Alcohol and substance use disorders are serious and potentially dangerous, especially for nurses who are tasked with protecting the health and well-being of their patients on a daily basis. As a nurse, you might think you and other medical professionals are held to a higher standard and that you should be able to handle more stress than the average person, but that just is not true. Alcohol and substance use disorders can happen to anyone; they are not a moral failing. It is common for nurses to suffer from alcohol and substance use disorders, particularly after the extreme stress and trauma they suffered during the COVID-19 pandemic. In fact, studies have revealed an increase in nurses battling alcohol and substance use disorders during and following the pandemic.
If you are a Rhode Island nurse facing a complaint against your license for an alcohol or substance use-related offense, the Lento Law Firm Professional License Defense Team is here to help. At the Lento Law Firm, we understand how hard you worked to become a nurse and how much your career means to you. We believe you do not deserve to lose your nursing license or face other negative consequences over a condition that is out of your control when you should be getting the help you need to become the best nurse possible. Our Team can discuss alternatives to the disciplinary process and help you decide if an alternative program is right for you. Let us help you by calling 888-535-3686 or schedule your consultation online.
Rhode Island Nurse Regulatory Body
In Rhode Island, the government agency in charge of regulating the nursing field is the Board of Nurse Registration and Nursing Education, which is housed in the Rhode Island Department of Health. In addition to developing the educational standards and programs for nursing, dealing with nursing license applications and renewals, and developing and distributing policies and guidelines for nursing practice, the Board is responsible for addressing all complaints against nurses in its jurisdiction.
The Board will thoroughly investigate all complaints against licensed nurses who have allegedly violated nursing laws and regulations, including the Rhode Island Nurse Practice Act, the predominant law affecting nurses in the state. If, after an in-depth investigation, the Board determines a nurse is guilty of the allegation against them, it will likely take disciplinary action against the nurse. Disciplinary actions can range in severity. Some nurses get away with just a reprimand, while others face lengthy license suspensions and may even get their nursing license revoked.
What is the Non-disciplinary Alternative Program?
Under Rhode Island law, the Board has the authority to offer nurses dealing with alcohol, drug abuse, or mental illnesses, as identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Disease Manual (ICO), a non-disciplinary alternative in a situation which the nurse agrees to voluntarily participate in a treatment program or rehabilitation. Accordingly, the Board established the Non-disciplinary Alternative Program. Rhode Island regulations on the licensing of nurses and standards for the approval of basic nursing education programs provide guidelines on the Non-Disciplinary Alternative Program.
Participation in the Non-disciplinary Alternative Program means that even though the nurse has violated Rhode Island nursing laws, regulations, and policies, they will not face disciplinary action. The violations a nurse will have committed that would subject them to disciplinary action include the chronic use or addiction to habit-forming drugs or alcohol. The Non-disciplinary Alternative Program is completely voluntary and must be requested by the nurse. A nurse cannot be required to participate in the Non-disciplinary Alternative Program; it is their prerogative to alternatively move forward in defending themselves in a disciplinary action against them and their license.
Because disciplinary action is not being taken against their license, the consequences of their violation are limited. The nurse's license should remain active and in good standing without disciplinary action. While, as discussed below, practice restrictions may be placed on the nurse, these restrictions will not be reflected as a formal disciplinary action and, therefore, will not be publicly available. All records of a nurse's participation in the Non-disciplinary Alternative Program must be kept confidential under Rhode Island law. The exception to this confidentiality requirement is if the nurse violated their legally binding agreement under the Non-disciplinary Alternative Program.
Participating in the Non-disciplinary Alternative Program requires the nurse to enter into a legally binding contract with the Board. This contract will outline what treatment and rehabilitation a nurse must complete, the timeline, and how compliance will be monitored. Typical components of these contracts include:
- Specific medical treatments the nurse will participate in
- Specific mental health treatments the nurse will participate in
- Any alcohol or substance abuse disorder rehabilitation the nurse will participate in
- Mandates for attendance of Alcoholics Anonymous or Narcotics Anonymous meetings
- Mandates for attendance of nurse recovery group meetings
- Random drug screenings
- Commitment to abstaining from all addictive substances, including alcohol and prescription drugs
- Direct supervision by another nurse or medical professional while practicing
- Restrictions on nursing practices, such as prohibition from or monitored prescribing, handling, and administering of certain prescription drugs to patients
- The duration of participation in the Non-disciplinary Alternative Program
The contents of each contract are tailored to each nurse's case. The Board will decide which combination of requirements and restrictions are necessary following receipt of evaluations and assessments required for participation, which are discussed in greater detail below.
