What Happens If A RN Diverts From Diversion?
RN Guardian’s Panel Attorneys, Goyette & Associates’ have recently represented a number of Nurses who have either withdrawn or been removed from the Board of Registered Nursing’s Diversion Program.
G&A attorneys have actually begun advising our clients that surrendering their license may be the best option, and we’ve been hearing that more and more frequently when it comes to DUI or Drug issues. You see, nurses with a chemical dependency problem can battle an addiction for years with in-patient programs, out-patient programs, NA/ AA … any A you could think of. They stay clean for a few months and then relapse. Many enlist the help of the BRN’s diversion Program at this time, but it turns out that seeking help from the one group who is supposed to be their biggest advocate, can turn out to be the biggest mistake they could have made.
The BRN’s Diversion Program is no-nonsense and they very strictly adhere to the AA/ NA model of recovery:
- 90 meetings in 90 days
- Finding a sponsor with 5 years of sobriety
- Working the 12 Steps
- Going to Nurse Support Groups
- Calling in daily for random Drug testing
- Submitting to drug tests as required
- Meeting periodically with a case coordinator
- Submitting to a psychological exam
- Sticking with the program until the program itself deems one “recovered”
Obviously this model has not worked for all of our RNG Members before. They have done all of the above. They have done them all many times. But there is alternative mode of treatment called Medical Management, where the nurse meets with a Psychiatrist and is diagnosed. The subsequent medication prescribed can diminish cravings and enable the nurse to remain clean and sober. The Diversion program will encourage Medical Management, but only after an internal referral from a BRN psychiatrist which of course requires a full disclosure of all behavioral issues, drug and alcohol additions, etc.
The problem with Diversion arises if the nurse is kicked out of Diversion for non-compliance or withdraws on their own. The BRN can then use one’s own self –referral against them. They can use everything the nurse discloses to the Diversion’s Case Manager. They can use all the records the nurse has allowed them to obtain. They can use the nurse’s own physiological evaluations against them and they can do all of this legitimately because the RN must sign a waiver in order to be admitted to the Diversion Program in the first place.
These cases are especially heartbreaking for me because I develop relationships with and get to know our Members over the years as I manage their cases. They are exactly the kind of people who should be nurses. I believe so fully in their abilities and natural propensity as caregivers that if I had a choice and could pick a nurse, I would pick one of them as mine. Yes, they have imperfect pasts. Yes, drug use is “substantially related to the Practice of Nursing” as is defined by the Nurse Practice Act. But if a nurse seeks help for their issue, removes themselves from work so that they can get a grip on their addiction and then are eventually able to get sober, is this the kind of person who should have their license to be a nurse revoked? NO!!!
Make no mistake; I am not advocating that nurses who are the midst of battling a chemical dependency issue should be dealing with patients. I am not advocating that a nurse who harms a patient in any way because of impairment be allowed to continue practicing as a nurse. What I am saying is that RNs who recognize a dependency problem, seek help for that problem and are able to overcome an addiction should not have their license to practice Nursing be revoked indefinitely.
I am also saying that it is an outrage that once a Nurse is either removed from or leaves Diversion, that everything they have disclosed becomes immediate fodder for a license revocation case against them. I’m saying that it is an outrage that a nurse’s Diversion Case Manager can be called as an expert witness in a BRN Hearing AGAINST the nurse. I’m saying that one mode of recovery may not work for everyone and that if it turns out that the Diversion model may not work for you; I would advise you to think very carefully about entering into the Diversion Program in the first place.
Our attorneys have been able to successfully negotiate with the Deputy Attorney General for Probation Settlements, Stipulated Surrenders or License Suspensions in lieu of revocation. The bottom line is that this is not something a nurse should go alone. If you are in Diversion and thinking of leaving, call us. If you have a dependency problem and are considering Diversion as a option, call us. If the BRN is offering you Diversion as an alternative to Revocation or Probation, please call us. We can help.