Investigating a Nurse With Suspected Substance Use Disorder: Guidance for Nurse Leaders and Hospital Administration

Abstract

Substance use while on duty and diversion of controlled substances represent significant societal and economic challenges facing healthcare facilities, the nursing profession, and occupational licensing boards. Nursing-specific policies and education for healthcare staff will aid in protecting patients through early identification of substance use disorder (SUD) and diversion. Such actions could be the first step in supporting nurses in need of assistance and facilitating entry into treatment for substance use disorders, when appropriate. Established healthcare facility policies will assist in conducting a thorough investigation and could facilitate swift action by state boards of nursing (BONs) to protect patients and nurses. Collaboration between a healthcare facility and a BON is an essential element of the regulatory mandate to protect the public. The North Carolina Board of Nursing has developed state-specific processes that could be beneficial to healthcare facilities and other BONs. This manuscript will detail the processes of conducting nurse SUD and drug diversion investigations with the goal of developing nursing regulatory guidance to enhance public protection.