New Hampshire Nursing News - June 2022

June, July, August 2022 New Hampshire Nursing News • Page 19
to diversion of medication, impairment, alcohol,
and other drugs. For Fiscal Year 2020, the NHBON
received 310 complaints; however, the data for
categorizing and tallying the complaints was not
listed on the OPLC Annual Report or captured by
the NHBON (L. Courtney, personal communication,
January 22, 2021). The NHPHP is currently
monitoring 23 nurses and four Licensed Nursing
Assistants known to the NHBON, and they also
have four nurses under voluntary monitoring that
are unknown to the NHBON (S. Garhart, personal
communication, November 9, 2020).
Diverting controlled substances is a tactic that
healthcare providers with SUD sometimes employ.
Communication, interventions, and programs for
people in crisis or who misuse substances are not
benign. In the past, impairment and diversion were
often met with only discriminatory and punitive
practices where the process of being worked up
for SUD in the workplace or licensure board led to
bad outcomes. The thought of losing one’s license
and means of making a living, not having money
for treatment, medications, or legal fees can be
devastating. The result is individuals do not seek
help. This alienates colleagues, co-workers, and/or
work supervisors whou could assist the individual,
by connecting them to a non-punitive pathway
of self-reporting and treatment options through
the NHPHP. Workplace policies can outline these
non-punitive pathways. Today, we can empower
our nursing workforce to self-report rather than
gamble with broadly administered discipline once
misconduct is reported or risk patient harm. Much
time, energy, and money go into shaping highquality
providers, as the healthcare workers’
shortage exemplifies. Access to quality treatment
for nurses and healthcare workers who struggle with
SUD needs to be readily available to protect the
public, the families of the providers, and hopefully,
allow for a return to safe practice.
The appropriate treatment level for someone with
SUD may include residential care or intensive
outpatient therapy; an extended monitoring
program follows both. In a meta-analysis, Geuijen
et al. (2021) found that monitoring programs, like
NHPHP, demonstrated pooled success rates of 72%
for abstinence and 77% for work retention. Much
less is known about those who have fallen through
the cracks or were lost to suicide. Organizations
that successfully incorporate recovered nurses
foster support rather than stigma, provide exemplars
who have overcome addiction, and better detect
undiagnosed addictions, improving workforce
quality (Parsa, 2011). Stigma and lack of awareness
may result in the underutilization of alternative to
discipline programs like the NHPHP. Preserving
professional viability by facilitating treatment and
reducing discipline benefits the healthcare system
and the public.
Does your organization have a comprehensive
program that speaks to suspicion of impairment and
diversion? Is there routine education of all providers
on the clinical presentation of SUD and resources
to approach it? If not, there are resources to
develop and institute a process for safely addressing
situations. A milieu can be established where
nurses know that facing seemingly unbearable
personal or professional challenges can happen
and that seeking support is the right thing to do.
There is hope. Those suffering from SUD are not
alone; they can get help and arrive in a better
place. As with many diseases, the sooner signs and
symptoms are addressed, the more opportunity
there is to circumvent catastrophic consequences.
You can spread the word that addiction benefits
from treatment, notice and address concerning
behavior in your family, friends, and colleagues,
and support the alternative to discipline approaches
for concerns related to alcohol and other drugs.
Ensure that your team and our nursing workforce
understand that NHPHP is confidential and ready
to support practitioners experiencing various
difficulties, including SUD (nhphp.org). National
resources include the Substance Abuse and Mental
Health Services Administration’s national helpline
(1-800-662-HELP), Narcotics Anonymous (na.
org), Alcoholics Anonymous (aa.org), and the
National Suicide Prevention Lifeline (1-800-273-
8255). Because patient safety is a priority, we as a
community can better protect patients, preserve
careers, and save lives when the risks of SUD in
healthcare providers are addressed early.
Kisha Thompson MS, CRNA, is a per-diem Nurse
Anesthetist at Cheshire Medical Center in Keene,
NH. She is a Board Trustee for the New Hampshire
Association of Nurse Anesthesiology. She is also a
State Peer Advisor for the American Association of
Nurse Anesthesiology. As such, she is available to
provide support and information for those engaged
in substance misuse. Her past education includes
a Bachelor of Science degree from Johns Hopkins
University and a Master of Science degree from
Georgetown University. Additionally, she retired, at
the rank of major, from the Army Reserve.
I have no conflicts of interest nor any commercial
affiliation.
