What is the Diversion Program?
The Board of Registered Nursing (BRN) is one of several professional regulatory boards and bureaus that exist within the Department of Consumer Affairs. The BRN has the primary responsibility of licensing and regulating registered nurses in California. The BRN’sresponsibilities come from the Nursing Practice Act, which is composed of California statutes that give the BRN, among other functions, the authority to manage a Diversion Program for registered nurses.
The Diversion Program is a voluntary, confidential program for registered nurses whose practice may be impaired due to substance use disorder or mental illness. The goal of the Diversion Program is to protect the public by early identification of impaired registered nurses and by providing these nurses access to appropriate intervention programs and treatment services. Public safety is protected by suspension of practice, when needed, and by careful monitoring of the nurse.
What Service Does the Program Provide?
- Confidential consultation when considering entering the program
- Assessment and referral for appropriate detoxification or treatment
- Development of a rehabilitation plan for substance use disorders or mental illness
- Consultation with employers to assure a safe and smooth transition back to nursing practice for the nurse participant
- Random body fluid testing
- Referrals to local support services
- Encouragement, support, and guidance for the registered nurse in recovery as an effective alternative to disciplinary action, and determination that the registered nurse is able to resume nursing practice
Why is the Program Needed?
Registered nurses are not immune from the diseases of substance use disorder or mental illness. Experts estimate that at least 10% of the general population will have a problem with alcohol or drugs at some point in their lives. Health care professionals, including registered nurses, may be particularly susceptible to substance abuse problems due to the stresses of working in a health care environment and due to an increased opportunity to obtain controlled substances.
Many registered nurses who experience problems with substance use disorders are able to find the help and support they need to stay clean and sober without BRN involvement.
Mental illness, although not as prevalent, is also a disease that may affect a registered nurse’s ability to practice safely. For example, untreated major depression can seriously impair an individual.
Unfortunately, most people suffering from substance use disorder or mental illness deny the problem. Many times they are the last to recognize and admit that they need help. If mental illness or substance use disorder problems are left untreated, they may eventually jeopardize patient health and safety. They can also threaten the life of the person afflicted.
In these cases, it becomes imperative that those individuals who detect substance abuse or mental health problems in a registered nurse take action. Without intervention, diseases have predictable courses and outcomes. The BRN’s Diversion Program aims to identify symptoms, intervene, and change the outcomes.
The Diversion Program also provides an effective alternative to the traditional disciplinary process.
Who is Eligible?
Registered Nurses Who:
- are licensed and reside in California
- are mentally ill or abuse alcohol or drugs to the extent that their nursing practice may be affected, and
- voluntarily agree to enter the program and provide consent for appropriate medical or psychiatric evaluations
Registered Nurses are Ineligible for the Program if They Have:
- previously been disciplined by the Board for substance abuse or mental illness,
- been terminated previously from this program, any other diversion program for non-compliance,
- sold drugs, or
- caused patient harm or death
How Does an RN Get Into the Program?
Nurses enter the program in one of two ways:
- Self-Referral – Registered nurses who would like assistance may contact the program directly.
- Board-Referral – Registered nurses are referred to the Diversion Program by the BRN as a result of a complaint indicating the RN may be impaired due to substance use disorder or mental illness. If a nurse chooses not to enter the program, the complaint is referred to the Enforcement Program for investigation and possible disciplinary action.
Is the Diversion Program Successful?
Yes! Over 1,900 registered nurses have successfully completed the program. To complete the Diversion Program, a nurse with a substance use disorder must demonstrate a change in lifestyle that supports continuing recovery and have a minimum of 24 consecutive months of clean, random, body-fluid tests. A nurse with a history of mental illness must demonstrate the ability to identify the symptoms or triggers of the disease and be able to take immediate action to prevent an escalation of the disease.
The success of the Diversion Program is due to close monitoring of participants for an average of three years, but more importantly, it is attributable to the encouragement, support and guidance provided to nurses by other nurses.
Is the Program Confidential?
Diversion Program staff are available for confidential consultation regarding possible referral to the Diversion Program.
The confidentiality of participants is protected by law. Once a nurse enters the program, the information gathered to assist in developing a rehabilitation plan, and all other information in their record, is confidential.
When a nurse successfully completes the Diversion Program, the Diversion Program records are destroyed. If a nurse does not successfully complete the program, the original complaint, if any, is investigated by the Board’s Enforcement Program. (As of January 1, 2000, Diversion Program records may be forwarded to the Board’s Enforcement Program if a registered nurse who is terminated from the Diversion Program presents a threat to the public or his or her own health and safety.
Where Can I Get Additional Information About the Diversion Program?
For general program information, to schedule intake appointments or interventions, and for questions regarding monitoring nurses in the program, call 1-800-522-9198.
For questions regarding the Diversion Program or the Board of Registered Nursing’s role in protecting public safety and identifying impaired practitioners, contact the Board’s Diversion and Probation Programs Manager and staff at (916) 322-3350.