Eligibility to Participate in the Non-disciplinary Alternative Program
The Board is not required to let all nurses battling alcohol and substance use disorders participate in the Non-disciplinary Alternative Program. There are basic eligibility requirements the nurse must meet, and still, entrance into the Program will be up to the Board's discretion. Rhode Island nursing regulations state the following eligibility criteria must be met for a nurse to participate in the Non-disciplinary Alternative Program:
- The nurse must agree in writing to comply with all terms of the Non-disciplinary Alternative Program contract
- The nurse must agree they will be financially responsible for all costs related to assessment, treatment, and monitoring required under the Non-disciplinary Alternative Program
- The nurse must agree to evaluations and drug testing necessary to determine treatment and monitoring needs under the Non-disciplinary Alternative Program
- The nurse must agree to participate in the treatment program determined necessary by their health care providers and approved by the Board
- The nurse must agree to have their information related to their participation in the Non-disciplinary Alternative Program provided to their employer to ensure adequate workplace monitoring and compliance
In addition to the above eligibility requirements, several disqualification criteria permit the Board to automatically remove a nurse from consideration in the Non-disciplinary Alternative Program. The disqualification criteria for the Non-disciplinary Alternative Program are as follows:
- The nurse has previously been enrolled in and terminated for non-compliance from a non-disciplinary alternative program in Rhode Island or another state
- The nurse has an alcohol or substance use disorder or diagnosis of mental illness of such severity that it could present a clear and present danger to the patient's health and safety
- As a result of an alcohol or substance use disorder or diagnosis of mental illness, the nurse has had nursing practice problems resulting in the death of a patient or involving significant harm or potentially significant harm to a patient
- The nurse has previous formal disciplinary action related to their alcohol or substance use or mental illness taken by a nursing board against them
- The nurse has been convicted of any crime related to a controlled substance or legend prescription drug
Evaluations and Assessments Required for the Non-disciplinary Alternative Program
As mentioned above, nurses entering the Non-disciplinary Alternative Program must undergo any evaluations and assessments the Board deems necessary. There are a variety of evaluations and assessments the Board may request, but the most common is an alcohol or substance use assessment. The Board gets to decide what providers are qualified to perform these assessments. Generally, alcohol and substance use assessments are performed by a physician or advanced practice registered nurse specializing in addiction medicine.
Before scheduling or undergoing an alcohol or substance use assessment, contact the Board to ask what their requirements are for a provider. The Board may require the provider conducting your assessment to have a certification in addiction. There are different certification programs, so make sure you have the specific names of the certifying authorities the Board approves of. Arguably, the most common addiction certification program is offered by the Addictions Nursing Certification Board.
Once you have the information from the Board about which providers are acceptable, you can begin searching for a provider. Finding a provider can be difficult, especially if you are in a rural area of Rhode Island. The American Academy of Addiction Psychiatry and the American Board of Addiction Medicine have online search tools and staff available to assist you in finding a qualified provider.
Unfortunately, alcohol and substance use assessments can be expensive, generally costing between $250 and $500. As mentioned in the eligibility section above, the Board does not cover any costs related to the Non-disciplinary Alternative Program. Nurses are responsible for the cost of these assessments and any other evaluations, assessments, treatment, and other costs associated with participation in the Program. Your insurance company may cover the cost or part of the cost of the assessment. They may also be able to direct you to providers who are covered under your plan.
Termination from the Non-disciplinary Alternative Program
Participating in the Non-disciplinary Alternative Program is not a get-out-of-jail-free card for nurses. The Board has the authority to terminate a nurse's participation at any time during the Program if the nurse fails to comply with any aspect of their Non-disciplinary Alternative Program contract. The nurse can also face termination from the Program if the Board receives additional information and investigation leads to disciplinary action by the Board or if the nurse engages in any conduct that would have caused them to initially be disqualified from participation in the Program. If the nurse fails at any time to follow their treatment protocol or fails to satisfactorily complete the treatment program, the Board may terminate the nurse's participation and pursue disciplinary proceedings against them.
Risks and Benefits of Entering the Non-disciplinary Alternative Program
Like most things, The Non-disciplinary Alternative Program has risks and benefits. The Non-disciplinary Alternative Program can be a good option for many nurses for many reasons. However, nurses must realize that while avoiding disciplinary action, their careers will still be greatly impacted.
An attorney in the Lento Law Firm Professional License Defense Team will assess your case and present a comprehensive list of the benefits and risks of participation in the Non-disciplinary Alternative Program. While the pros and cons will differ based on each situation, the general pros and cons are as follows.
Benefits
Arguably, the most significant benefit to the Non-disciplinary Alternative Program is that there will be no disciplinary action against your Rhode Island nursing license or public record of your alcohol or substance use disorder in publicly available nursing records. Participation in the Program can be viewed as a positive thing to those you choose to share this information with and potentially for your employer, who will already know the situation. When you enter the Non-disciplinary Alternative Program, because of its voluntary nature, you are being proactive about your alcohol or substance use disorder. By avoiding disciplinary action, you are not being reactive or defensive about the situation because you have acted before your alcohol or substance use disorder harmed a patient.
