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Recovering Nurse Program:
Statement of Belief
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The primary
responsibility of the Board of Nursing is to protect the public
by regulating the practice of licensed nurses. An impairment
that renders a licensee unable to perform nursing services or
duties with reasonable skill and safety is hazardous to the
well-being of the public. A physical, mental and/or emotional
condition or disability may result in impairment of a licensed
nurse.
Many mental
and/or emotional disorders that impair practice are responsive
to treatment/rehabilitation. These include substance abuse,
substance dependence, and certain psychiatric disorders.
Substance
abuse/dependency disorders are complex processes that are
chronic, progressive and sometimes fatal and respond positively
to intervention and treatment.
A structured
recovery program which identifies the problem, helps restore the
individual to a state of biological, psychological, social and
spiritual well-being, and provides monitoring during recovery
can contribute to return to safe practice.
Nurses who
have participated in and maintained rehabilitation and recovery
are vital to health care and, with appropriate support and
monitoring, can safely continue or resume the practice of
nursing.
Approved: MBN 12/02/1987
Reaffirmed: MBN 6/04/1998
Revised and approved: MBN
10/03/2003
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Eligibility Criteria
A physical, mental, and/or emotional condition and/or disability that renders
a licensee unable to perform nursing services or duties with reasonable skill
and safety is hazardous to the well-being of the public. Some of these
conditions and/or disabilities are treatable disorders. With proper treatment
and management, an impaired nurse may be restored to a state of physical,
mental, spiritual and psychological well-being. Close monitoring during the
healing process is a means of facilitating recovery and thereby protecting the
public.
The Mississippi Board of Nursing Recovering Nurse Program is a mechanism whereby
qualified nurses may enter into a contractual agreement with the Board to
restrict licensure or privilege to practice in lieu of a formal disciplinary
hearing before the Board. During this period of restricted licensure,
restoration to a state of well-being is supported. Re-entry into nursing
practice and practice performance is closely monitored.
Interested nurses may inquire as to eligibility by completing the Recovering
Nurse Program Questionnaire and Authorization to Release Information Form. Once
the completed forms are received in the Board office, they will be reviewed by
the Director of the Recovering Nurse Program or the RNP Monitoring Counselor to
determine eligibility. An assessment, including clinical interview and
psychological testing by a Board approved assessor may be necessary to evaluate
eligibility.
Guidelines for Program Eligibility include:
1. currently licensed or privileged to practice nursing in Mississippi or making
application for licensure in Mississippi;
2. having a physical, mental and/or emotional condition or disorder that may
result in impairment of practice and is responsive to treatment;
3. willingness to sign a Program Participant Affidavit for the Recovering Nurse
Program of the Mississippi Board of Nursing.
Approved: MBN 10/03/2003
RECOVERING NURSE PROGRAM
CRITERIA FOR APPROVAL OF TREATMENT PROVIDERS: To include inpatient, intensive
outpatient and aftercare
1.
Incorporate the 12-step philosophy into treatment and provide some
exposure to the 12 step programs.
2.
Provide education on the neurobiology of addiction and the disease
concept.
3.
Conduct or provide for continuing care a minimum of one day per a week
for 12 months following discharge from treatment.
4.
Must have current certification thru the Department of Mental Health
and/or another nationally recognized certification program.
a.
Verification of admission including name of counselor, contact #, and
email where applicable.
b.
Written plans of care including assessment, diagnosis, treatment goals,
discharge criteria, guidelines for continuing recovery and recommendations for
return to practice.
c.
Progress report in writing monthly, notification of noncompliance up to
and including premature discharge or client initiated termination of treatment.
d.
Notification of changes in treatment plan, lack of compliance, or
positive drug screen.
5.
Willingness to communicate with monitoring counselors and understanding
of the third party referral system.
6.
Family educational component.
7.
Family conferences.
8.
Working knowledge of the treatment of sophisticated clients. Willingness
to research and increase understanding of the particular issues of the nursing
population.
9.
Ability to provide client access to an addictionologist or psychiatrist
if appropriate.
10.
Use of the treatment team approach to case management to include
inclusion of addictionologists, psychiatrists, psychologists, or master’s level
counselors in addiction to certified alcohol and drug counselors.
11.
The use of suboxone, subutex, methadone, benzodiazepines or other similar
medications are not acceptable past the initial detoxification period. If a
client is determined to have a diagnosis of addiction in which abstinence from
these substances is not possible, then this will need to be documented and
reported to the Recovering Nurse Program Director.
Approved by MSBN October 8, 2010
LENGTH OF STAY CRITERIA
The following shall serve as an
approved guideline for length of stay of long term inpatient, short term
inpatient, and intensive outpatient treatment:
Inpatient length of stay:
- 90 days of inpatient will be the minimum length of
stay for these situations:
a.
For individuals who have diverted medications from their work
environment.
b.
I.V. method of administration.
c.
A diagnosis of substance dependency
d.
A history of any of the following: failed treatments, chronic use
patterns, legal complications, relapse history,
e.
Prescription Forgery of controlled and mood altering substances.
- 28 day to 60 day inpatient length of stay:
a.
