Hi! Welcome to the Program for Recovering Nurses (PRN) online worksite monitor training.
*We encourage you to participate in this online training using a desktop or laptop. The use of a mobile device may be difficult and cumbersome.
The purpose of this training is to get the PRN worksite monitor familiar with:
- The PRN program
- Work Requirements for the PRN Nurse
- PRN Worksite Monitor Requirements
- Substance Use Disorders and Signs of Impairment in Nurses
This training consists of reviewing some educational materials, watching a video on substance use disorder in nurses and completing a short quiz. This process should take you approximately 30 minutes.
About the PRN Program
The Program for Recovering Nurses (PRN) is a confidential alternative to formal disciplinary action offered by the Idaho State Board of Nursing. This program monitors impaired nurses suffering from substance use disorders, mental health issues, or behavioral problems. The PRN works in conjunction with the Idaho State Board of Nursing to assist in the education of nurses and employers regarding provisions of the Nursing Practice Act and providing a safe environment in a health care setting.
The Board believes that nurses who acknowledge that their practice may be impaired as a result of a substance use disorder or mental conditions and who are actively engaged in recognized recovery methods and as a result do not represent a threat to the public, should be allowed to continue practicing nursing. In order to ensure public safely, the Board supports monitoring of these nurses outside of the process of formal disciplinary investigation and action under provisions that ensure support of recovery and prevention of relapse.
The purpose of the program is to assist nurses and their families in identifying alcohol, drug, or behavioral problems that pose a potential threat to that nurse, the family, or the patients. The PRN will work to identify and facilitate acute treatment and to provide long-term support for the nurse to return to a productive place within his/her profession. While the program provides no direct counseling, treatment, or aftercare services, it does support and endorse the development of self-help groups at the local level.
The Idaho Board of Nursing Believes:
- Alcohol and/or substance use and mental health disorders are primary illnesses.
- These illnesses may impair the nurse’s ability to practice safely.
- Appropriate treatment and aftercare can assist nurses in their recovery.
- Assistance programs that include treatment and monitoring are effective in protecting the public while assisting the nurse in recovery.
- Nurses who willingly cooperate with an assistance program by complying with treatment and monitoring requirements should be allowed to avoid disciplinary action.
The PRN’s Mission Statement:
Protecting public safety, health and welfare by assisting nurses in their recovery and return to safe practice.
The Idaho Board of Nursing supports an alternative to discipline for nurses who have been (or are likely to be) charged with violating the Nursing Practice Act, but who are willing to stipulate to certain facts and enter a program approved by the Board. The Board offers three enrollment options for this alternative to disciplinary action. They are self, non-board referral and board referral. Details on these tracks can be viewed on the Program for Recovering Nurses page under Monitoring.
Work Requirements for the PRN Nurse
Since you have been asked to serve as a worksite monitor for the PRN nurse, that means the PRN nurse has successfully undergone the evaluation process and started treatment (if recommended). They have also signed their PRN monitoring contract and have permission to return to work.
So, what is the work restrictions associated with a PRN nurse?
The standard restrictions include:
- work under supervision with a worksite monitor,
- not allowed to work night shift (11pm-7am),
- no work in a home health setting, as a traveling nurse, or with a temporary agency,
- not to work more than 40 hours per week in the nursing field,
- no rotating shifts or floating units,
- no work in an ER, CCU, ICU, OR, and/or recovery room, and
- no access to narcotic keys or controlled substances (including any mood altering drugs).
These stipulations will remain in effect until written approval is given by the PRN.
Does a Nurse have these Restrictions for the entire 5 years?
No, these work restrictions can be lifted over time in the program. The client can make a request to the PRN program for a restriction to be lifted. After a case review and collection of collateral information, the PRN will inform the nurse if a practice restriction has been lifted. The worksite monitor will be copied on that letter.
PRN Worksite Monitor
As a worksite monitor for the PRN, you will be sent a packet of information that includes a letter detailing the client’s contract requirements and work restrictions, worksite monitor instructions, a work performance report, Signs of an Impaired Nurse handout, Identification of Impairment in the Workplace handout, business cards and a worksite monitor agreement. The worksite monitor agreement is a signed document the worksite monitor returns stating that they agree to the following statements:
- I will be available to the nurse by working the majority of the same shifts.
- If I am in recovery I have at least two (2) years of sobriety.
- I am familiar with the warning signs of relapse (found in Signs of Impairment handout, Identification of Impairment in the Workplace handout).
- I am a licensed health care professional in a position at or above the management step of the re-entering nurse
- I am willing to communicate with the Program for Recovering Nurses (PRN) regarding the nurse.
- I agree to notify PRN immediately of any concerns about the nurse’s practice, behavior, etc.
- I agree to maintain strict confidentiality of the nurse’s enrollment in PRN.
- I am responsible for face to face observation of the nurse to assess and document practice and behavior as well as support recovery.
- I am responsible for completing the required progress notes.
- I am responsible for observing and reporting workplace performance and behavior, to include: time and attendance adherence, relationships with colleagues, and compliance with work conditions.
The PRN and the Idaho Board of Nursing takes workplace monitoring very seriously. Your part in a PRN’s nurses program is an important part of protecting the public. The worksite monitor may be the first to notice red flags in a PRN’s nurses program. They are also very helpful in documenting that the nurse is on the right track with their program.
In order to document how things are going in the workplace, the PRN office will request a quarterly Work Performance Report from you. This report allows you to give input on the PRN nurse’s professional ability and performance of duties, responsibility to handle narcotics, interpersonal relationships, behavior issues or concerns, and attendance. At the bottom of that report, it asks if you would like the PRN office to contact you. Please mark yes if you need to have the PRN office reach out to you. We will also be calling in between the written quarters to inquire about how the nurse is doing in the work place. Other reasons PRN might contact you is to report positive drug screens, discuss concerning behaviors or to get your input on a PRN nurse’s request to decrease contract requirements or lift a work restriction.
- The below link has a sample Work Performance Report filled out.
- Click this link to view a sample worksite monitor packet.
Substance Use Disorders and Signs of Impairment in Nurses
The National Council of State Boards of Nursing has put together a fantastic video about substance use disorders in nursing. The video is about 12 minutes long and cover topics such as:
- Substance Use Disorder
- Nurses and Substance Use Disorder
- Identification and Reporting
- Investigation and Intervention
- Protection of the Public
- Return to Practice
Since PRN is an alternative to discipline program, some of the things mentioned in the video are handled by the PRN. We can:
- Assist in or perform interventions.
- Facilitate the referral for an evaluation and placement in a treatment program
- Monitor the PRN nurse on a recovery contract. These requirements include, but are not limited to, tracking meeting attendance, support group attendance, drug testing (urine, blood, hair, nail, breath), updates from a worksite monitor, updates from a counselor/therapist, and updates from a medication management provider.
Please click on this link to view the Substance Use Dsisorder in Nursing Video.
Now you are ready for the quiz. Please click on this link to pull up a copy of the Impaired Nurse handout, which will assist you in answering a few of the questions.
Click on this link to view the quiz. https://docs.google.com/forms/d/e/1FAIpQLSe0hKvDuCpUnSRLHkKguriajZhI99G2Bk0YJaEuXzNa_OykUw/viewform?usp=sf_link
After you submit the quiz, please notify the PRN nurse compliance monitor. They will collect the response and answer any questions regarding missed answers.
This concludes PRN’s worksite monitor online training. If you have any questions or need more detail about anything, please contact us at (208) 323-9555. Be sure to ask for the Program for Recovering Nurse Compliance Monitor.