Alternative programs can save your license

Alternative programs for chemically dependent nurses are the wave of the future, according to Valerie Murchake Wright, RN, MLHR, alternative program coordinator for the Ohio Board of Nursing in Columbus.

"There is a definite trend toward alternative programs as opposed to formal discipline," she says. "Currently, 20 states have an alternative program for nurses, and the number continues to grow."

All state boards of nursing are required to investigate complaints about nurses, Wright explains. "Many of the complaints are about nurses with drug or alcohol addictions."

If the complaint is substantiated, a formal board action may be imposed against the nurse. "Actions can include a reprimand, suspension, or revocation of licensure," Wright explains.

All action taken by boards are considered public information and are reported to the national practitioner data bank, she adds.

Alternative programs were developed essentially as an "alternative to formal disciplinary action," says Wright. With alternative programs, the nurse is asked to sign a monitoring agreement that typically includes requirements to complete chemical dependence treatment, maintain abstinence from drugs and alcohol, and provide regular reports to the alternative program of their progress in recovery.

If the nurse successfully meets the terms and conditions of the alternative program agreement, the board will abstain from taking any formal action against the nurse’s license. "A nurse’s participation in an alternative program is confidential and is not reported to the national data bank," Wright says.

Impaired nurses may be unable to work for a lengthy period of time, she says. "Nurses need to be away from work in the early part of treatment. We have found that it’s important for nurses to focus on their recovery. So it’s not unusual for the board to say they can’t work as a nurse for six months or more, depending on the circumstances," she explains. "When it comes to employment issues, we take into account the individual nurse and look at the whole picture."

Alternative programs create a structure to facilitate recovery and assist the nurse in returning to work once they have completed treatment.

"This structure allows boards to work with nurses as soon as there is knowledge of a problem," says Wright. "The programs protect the public by encouraging nurses to seek help for their addiction and to establish a drug-free lifestyle."

(Editor’s Note: Nurses may obtain additional information about alternative programs in their state by contacting their state Board of Nursing or their state nurse’s association.)


For more information about confronting substance abuse in your ED, contact the following:

Liz Jazwiec, RN, 10640 S. Kildare, Oak Lawn, IL 60453. Telephone: (708) 422-7074. E-mail:

Madeline Naegle, RN, CS, PhD, FAAN, New York University, Division of Nursing, 50 W. Fourth St., Room 429, Shimkin Hall, New York, NY 10012. Telephone: (212) 998-5301. E-mail:

Jill Pollock, RN, Loma Linda University Medical Center and Children’s Hospital, Room 4700H, P.O. Box 2000, Loma Linda, CA 92354. Telephone: (909) 824- 4174. E-mail:

Valerie Murchake Wright, RN, MLHR, Ohio Board of Nursing, Compliance Unit, 77 S. High St., 17th floor, Columbus, OH 43266. Telephone: (614) 466-7934. E-mail: