The faculty of the Wellstar School of Nursing (WSON) believes they have an ethical and professional responsibility to provide a safe and effective educational environment to students and to patients who receive nursing care from students. Students are expected to participate in any learning experience, including classroom, campus laboratory, clinical settings, and other WSON sponsored functions, free of chemical impairment. Based on the assumption that addiction is an illness that can be successfully treated, the faculty is committed to assisting students with recovery from substance abuse. In developing the policy and procedures for intervening with a student who displays symptoms of substance abuse, the faculty has adopted the following basic assumptions of the American Association of Colleges of Nursing Policy and Guidelines for Prevention and Management of Substance Abuse in the Nursing Education Community (1998):
- substance abuse compromises both the education process and patient safety and must
be addressed by schools of nursing;
- academic units in nursing have a commitment to and a unique role in the identification
of abuse, intervention, referral for treatment, and monitoring of recovering individuals;
- addicted individuals need to recognize the consequences of their substance abuse;
- addiction is a treatable illness, and rehabilitative and therapeutic approaches are
effective in facilitating recovery;
- individuals with addictive illnesses should receive an opportunity for treatment in
lieu of, or before disciplinary action (p.2).
Definitions and Assumptions
The WSON faculty define the chemically impaired student as a person who, while in
the academic or clinical setting, is under the influence of, or has abused, either
separately or in combination, mind-altering substances including alcohol, over-the-counter
medications, prescribed medications, illegal drugs, inhalants or synthetic designer
drugs.
Chemical abuse is a disease process with physical, social, emotional and spiritual aspects that can have either episodic or chronic presentations.
Chemical abuse is a condition that can be treated successfully and that individuals
can be returned to a productive level of functioning.
A student known to be chemically impaired places a legal and ethical burden on WSON
faculty and administration. Legal ramifications of a chemically impaired nursing student
are injury to patients and potential malpractice, implicating the student, faculty,
clinical agency, and educational institution. WSON faculty has a responsibility to
intervene when patient safety and clinical performance are compromised by a student
who is chemically impaired. When chemical impairment is suspected, the WSON Procedure
for Faculty Intervention with the Chemically Impaired Nursing Student will be implemented.
The policy on the chemically impaired student nurse incorporates the following components:
- Prevention and education to WSON students, faculty, and staff regarding substance
abuse and addiction.
- Procedure for drug testing.
- Identification of suspected chemically impaired nursing students during the time the
student is enrolled in the nursing program.
- Intervention whereby student is confronted with his or her reported behaviors and
is asked to seek evaluation of a possible substance abuse problem.
- Evaluation and referral for treatment.
- Provisions for re-entry to WSON upon successful rehabilitation.
- Disciplinary procedures for a chemically impaired student who is unable or unwilling
to be rehabilitated.
Prevention and Education
Education is a crucial component in the management of substance abuse. WSON students, faculty, and staff will be provided information about substance abuse, along with the consequences of impairment due to abuse and addiction. During the WSON orientation process, the Chemically Impaired Student Nurse Policy and Procedures will be disseminated and reviewed, along with information on services and programming offered by the Student Success Services at Kennesaw State University (91青青草), the Collegiate Recovery Center at 91青青草 and the 91青青草 Health Center.
Procedure for Drug Testing
Drug and breathalyzer testing must be conducted by a qualified laboratory using established methods and procedures. Cost associated with drug and breathalyzer testing is the responsibility of the student. The procedure for urine collection, as determined by the collection site, will involve a witness to the voiding of the urine sample, securable urine containers, and chain of custody procedures. The urine sample will be screened for drugs as identified in Appendix B of this document. A drug test will be deemed positive if any of the drugs listed in Appendix B are identified. If a urine test is positive, a second test will be conducted on the original urine specimen. If the test is positive, the available evidence, including health history, will be used to determine the presence or absence of drug abuse. The testing laboratory will notify the Director of the WSON with test results. The WSON will ensure confidentially of results by making the information available only to the student and appropriate WSON Administrators, Faculty, and clinical agencies (when needed).
Procedures for Faculty Intervention with the Chemically Impaired Student Nurse
The WSON Faculty will follow the University鈥檚 policy prohibiting the illegal possession, use, or distribution of drugs and/or alcohol by students on University property or as part of any University affiliated academic activity, including off-campus learning activities, such as clinical. Violators will be prosecuted in accordance with applicable laws and ordinances and will be subject to disciplinary action by the University in conformance with University policy (See 91青青草 Student Handbook and Daily Planner regarding Student Code of Conduct鈥擴se and Possession of Drugs, Including Alcohol).
Identification
Indicators suggesting chemical impairment of a student鈥檚 ability to meet standards of performance, competency, and safety are gathered and documented (See Appendices D and E).
While an isolated incident may not indicate substance abuse directly, the occurrence of several incidents should be documented on the Reporting Form for Alleged Chemically Impaired Student (Appendix E).
If impairment is observed, the student must submit to random drug testing as described in the section on Drug Testing Procedure and in Appendix C. Refusal of a student to submit to testing may result in disciplinary action, including dismissal from the nursing program in accordance with the WSON policy.
Faculty who suspect student impairment are to notify the WSON Director of their concern.
Faculty is advised to keep detailed, anecdotal notes that describe the events involving the students. Identification of impairment should be based on a pattern of observable, objective, and quantifiable behaviors. Notes should document the date, time of day, location of the event, persons present, and a description of what took place.
If the student demonstrates impaired behaviors (see appendices D and E for examples
of such behaviors) that compromise patient safety and/or academic performance, remove
the student to a private area. With a neutral party present (i.e., clinical manager,
91青青草 Faculty) discuss with the student behaviors observed and allow the student to
provide a verbal explanation. Question the student regarding the use of substances
and, if used, what, when, how much was used, and by what route consumed.
If symptoms or other indicators of impairment are observed in a student, the student will be informed of the faculty鈥檚 responsibility to dismiss a student who is physically or mentally unable to meet the standards of performance, competency, and safety. The student is to be relieved of further clinical/laboratory/classroom responsibilities for the day. Inform the student that she/he is suspected to be in violation of the 91青青草 WSON Chemically Impaired Student Nurse Policy Procedure Statement. It is the student鈥檚 responsibility to arrange safe transportation to the nearest Advantage Testing facility for immediate testing. Faculty may assist in making the transportation arrangements and will document how the student left.
Intervention
Phase I
Faculty completes a report of the alleged chemically impaired student nurse with observed
behaviors indicative of chemical impairment (see Appendix D).
Faculty informs student of observations indicative of chemical impairment. Student
must submit to drug testing at the time of the reported behaviors. The test will be
conducted by a qualified laboratory using established methods and procedures.
The student is to be relieved of further clinical/laboratory/classroom responsibilities
until a comprehensive professional evaluation of chemical abuse can be completed.
A copy of this report is given to the student and the WSON Director. The student is informed that a copy of this report will be placed into the student鈥檚 file.
WSON Director informs all other appropriate faculty members also involved with the student during the semester on a 鈥渘eed to know鈥� basis.
WSON Director reviews the procedural requirements of the 91青青草 WSON Chemically Impaired
Student Nurse Policy.
Refusal of a student to submit to immediate testing or to any other requirement of
this Chemically Impaired Student Nurse Policy/ Procedures may result in disciplinary
action, including dismissal from the nursing program in accordance with the WSON policy.
Phase II
Within five working days of the filing of a report of alleged student chemical impairment, a conference is scheduled with the student, involved faculty member, committee member of the Advisory Committee to Faculty on Clinical Performance, and WSON Director. In addition, a Counselor from Student Success Services at 91青青草 will act as a neutral party, but not enforce nursing policies. The WSON Director will take the lead in conducting the conference.
Purposes of conference are to:
- convey concern for the student as caregiver as well as concern for the patients;
- explain how the behavior interferes with the student鈥檚 performance in the course;
- explain academic consequences resulting from the student鈥檚 chemical impairment identification;
- secure student agreement to a comprehensive chemical abuse evaluation for the purpose
of professional evaluation of chemical abuse status and the determination of a treatment
plan.
A written contract for the chemically impaired student nurse (see Appendix F) is reviewed and the student is requested to agree to the terms set forth. WSON Director asks the student to sign the contract and the Agreement for Monitoring the Chemically Impaired Student (see Appendix G) confirming that the student understands the terms of the contract and academic consequences. If the student refuses to sign the contract, the student may be administratively dismissed from the nursing program in accordance with the WSON policy. (see Policy on Unsafe Practice in 91青青草 WSON Student Handbook).
WSON Director provides student with a list of state licensed agencies that provide chemical abuse evaluation services (see Appendix A). WSON Director also reviews with student that he/she is responsible for the cost of the chemical abuse evaluation and any prescribed treatment.
Other issues to be considered when obtaining treatment:
- Realize the potential of suicidal risk upon intervention/confrontation of an issue
of concern, and the time lapse to have an evaluation.
- There are options on campus at 91青青草 for the student to obtain evaluation, counseling
and treatment services: The Collegiate Recovery Center, the 91青青草 Health Clinic and
Student Success Services
- Have student/parent check insurance plan to see what providers are in network.
- Utilize county mental health facilities if the student does not want to use services
available on campus and insurance or finances are an issue.
- Many treatment centers will do an initial triage for free, to at least evaluate for
any risk of self-harm, and will provide resources for students.
