Jennifer Thew, RN, June 14, 2017

Nursing organizations advocate for rehabilitating rather than punishing nurses experiencing substance use disorder.

The American Association of Nurse Anesthetists is endorsing a new position statement that advocates for an alternative-to-discipline approach for nurses and nursing students with substance use disorder.

The position statement Substance Use Among Nurses and Nursing Students, co-authored by the International Nurses Society of Addictions and the Emergency Nurses Association calls for an alternative-to-discipline approach with the stated goals of:

  • Retention
  • Rehabilitation
  • Re-entry into safe, professional practice

The position statement also says drug diversion for personal use should be considered a symptom of a serious but treatable disorder rather than strictly as a crime.

“It’s about education for prevention and fair handling when it happens,” says Lynn Reede, DNP, MBA, CRNA, FNAP, AANA senior director of professional practice. “Education raises awareness and understanding, and at the same time decreases the stigma related to the disease. Treatment of substance use disorder helps keep patients and healthcare professionals safe.”

Recovery is the Goal

A disciplinary approach to impaired practice or drug diversion involves due process with a state board of nursing and suspension or revocation of a nurse’s professional license. There is no offer of a recovery program and the nurse may be terminated and legal charges can be filed.

Through an alternative-to-discipline program, a nurse does not practice for a specific time while undergoing treatment and establishing sobriety and recovery program. He or she may undergo psychiatric evaluations, specialized treatment like one-to-one therapy and support groups, and random drug screens.  A return-to-work agreement is created and often involves a reduction in hours, limited shifts, and restrictions in assignments with continued treatment and monitoring for periods of up to three to five years. Restrictions are lifted as the nurse demonstrates he or she is making progress.

Alternative-to-discipline programs make it easier for impaired nurses, including nurse anesthetists, to step away from work while they receive treatment, says the AANA in a news release.

“An ATD approach gives Certified Registered Nurse Anesthetists and student registered nurse anesthetists three opportunities: 1) To enter treatment to address their addiction, 2) To work toward lifelong sobriety, and 3) When possible, their eventual return to the workplace,” says Linda Stone, DNP, CRNA, chair of the AANA peer assistance advisors committee.


Response from Marie: This position statement is also included as a position statement of the American Nurses Association.

In our work creating and building the Nursing Peer Support Network (NPSN) in Minnesota, I believe the position taken here is vitally important.  Within the culture of nursing, there are negative attitudes toward addictions which act as a disincentive to get help when the person with the addiction is a nurse.    One large piece of the problem is the lack of education for student nurses to understand the heightened risks and extreme consequences experienced when a nurse becomes an addict.   The incidence with nursing is now thought to be one in seven!!!   Fortunately, the U of M SON has developed a curriculum module that DOES present important information about the RISKS AND CONSEQUENCES OF ADDICTION IN NURSING. See our earlier post here for more information about that exciting curriculum addition!

For more information on NPSN go to the website www.

It’s great to be part of this point in time, moving forward together on this important issue!