Participating in the Non-disciplinary Alternative Program is a unique opportunity to dedicate yourself fully to treatment and recovery from your alcohol or substance use disorder. If you feel you are genuinely ready to begin your journey to sobriety, the Program can be a very good option. While you likely have other responsibilities, like your family, for example, your contract under the Non-disciplinary Alternative Program will require you to dedicate a lot of your professional time to recovery and treatment. This can mean taking off time from work, at least temporarily, for more extensive and time-consuming treatments like alcohol and substance use day out-patient programs. If your insurance or finances provide it, an in-patient program could also work for you. The Non-disciplinary Alternative Program provides a unique opportunity to throw yourself into recovery with minimal other responsibilities to distract you.
The long-term nature of the Program and the extensive monitoring that will almost certainly be included in your Non-disciplinary Alternative Program contract can be a beneficial aspect of the Program. While they may feel suffocating at times, many nurses find these features of the Program helpful in holding them accountable. Constant check-ins increase your chances of successfully completing the Program and ideally making long-term changes that will allow you to manage your alcohol or substance use disorder long past your participation in the Non-disciplinary Alternative Program.
Risks and Downsides
While many nurses may think the Non-disciplinary Alternative Program is a win-win, confidentially getting the help they need while keeping their nursing license, the reality isn't that simple. While it is a win-win in theory, the Non-disciplinary Alternative Program is not necessarily designed to meet nurses' needs, whether this be by ignoring the inherent nature of the addiction or by turning a blind eye to the financial and time costs associated with participation in the Program.
One of the most significant issues with the Non-disciplinary Alternative Program is its unrealistic expectations of the participating nurses. Fighting alcohol and substance use disorders is a life-long battle with ups and downs. The Non-disciplinary Alternative Program oversimplifies addiction treatment and recovery. Addiction isn't like breaking your arm; you can't just follow the medical treatment and expect to permanently recover. Relapses happen; they are normal and nothing to be ashamed of. Recovery is hard; perhaps the hardest thing you will do in this life.
The Non-disciplinary Alternative Program is a one-strike, and you're out Program; relapses will often not be tolerated, and the consequences are steep. Relapse automatically makes the nurse non-compliant with their contract and subject to immediate termination from the Program. The Board will likely pursue disciplinary action against you, potentially resulting in license probation, suspension, or revocation. Remember, being in this Program means you have admitted you are guilty of violating Rhode Island nursing laws and regulations, which will put you at a disadvantage in the disciplinary action process.
Additionally, participating in the Non-disciplinary Alternative Program can be costly. While enrollment in the Program itself doesn't have a financial cost, as mentioned above, the nurse is fully responsible for funding all treatment and associated costs. If your health insurance does not cover addiction treatment or you have lost your job and subsequently your health insurance as a result of your alcohol or substance use, this cost could be unmanageable. Treatment can cost thousands upon thousands of dollars.
In addition to cost, participation in the treatment and rehabilitation programs mandated in the Non-disciplinary Alternative Program contract is often lengthy and time-consuming. The length of your time in the Program can vary, but it is fairly common for contracts to include years of participation.
Even once completing more extensive rehabilitation and treatments early on in the Program, it is likely there will be various Alcoholics Anonymous, Narcotics Anonymous, or other recovery group meetings you will be required to attend. You may face additional negative professional consequences if your mandated treatment impacts your work schedule. Accommodating your need for time off and potential requirements for workplace supervision may be too much for an employer. Participating in the Non-disciplinary Alternative Program can threaten the job you are trying hard to save.
Why You Need the Lento Law Firm Professional License Defense Team
There are many considerations to be thought through when deciding if the Non-disciplinary Alternative Program is right for you. You don't have to go through the overwhelming process of deciding if the Program is right for you alone. Your Lento Law Firm attorney can play a big role in guiding you in making the best decision for you. Our Team has helped numerous Rhode Island nurses in exactly your situation, whether that be a true alcohol or substance use disorder or a one-time incident related to alcohol or drug use.
We help by listening to your side of the story, learning how the complaint to the Board against you came about, and assessing your case. Because we have worked with numerous Rhode Island nurses, we have seen first-hand what the Board will likely include in your Non-disciplinary Alternative Program contract if you pursue that route and how entering the Program has worked for other nurses throughout the state. We use this information to make a customized pros and cons list detailing all the risks and benefits of entering the Non-disciplinary Alternative Program.
Retain the Lento Law Firm Today
If you are a Rhode Island nurse facing an alcohol or substance use allegation, whether or not you are suffering from an alcohol or substance use disorder, the Lento Law Firm Professional License Defense Team is here to help. We want what is best for you and will do everything in our power to protect your Rhode Island nursing license. Call us today at 888-535-3686 or contact us online.
