“Protect the public—that's first. The second [goal] is getting the nurse to recovery”: Interviews with alternative-to-discipline program administrators

IF 6.3 4区医学 Q1 NURSING

Journal of Nursing Regulation Pub Date : 2025-07-01 DOI:10.1016/j.jnr.2025.06.002

Emily Naiser , Ashley Myers , Christina Orzabal , Georges Naufal , Cindy Weston , Nancy Fahrenwald , Jane N. Bolin

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引用次数: 0

Abstract

Background

Substance use disorder (SUD) among nurses presents significant challenges for both healthcare professionals and patient safety. Rough estimates suggest that 10 % of nurses, or more than half a million nursing professionals, experience SUD in the United States. Alternative-to-discipline (ATD) programs offer a nonpunitive approach to rehabilitation for nurses while ensuring public safety.

Purpose

This study examines the effectiveness and functioning of ATD programs through the perspectives of state-level program administrators.

Methods

Semi-structured qualitative interviews were conducted with ATD program administrators in the United States. Using a thematic analysis approach, common successes and challenges related to ATD programs were identified.

Results

Administrators from eight ATD programs participated in the interviews, and one submitted written responses to the interview questions. Findings revealed that functionally, ATD programs vary in the supports and restrictions given to nurses and that these decisions are primarily based on public safety. The ATD program administrators utilized the resources available to them but wished they could serve more nurses, minimize the costs to nurses, and provide additional support. While ATD programs facilitate recovery and professional reintegration, barriers such as stigma and resource limitations persist.

Conclusions

This study highlights the need for standardized program guidelines and enhanced support structures to optimize outcomes. These insights contribute to a broader understanding of SUD intervention strategies in nursing, inform policy improvements, and identify future research directions.

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“保护公众——这是第一位的。第二个[目标]是让护士康复”：采访另类纪律项目的管理者

护士中的物质使用障碍（SUD）对医疗保健专业人员和患者安全都提出了重大挑战。粗略估计，美国有10%的护士，或超过50万的护理专业人员经历过SUD。纪律替代（ATD）项目为护士提供了一种非惩罚性的康复方法，同时确保了公共安全。目的：本研究从州一级项目管理者的角度考察ATD项目的有效性和功能。方法对美国的ATD项目管理人员进行半结构化定性访谈。采用主题分析方法，确定了与ATD项目相关的共同成功和挑战。结果来自8个ATD项目的管理人员参与了访谈，其中1人对访谈问题进行了书面回答。调查结果显示，ATD项目在功能上对护士的支持和限制各不相同，这些决定主要基于公共安全。ATD项目的管理者利用了现有的资源，但希望他们能服务更多的护士，尽量减少护士的成本，并提供额外的支持。虽然ATD项目促进了康复和重返职业社会，但诸如耻辱和资源限制等障碍仍然存在。本研究强调需要标准化的项目指南和增强的支持结构来优化结果。这些见解有助于更广泛地了解护理中的SUD干预策略，为政策改进提供信息，并确定未来的研究方向。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Nursing Regulation NURSING-

CiteScore

4.60

自引率

12.50%

发文量

审稿时长

54 days

期刊介绍： Journal of Nursing Regulation (JNR), the official journal of the National Council of State Boards of Nursing (NCSBN®), is a quarterly, peer-reviewed, academic and professional journal. It publishes scholarly articles that advance the science of nursing regulation, promote the mission and vision of NCSBN, and enhance communication and collaboration among nurse regulators, educators, practitioners, and the scientific community. The journal supports evidence-based regulation, addresses issues related to patient safety, and highlights current nursing regulatory issues, programs, and projects in both the United States and the international community. In publishing JNR, NCSBN''s goal is to develop and share knowledge related to nursing and other healthcare regulation across continents and to promote a greater awareness of regulatory issues among all nurses.