The stress of the modern world, and unfettered access to both legal and illicit short-term medications for that stress, means that substance use disorders have become more common than is healthy. Even our society’s most driven, self-disciplined, and clear-minded—we’re talking about nurses—can slip into the vicious cycle of substance misuse before they realize what’s happened.
Once they recognize that once manageable substance use has spiraled into a real problem, nurses must ask for help. Before they do, though, they often think about the potential professional ramifications of admitting their struggles.
Fortunately, nursing boards nationwide offer alternative-to-discipline (ATD) programs to nurses struggling with alcohol, prescribed drugs, illicit drugs, and other impairing substances. These programs typically allow nurses to avoid license suspension or revocation—and thus, avoid the need to reinstate their license after treatment is complete.
However, there are many other cases in which nurses have their licenses taken away (whether through suspension, revocation, or other discipline) as a direct result of their substance-related struggles. In these cases, they need to know the pathway to potential reinstatement once they have tread far enough down the road to recovery.
In this page, we will discuss both such scenarios. Know that the first step you should take—regardless of where you are in the recovery process—should be to call the LLF National Law Firm Professional License Defense Team today at 888-535-3686 or contact us online. We will advise you through a process that is more perilous than many nurses realize.
First, Know That Your License May Not Be Suspended or Revoked While You Get Treatment for Substance Abuse
There is a subtle implication when you ask, “Can my nursing license be reinstated if I’ve completed a substance abuse treatment program?” The person asking this question is assuming that, if they are in a treatment program, their nursing license will have been revoked. This is not necessarily how your circumstances will be.
License suspension and revocation are forms of discipline. It is noteworthy, then, that many nurses struggling with substance abuse may be enrolled in an alternative-to-discipline (ATD) program. Such programs typically have a rehabilitative element and may even serve as the primary mode of treatment for your substance use.
We will soon discuss what ATD programs are, who may be eligible, and how they may allow you to return to work without losing your license.
When Can a Nurse’s License Be Suspended, Revoked, or Otherwise Sanctioned Because of Substance Abuse?
Some nurses are sanctioned for their substance abuse—or, in some cases, circumstances that are directly related to their substance use. The likelihood that you face the suspension or revocation of your nursing license, or other professional license sanctions, is greater when:
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You do not voluntarily report and seek treatment for your substance use disorder: If your state’s nursing board discovers your substance use on its own, it may be less compassionate in its response to your problem.
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You are convicted of (or plead guilty to) a crime related to substance use: Florida statutes, for example, explain that a nurse can be disciplined if they are “convicted or found guilty of…“a crime in any jurisdiction which directly relates to the practice of nursing or to the ability to practice nursing.” Nursing boards often find drug- and alcohol-related offenses to be related to the ability to practice nursing, particularly if they are indicators of abuse.
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You endanger a patient through your impairment: An impaired nurse is typically considered a threat to patient well-being, even if a nurse feels they could perform their duties suitably while at less than 100%. Therefore, if your nursing board’s representatives determine you put even one patient at risk, you might face license suspension or revocation.
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You harm a patient because of your impairment: If you caused direct harm to a patient, you are likely to face some form of sanction—potentially a severe one. A substance use disorder is not typically an excuse that spares a nurse from discipline in these circumstances.
These circumstances can be grounds for discipline even if they are unrelated to substance use or abuse. However, we mention the role that substances can play in criminal convictions and patient endangerment due to the topic at hand.
What Is an Alternative-to-Disipline Program, and How Does It Relate to My License Reinstatement Concerns?
Alternative-to-discipline programs, as their name suggests, allow nurses to avoid discipline. You might think of these programs as you would probation—if you abide by the terms, you may regain the ability to practice at full capacity (and without having formal discipline on your record).
Like a probationary period, though, failure to comply with the terms of the ATD program can trigger a formal disciplinary process. That process is likely to lead to sanctions against your license, given that you had your shot at an alternative to discipline.
Here is a look at a few different nursing boards’ ATD programs for those suffering from substance abuse:
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Nurses in Texas may be admitted to the Texas Peer Assistance Program for Nurses (TPAPN), which is operated in tandem by the Texas Nurses Foundation and the Texas Board of Nursing. The program was created for nurses with “an identified substance use or mental health condition.” The Texas Board of Nursing may rely on this program as an alternative to discipline for some nurses.
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The California Board of Registered Nursing offers “A Recovery and Alternative to Discipline Program” called the Intervention Program. The Program provides “effective treatment” under the supervision of the nursing board, with the goal of “returning them [the nurse] to safe practice.”
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Nurses who practice in Pennsylvania may turn to the Voluntary Recovery Program (VRP), where they can receive “appropriate treatment and receive monitoring to ensure that they remain capable of practicing safely.”
These programs are often voluntary. They may also be a required condition for reinstating a nurse’s license that has been suspended or revoked.