Contact Info:
Kisha Thompson MS, CRNA
Kisha.lifgren@gmail.com
914-260-2218
References
Cornwall, L. (2018, December 12). RNnetwork 2018
Portrait of a Modern Nurse Survey. RNnetwork.
https://rnnetwork.com/blog/rnnetwork-2018-portraitof-a-modern-nurse-survey/
Davidson, J. E., Proudfoot, J., Lee, K., Terterian, G.,
& Zisook, S. (2020). A longitudinal analysis of
nurse suicide in the united states (2005-2016)
with recommendations for action. Worldviews on
NHNA Student Nurse of the Year
Sara Fazzi Garcia
The NHNA Commission on Nursing Practice hosts
an annual graduating student nurse conference at
which time we award the NH Student Nurse of the
Year Award. Commission members have identified
five qualities that should be exemplified by the
professional nurse these include: Professionalism
(Competence and Qualities), Patient Advocacy,
Leadership, and Involvement in Nursing/Community
ANA Enterprise. This year’s award winner was Sara
Fazzi Garcia, a second year Direct Entry Master’s
Student from the University of New Hampshire. Sara
was nominated by her advisor Pamela Kallmerten,
RN, DNP, PHD. The nomination narrative included
the following:
Ms. Fazzi Garcia entered the Direct Entry Master's
in Nursing (DEMN) program with a previous degree
in Fashion Technology and from the beginning, it
was clear that she had made the right decision for
nursing. While she has had faculty report that she
needs support for caring for her patients through
psychomotor skills due to the disparate competencies
between her previous program of study and nursing,
there is never any doubt for her caring about her
patients well-being. She constantly nurtures those
in her care in the professional as well as informal
Evidence-Based Nursing, 17(1), 6-15. https://doi.
org/10.1111/wvn.12419
DuPont, R. L., & Merlo, L. J. (2018). Physician health
programs: A model for treating substance use
disorders. Judges' Journal, 57(1), 32-35.
Geuijen, P. M., van den Broek, S. J. M., Dijkstra, B. A.
G., Kuppens, J. M., de Haan, H. A., de Jong, C. A.
J., Schene, A. H., Atsma, F., & Schellekens, A. F. A.
(2021). Success Rates of Monitoring for Healthcare
Professionals with a Substance Use Disorder: A
Meta-Analysis. Journal of Clinical Medicine, 10(2).
https://doi.org/10.3390/jcm10020264
Mumba, M. N., & Kraemer, K. R. (2019). Substance use
disorders among nurses in medical-surgical, longterm
care, and outpatient services. MEDSURG
Nursing, 28(2), 87-118.
Parsa, N. (2011). Reasons to Hire Recovered Physicians.
Physician Executive, 37(4), 58-61.
Stone, L., Rice, J., & Garcia, R. (2021). Addressing
substance use disorder and diversion in the
healthcare environment. American Nurse Journal, 16
(2). https://www.myamericannurse.com/addressingsubstance-use-disorder-and-diversion-in-thehealthcare-environment/
Sutherland, S. (2017, February 28). Portrait of a modern
nurse survey finds half of nurses consider leaving the
profession. RNnetwork. https://rnnetwork.com/blog/
rnnetwork-nurse-survey/
Wright, E. L., McGuiness, T., Moneyham, L. D.,
Schumacher, J. E., Zwerling, A., & Stullenbarger, N.
E. N. (2012). Opioid abuse among nurse anesthetists
and anesthesiologists. AANA Journal, 80(2), 120-128.
caregiver roles. She is an authentic listener and
manages to care for her family, their friends, her
peers and her patients.
The ideal nurse has an appreciation for the skills for
entry into practice and she (Sara) is competent in this
regard. She reflects in the moment as well as after the
moment has passed-the ability to reflect in action and
on action. She verbalizes "how could I have improved
my care?" She goes beyond what is competent
to what is exemplary practice during a time of
compassion fatigue. It is clear that the tenets of
diversity, equity and inclusion are woven throughout
her practice. It is clearly demonstrated with her
actions that her sense of social justice and health
equity are foremost in her mind. She has an uncanny
ability to stop everything and ask "what really matters
here" and is not afraid to let things go to prioritize
the needs of the vulnerable person whether it be a
patient, their family or someone from her personal
encounters. She is always a nurse, demonstrating that
she sees her role as their advocate.
She is an authentic, humble leader who will do
doubt continue to represent the best of nursing
during these challenging times. Like her peers,
she has had many opportunities for community
based care including vaccination clinics. She was
also recently inducted into the Eta Iota At Large
Chapter of Sigma Theta Tau International. She is a
certified lactation consultation and is leveraging
this knowledge for a quality improvement project to
support the Baby Friendly Hospital Initiative at her
organization. She was invited to apply to become
a member of the organizational team before midsemester
of her immersion. It is my belief that they
recognize her potential as I do for a life-long career
in service to her community.
Like her peers, she has had many opportunities for
community based care including vaccination clinics.
She was also recently inducted into the Eta Iota At
Large Chapter of Sigma Theta Tau International. She
is a certified lactation consultation and is leveraging
this knowledge for a quality improvement project to
support the Baby Friendly Hospital Initiative at her
organization. She was invited to apply to become
a member of the organizational team before midsemester
of her immersion. It is my belief (Dr.
Kallmerten) that they recognize her potential as I do
for a life-long career in service to her community.
CONGRATULATIONS SARA