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progress are: • Compliance with Advocacy Contract • Negative Random Urine Drug Screens • Consistent Attendance at Support/Monitoring Groups • Favorable Monitoring Reports o Employer o Primary Treatment Provider Material Protected by Copyright o Support Group Facilitator o Self-Report (Smith, 2013) Return to Practice The healthcare worker may return to practice when IPN has determined the following is in place: • Signed Advocacy Contract is received • Treatment is completed or the nurse is well engaged • Once practice restrictions are understood: o No overtime o No floating o No multiple employers o No agency, home health, hospice employment • When there is a narcotic restriction; a labor exchange buddy is recommended • Random urine drug screening assignment is set up • A workplace monitor who can offer feedback on performance is established • Engagement in weekly nurse support group • Relapse prevention workbook is received (Smith, 2013) Successful Completion The healthcare worker has successfully completed the program when: • Fitness to practice is established • Progress and stability in recovery is validated • Healthcare worker’s record is sealed (Smith, 2013) Failure to Comply Should a nurse fail to satisfactorily progress, discontinue treatment, and/or fail to comply with program stipulations, the IPN immediately provides this information to the DOH to initiate swift action to ensure the health, safety and welfare of the citizens of Florida. (Florida Statute 455). Effective Alternative to Discipline Programs It is imperative to have a strong framework for developing successful alternative to discipline programs (ATD). This framework should be based on: • Evidence-based practice o Multistate research outcomes as they become available • Collaboration with: o American Society of Addiction Medicine (ASAM) o Florida Board of Nursing (FBON) o National Council of State Boards of Nursing (NCSBN) o National Institute on Drug Abuse (NIDA) o Substance Abuse and Mental Health Services Administration (SAMHSA) Additionally, an effective ATD program should have the following components: • Support by all key shareholders • Passage of Legislation • Knowledgeable and qualified staff Material Protected by Copyright • Well researched and thought-out Policies/Procedures • Network of knowledgeable evaluators and treatment providers • Facilitated nurse support groups • Worksite monitors communication and education • Clearly stated Relapse policy • Established program evaluation parameters and performance measures (ACCOUNTABILITY) (Smith, 2013) Advanced Practice Nurses Advanced Practice Nurses must participate in a state approved Impaired Practitioner Program. The two programs designated by Florida Statute 64B31-10.001 are: • The Intervention Project for Nurses (IPN) • Professionals Resource Network (PRN) Case Study Penny Loafer RN has been employed by the PICU for 5 years. During this time, her colleagues would describe Penny as a well-respected, happy, skilled, experienced nurse; who is often requested as a caregiver by patients, a preceptor, and committee member. During the past few years, Penny has been complaining of increasing intensity of migraine headaches and has been on intermittent family medical leave to accommodate her frequent migraines. Recently, Penny returned from maternity leave after an uncomplicated pregnancy and C-section. Coworkers notice that Penny’s behavior and personality have changed; she is tired, complains of minor irritations, and is refusing to take newborn, opting for pre-teens and teenaged patients. What are your thoughts? A. She is having post-partum depression B. She is reacting to having a newborn at home and doesn’t want to associate her patients with her newborn C. She is just tired from caring for her newborn D. She has a substance use disorder Penny may certainly have the first three, after all, she is caring for a newborn and working. There is not enough information to determine if she has a substance abuse disorder. However, if she has post-partum depression, she could be impaired and need help. A close friend and co-worker approaches Penny about her concerns of
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