I do not believe any nurse wakes up in the morning saying to themselves, “I want to do drugs today!”

I consider substance use disorder (SUD) to be a biological condition where the brain has cravings for a particular substance, and nothing will alleviate it except getting that substance into their system.

Unfortunately, a nurse with SUD doesn’t just wake up and say, “I’m not going to do this anymore.”  It usually requires treatment and intervention.

Some nurses suffering from chronic pain subsequently develop a SUD for which the pain can be alleviated only through the narcotic or Suboxone which relieves the craving as well as reduces the pain symptoms.

It is unfortunate that in Indiana the peer assistance monitoring program, Indiana Professional Recovery Program (IPRP), is an abstinence-based program by regulation.  It was a regulation promulgated by the Indiana State Board of Nursing through the rule making process.

The Board has been inflexible with those who are on Suboxone who need monitoring.

An aggrieved nurse brought a complaint to the Department of Justice stating that she had been taking Suboxone and in solid recovery for a year.  However, for her to get off that medication to participate in the monitoring program would be detrimental to her health and well-being.

The Department of Justice agreed and opined that a person with substance use disorder in recovery has a disability and public programs that prevent access, such as the peer assistance monitoring program (IPRP), is a violation of the Americans with Disabilities Act.

I know that throughout the years, nurses on Suboxone had to agree to revocation or suspension of their license until they could get off the medication before being allowed to participate in the program.

It will be interesting to see if the Board will change their rules to allow people who take Suboxone to participate in the program or if they will require monitoring elsewhere.  This is a big win for some nurses who require Suboxone to keep them from abusing narcotics.

This also has additional ramifications for nurses who take Adderall for ADHD or take a controlled substance for epilepsy to prevent seizures or narcolepsy.

I am glad that the Department of Justice does not see this as “a one size fits all” approach and is meeting nurses with their disability where they are and requiring the Board to give them options.

Can you imagine seeing on social media a picture of a baby that was born with gastroschisis, a congenital disorder where the infant is born with the intestines outside the body?

That is what happened with a photo containing the caption of “My night was going great, then BOOM!”

A neonatal care unit nurse at Jackson Memorial Hospital in Florida decided to post this baby’s photograph and caption on Facebook without the consent of the parents or the hospital.

Clearly, this is a HIPAA violation!

Any healthcare facility employee who violates privacy rules of any patient is subject to disciplinary action which could include suspension or even termination.  And nurse Sierra Samuels was terminated from her position at Jackson Memorial.

As of this writing, Ms. Samuels, who reportedly became a licensed practical nurse in 2015 and obtained her R.N. license 2 years later, still has a free and clear license.  It is unknown what the Florida Board of Nursing will do hereafter.

As nurses, we see many striking things during our care of patients.  But we can never share them with others, especially through social media.  It is important to protect every patient’s right to privacy, no matter how old or young they may be.  As in this case, even if the child’s face had not been shown, people knew where Samuels worked, and her actions could have exposed the child and parents for possible identification.

The protection of a patient’s privacy rights begins with YOU!

For example: you cannot post a photo of a room after a patient is discharged or passes away because if someone knew the room’s occupant was in that hospital, it could lead to the discovery of the patient’s identity.  Another point, any items that are removed from a patient’s body cannot be photographed and disseminated through any means.

It is safest to never photograph or comment on anything and keep your work life private with no discussion, no photographs going outside the health care facility.  Your license is too important to risk.