Evaluation
Upon completion of a comprehensive professional evaluation of chemical abuse status,
one of four courses of action may be taken by the WSON with the student:
- Non-validation of the Violation of the 91青青草 WSON Chemically Impaired Student Nurse Policy (i.e., the comprehensive chemical abuse evaluation does not support/substantiate the alleged report of student behaviors indicative of chemical impairment). In the event of a non-validation of violation, all documentation will be removed from the student鈥檚 file. Upon receipt of a negative drug test and written recommendations of the chemical abuse evaluator that there is no evidence of substance abuse, the student may return to all courses in progress with no academic penalty related to chemical impairment.
- Validation of the Violation Without Implementation of the 91青青草 WSON Chemically Impaired Student Nurse Policy (i.e., the comprehensive chemical abuse evaluation supports/substantiates the alleged report of student behaviors indicative of chemical impairment and the student refuses to follow the policy regarding treatment and monitoring). If the student refuses to sign the contracts for monitoring and return to the nursing program (See Appendices F & G), then the student may be administratively dismissed from the nursing program by the WSON Director. WSON Director will point out that it is in the student鈥檚 interest to accept the outlined treatment and monitoring for chemical abuse.
- Validation of the Violation With Implementation of the 91青青草 WSON Chemically Impaired
Student Nurse Policy (i.e., the comprehensive chemical abuse evaluation supports/substantiates
the alleged report of student behaviors indicative of chemical impairment and the
student agrees to follow the policy regarding treatment and monitoring). Student signs
the contracts for monitoring and return to the nursing program (See Appendices G &
H), and is allowed to continue in the nursing program as long as the student is in
compliance with his/her substance abuse treatment program.
- Mixed or Inconclusive Results of the Chemical Abuse Evaluation. The student will be given the option to seek another mental health assessment. The monitoring and treatment agreement will then depend on the outcome of the second evaluation. If the student requires professional treatment, the student will sign a written plan of action for correcting the behavior, with a realistic time frame for meeting the recommendations of the action plan. The student will be allowed to continue in the nursing program as long as the student is in compliance with the negotiated action plan.
Academic Outcome
The academic consequences required with the implementation of the 91青青草 WSON Chemically Impaired Student Nurse Policy is contingent upon the completion of the substance evaluation or follow up mental health assessment, and agreement of the treatment/action plan if indicated. A semester grade of 鈥淲鈥� (Withdrawal), 鈥淚鈥� (Incomplete), or 鈥淔鈥� (Failure) will be assigned to courses dependent upon factors related to grade determination as outlined in the 91青青草 Undergraduate and Graduate catalogs. If no treatment for chemical abuse or mental illness is required, the student may return to all courses in progress upon receipt of the written recommendation from the professional evaluator.
Other
All students must be aware that the state examining board has the right to refuse
to grant a registered nurse license to any individual regardless of educational credentials
under circumstances of (1) falsification of application for licensure; and/or (2)
conviction of a felony or crime of moral turpitude; other moral and legal violations
specified in the Georgia law.
Re-entry to WSON
Upon successful completion of a treatment program as outlined according to the written
plan by the chemical abuse evaluator or mental health counselor, the student can apply
for re-entry to the nursing program for the semester the student desires to return
or if there is an opening on a space available basis.
The student will be expected to provide written documentation of the course of specialized treatment together with the treatment or mental health counselor鈥檚 written assessment of the student鈥檚 ability to perform the academic/clinical requirements of the nursing program following treatment to the WSON Director. In addition, any restrictions of the student鈥檚 activities (i.e., limiting access to narcotics, schedule for counseling and self-help group meetings) are to be addressed in the written counselor鈥檚 assessment.
Participation in support programs for recovery from chemical dependence is a lifelong process. The cornerstone to this process is ongoing participation in twelve-step and other support program meetings. Students will be encouraged to attend such meetings and be given necessary time to do so when possible.
Noncompliance/Relapse
If additional or continuing chemical impairment occurs subsequent to the implementation of these procedures, the WSON faculty will recommend that the student be administratively dismissed from the nursing program by the WSON Director. The student has the right to grieve and appeal the procedure according to the University guidelines.
- Appendix A: Chemical Abuse Policy Quick Reference Sheet for Faculty
- Appendix B: List of Treatment Centers Providing Chemical Abuse Evaluation Services
in Metropolitan Atlanta
- Appendix C: List of Drugs Included in Drug Screening Test
- Appendix D: Consent for Drug Testing Upon Admission to WSON
- Appendix E: Indicators of Chemical Dependence
- Appendix F: Reporting Form for Alleged Chemically Impaired Student
- Appendix G: Contract for the Chemically Impaired Nursing Student
- Appendix H: Agreement for Monitoring the Chemically Impaired Student
- Appendix I: Contract for Return to Nursing Program
- Appendix J: Chemically Impaired Student Withdrawal Letter
- Appendix K: Chemically Impaired Student Nurse Letter for Returning to the Nursing
Program
- Appendix L: Chemically Impaired Student Dismissal Letter
APPENDICES