Recent onset of substance use disorder with a substance dependency
diagnosis.
b.
No prior treatment history, does not meet the criteria for 90 day length
of treatment.
- 12 week Intensive outpatient treatment:
a.
IOP may be utilized as a form of secondary treatment if the program can
meet the needs of a secondary client.
b.
Client displays extreme willingness, agrees to cease nursing practice,
has not diverted mediations from place of employment, forged prescriptions for
controlled drugs, used IM or IV, or has a prior substance use or treatment
history.
Approved by MSBN October 8, 2010
THE FOLLOWING SHALL SERVE AS THE
RECOVERING NURSE’S PROGRAM CRITERIA FOR AFTERCARE/CONTINUING CARE POST TREATMENT
1.
Provide a minimum of a 12 month aftercare program.
2.
Develop an individualized aftercare plan consisting of a plan of
actions and goals for early sobriety to include both long and short term goals.
Relapse prevention to include: relapse prevention plan, identification of
warning signs, managing high risk situations, identification of setups, triggers
and cravings.
3.
Address stress, anger, fear and denial management techniques.
4.
Address work reintegration issues.
5.
Provide living skills information
6.
Willingness to assess and provide “return to work” recommendations.
7.
Willingness to communicate with monitoring counselors and understanding
of the third party referral system.
8.
Working knowledge of the treatment of sophisticated clients. Willingness
to research and increase understanding of the particular issues of the nursing
population.
9.
Ability to provide or refer client to an addictionologist, psychiatrist
or licensed professional counselor if appropriate.
10.
Provide monthly update documentation on the RNP form regarding
attendance, compliance, and patient progress, recommendations, and completion
notification.
Approved by MSBN October 8, 2010
CRITERIA FOR ASSESSORS:
The following shall serve as the Recovering Nurse
Program criteria of approved assessors.
-
Should be an expert in the field,
e.g., and addictionologist, clinical psychologist or have a minimum of a
master’s level in counseling, psychology or social work and a minimum of
five years work experience in the field of chemical dependency.
-
Assessor needs to have an
understanding of public policy and safety issues, and understand how to
function performing assessments for third party referrals.
-
Be willing to consult with nurses
not only regarding the nursing field, but also the setting, to gain
appreciation of the elements, potential risk and the ethical implications of
the situation.
-
Willing to broaden sources for
evaluation and collateral information such as conduct telephone interviews
with employers, coworkers, and family members.
-
Willing to review accounts of the
allegation.
-
References from credible sources.
-
Willing to utilize multiple
assessment tools including but not limited to: bio-social interview, SASSI
3, DSM IV Criteria.
-
Demonstrated skill in evaluating
or treating sophisticated professional clients.
-
Willing to make a clear
diagnosis, or an explanation of the lack of diagnosis.
-
Willing to refrain from inclusion
of written recommendations for treatment unless assessment was in depth and
conducted for a period of 3 to 5 days by a multidisciplinary team.
Approved by MSBN October 8, 2010
CRITERIA FOR THE ASSESSMENT:
The following shall serve as criteria for approved
assessments:
- History of substance use and abuse including but not
limited to:
- Types of drugs/or alcohol used
- Frequency and patterns of use
- Severity of addiction
- Physical manifestations
- Last time of drug use
- Emotional manifestations
- Relation to employment
- Documentation of client’s willingness to participate
in treatment, acknowledge their problem and make necessary changes.
- List any prior treatment history.
- Psychiatric history and coexisting psychiatric
problems
- Family history, social support systems, current living
arrangements
- Administrative, ethical and /or criminal implications
of the nurse’s drug use.
- Employment history
- Identify elements that should be reviewed as part of
re-evaluation after treatment.
- Provide a clear diagnosis of substance abuse/misuse,
substance dependence, need for more evaluation, and or no diagnosis.
- Preferably conduct a GC/MS confirmed urine screen as
part of the assessment and provide results.
- Include a statement of evaluator’s degree of
confidence in findings, and an explanation.
- No recommendations for treatment unless assessment was
in depth, conducted for a period of 3 to 5 days and by a multidisciplinary
team.
Approved by MSBN October 8, 2010
THE
FOLLOWING SHALL SERVE AS THE
RECOVERING NURSE PROGRAM’S
CRITERIA FOR INTENSIVE OUTPATIENT TREATMENT PROGRAMS:
1.
Must meet a minimum of 3 times weekly with at least 8-9 hours of
treatment being provided weekly.
2.
Individual sessions need to be provided bi- weekly as well as weekly
groups.
3.
Education should be provided as a component. An excess of two hours of
video education weekly shall not meet the criteria for appropriate education.
4.
Length of treatment should be a minimum of 10-12 weeks.
5.
It is preferable that there be a family education program offered.
6.
Willingness to assess and provide “return to work” recommendations.
7.
Willingness to communicate with monitoring counselors and understanding
of the third party referral system.
8.
Working knowledge of the treatment of sophisticated clients.
9.
Willingness to research and increase understanding of the particular
issues of the nursing population.
a.
Ability to provide client access to an addictionologist or psychiatrist
if appropriate.
Approved by MSBN October 8, 2010
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