world disease (2012). An estimated 22% of Americans aged 18 and older or about 1 in 5 adults suffer from a diagnosable psychiatric disorder at any given time (ANA, 2007).

3 Epidemiology Substance use disorders estimated to occur in 1 in 5 or 20% of the population of nurses sufficient enough to impair practice (Monroe, Pearson & Kenaga, 2008). Others estimate nurses generally misuse alcohol and drugs at nearly the same rate of 10% to 15 % as the rest of the population. That means if you work with 10 nurses 1 of them is likely struggling with a substance use disorder (NCSBN, 2011).

4 Regulatory Management Alternative to discipline programs allow nurses with substance use disorders or psychological conditions in recovery to remain active in nursing while being monitored. (Fogger & McGuinness, 2009). These programs promote patient safety through early intervention and quick entry into monitoring (Fogger & McGuinness, 2009).

5 History Senate Bill 379 West Virginia Restore (WV Restore) a monitoring and recovery program for nurses, was established in July 2012, in order to assure patient safety while the nurse is healing. As the name expresses, the goal is to help restore a nurse to a state of wellness.

6 Program Overview History Monitoring Mission WV Restore Evaluation Objectives Entry Process

7 Mission To protect the public by providing a monitoring and recovery program for nurses with a substance use disorder and or a qualifying mental health condition.

8 Objectives Provide a confidential voluntary alternative program for affected nurses to be rehabilitated and monitored in a therapeutic non-punitive and confidential manner. Require a nurse to withdraw from practice immediately, and until such time WV Restore establishes that he/she is able to safely return to the practice of nursing. Develop a statewide resource network for referral.

9 Objectives Provide monitoring of the registered professional nurse who is actively involved in a recovery program. Provide education programs on substance use disorders and qualifying mental health conditions that may affect the practice of nursing.

10 Resources Treatment Education Evaluation Support

11 Contact WV RESTORE Main#: (304) Secondary#: (855) Fax #: (904) Mailing Address: P.O. Box Charleston, WV Web Address: WVRestore.org Address:

12 Resources WV Restore Forms, Handbook, Employer, Participant, and Nurse Support Group Facilitator Orientation Courses all online at the WV RN Board website homepage at or wvrestore.org Confidential communication for questions and form submissions can be made at Sandra L. Hudson, RN, BSN, CMHP, WVR Clinical Director, Case Manager

13 Entry Criteria A nurse self-reports, or is referred by another individual/employer, or the West Virginia Board of Examiners for Registered Professional Nurses. Holds or is eligible for licensure as a registered professional nurse in the State of West Virginia or in the process of applying for licensure. Agrees willingly to admission into the program.

14 Entry Criteria Has not been terminated from this, or any other, alternative program for non-compliance, unless entry is directed by WV RN Board. Abuses currently or has in the past, drugs and/or alcohol in a manner which may affect the nurse s ability to practice safely. Has psychological conditions and symptoms which may affect the nurse s ability to practice safely.

15 Entry Process Requirements A nurse contact seeking entry into WV Restore is initially screened by staff and then completes an evaluation by an approved certified addictions counselor for substance use disorders and or board certified psychiatrist for mental health conditions

16 Evaluation Process The evaluation process includes recommendations regarding a treatment plan. Factors considered in determining the type, modality and duration of treatment include: Types of drugs and/or alcohol used Frequency of use patterns Severity of addiction Psychiatric problems Administrative and/or criminal implications of the drug use Withdrawal symptoms

17 Monitoring Contracts Voluntary Monitoring Contract includes Date of participation Length of participation Treatment/continuing care and Aftercare Nurse Support Facilitated Group attendance Random body fluid, hair, or nail sample screens Health care (any prescribed medication must be reported) Job performance, status, and any practice restrictions Relocation/job change

18 Monitoring Contracts WV Restore participants must submit quarterly self-reports, treatment provider progress reports, nurse support group facilitator reports, twelve step program reports, individual counseling reports, or other reports requested by WV Restore during the monitoring contract by the due date as noted in the contract. Quarter s are: January, April, July, and October It is the responsibility of WV Restore participants to contact and provide forms to treatment providers, nurse support group facilitators and immediate supervisor.

19 Re-entry to Workplace Obtain approval from WV Restore. Provide the monitoring contract to the employer. Obtain information from your immediate supervisor. Provide your immediate supervisor WV Restore contact information and copies of your quarterly work performance evaluation(wpe1) form if needed.

20 Re-entry to Workplace Notify Immediate Supervisor they must complete and submit your Work Performance Evaluation Form by the due date. Restricted from agency, home health, home hospice, chemical dependency nursing, or float outside the areas supervised by your manager, travel nursing, shifts /day > than 12 hours, or hours/week > than 40. No odd schedules, lack of supervision, or unlimited access to controlled substances or other substances of abuse.

21 References American Nurses Association. (2007). Psychiatric mental health nursing: Scope & standards of practice. Silver Spring, Maryland: ANA. Fogger, S. A., & McGuiness, T. (2009). Alabama s nurse monitoring programs: The nurse s experience of being monitored. Journal of Addictions Nursing, 16(4), Monroe, T., Pearson, F. & Kenaga, H. Procedures for handling cases of substance abuse among nurses: A comparison of disciplinary and alternative programs. 19 (3),

22 References National Council of State Boards of Nursing (NCSBN). (2011). Substance Use Disorder in Nursing: A resource manual and Guidelines for alternative and Disciplinary Monitoring Programs. Chicago, IL: NCSBN. Smith, L. L. (2010). Recovery maintenance Workbook for Nurses. (2 nd Ed.). Linda L. Smith & Associates, LLC: USA. Smith, L.L. (2010). Recovery Maintenance: A Companion Guide for Group Facilitators. Linda L. Smith & Associates, LLC: USA.

23 References World Health Organization ( 2012). Retrieved October 22, 2012 from

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