While each state’s ATD program can vary in its scope, many of them:
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Provide treatment services similar to what you’d find in a private rehabilitation program
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Involve closely monitoring the nurse to ensure abstinence from substance use
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Provide personalized plans to guide the nurse’s treatment and progress
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Are a necessary process for nurses who voluntarily enter, are ordered to participate as a means of avoiding discipline, or are ordered to participate as a condition to regaining their license after suspension or revocation
Whether you have already suffered discipline, have yet to report your substance use, or have reported your substance use and are seeking to avoid discipline, enrollment in one of these programs could be highly beneficial.
Who Is Eligible to Participate in an ATD Program?
Eligibility criteria for nursing boards’ rehab-focused programs can vary from state to state. In Texas, for instance, any nurse struggling with substance abuse may be eligible. In other states, these programs may be used exclusively as an alternative to discipline, meaning that nurses who have already been suspended or stripped of their license are typically not eligible for enrollment.
Some other eligibility criteria for enrollment in an ATD program can include:
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The details of your substance abuse and any professional behavior that may have been influenced by it
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Whether you have previously failed to complete an ATD program
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Whether you have suffered discipline or are currently facing discipline
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Your willingness to admit a problem and exhibit a genuine desire to get better
Your representative from the LLF National Law Firm Professional License Defense Team will evaluate your state nursing board’s eligibility criteria for any ATD programs you might participate in. If there is a case to be made for your enrollment, we will make that case passionately.
How Should I Seek Treatment If I Am Not Eligible for My State’s ATD Program?
If you are not eligible to enroll in the treatment program associated with your state nursing board, you are likely already disciplined. The opportunity to seek an alternative to discipline has passed, and now you should consider:
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Seeing if your state’s treatment program will accept you: Even though some states reserve admission to their treatment programs to nurses who are pursuing an alternative to discipline, some states admit any nurse with a substance use disorder. In fact, if you can enroll in a nursing board-endorsed program, it is generally preferable. This way, when you seek reinstatement of your license, the nursing board will have a reliable record of your treatment and recovery progress.
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Seeking private treatment: Even though you will likely be required to undergo Board-monitored treatment upon seeking reinstatement, those suffering from substance abuse should not typically wait for the reinstatement process to seek help. If feasible, feel free to seek treatment from a reputable private provider.
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Documenting your treatment progress: Nurses seeking reinstatement of their license must demonstrate that they have rehabilitated. Having documentation from credible healthcare and mental health service providers—as well as documentation of your independent efforts to get better—may be instrumental to getting your nursing privileges back.
It’s not always clear who is eligible to enroll in nursing boards’ treatment programs, or whether doing so is the best choice. Our Professional License Defense Team is well-versed in these matters, and we will help you make the right decisions for your health and your nursing career.
How Can I Seek License Reinstatement After I Complete Treatment for Substance Abuse?
If your license has been suspended or revoked due to the circumstances surrounding your substance use disorder, your state’s nursing board will have strict criteria for reinstating your license. Each state’s criteria and reinstatement procedures are unique, so here are a few examples of how the process can unfold:
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The nurse fulfills a waiting period in accordance with the discipline: The nature of license suspensions and revocations is that they take time to elapse. In California, a nurse must wait three years from the date of revocation before applying for reinstatement. That deadline is only one year if the license was revoked “for impairment due to mental or physical illness,” which may apply to someone suffering from substance abuse.
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The nurse files their petition for reinstatement: This petition often requires the payment of a fee, the completion of a background check, a statement from the petitioner explaining why they should be reinstated, any relevant legal records, and any other required details and documents.
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The nurse provides evidence of their rehabilitation: This may include proof of completing a treatment program, results of drug tests or other screening, testimony from mental health professionals and healthcare providers, and letters from sobriety sponsors.
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The nurse may need to complete a hearing, interview, or both: The nursing board may want to evaluate you for fitness and rehabilitation, and this evaluation may come in the form of a hearing, interview(s), or a combination of both.
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The nurse may have to agree to conditional terms of reinstatement: In Texas, for example, nurses who return to practice after proving their sobriety “may be subject to Board monitoring and random drug screening for a period of time.”
The conditions upon which you are allowed to return to nursing should be reasonable and achievable. Our Professional License Defense Team will demand that you’re treated fairly throughout the reinstatement process (and after you return to work).
Under What Circumstances Should I Engage Representation from the LLF National Law Firm?
You should engage our Professional License Defense Team if:
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You are suffering from a substance use disorder that you have yet to report to your nursing board
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You have voluntarily reported your substance use and intend to enter an ATD program
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You face discipline related to your substance use
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You have already been disciplined and want to return to work as soon as possible
We are proud to serve nurses, and we are passionate about doing so. Most importantly, we are capable advocates for professionals seeking to preserve or regain their licenses, and we help in virtually every aspect of the licensing process.
Call the LLF National Law Firm Professional License Defense Team today at 888-535-3686 or contact us online to get help from proven, persistent advocates for healthcare professionals.