Georgia's drug-abusing nurses get 'secret sanctions' amid opioid crisis

The Georgia Board of Nurses handles over half of its disciplinary cases in secret — meaning patients cannot know which nurses are abusing drugs, how many nurses are addicted or how many relapse, an Atlanta Journal-Constitution investigation found.

Six things to know:

1. The AJC noted one case in which a registered nurse from LaGrange, Ga., displayed "strange behavior" while caring for patients. The nurse's supervisors found patients had not received their medication 27 times — prompting the board to issue a confidential order. The order came to light only after the opioid-addicted nurse failed to comply and had her license suspended.

2. Other Georgia nurses with substance abuse issues have been given second, third and fourth chances when they relapsed, the AJC investigation revealed. The board put one nurse on probation in 2002 for chemical dependence, again in 2013 after she was fired for diverting morphine, and again in 2017 after she had another relapse.

3. GOP Rep. Sharon Cooper of Georgia, MSN, RN, said the nursing board, which consists of nearly all nurses, is more concerned with protecting the nursing profession than patients. "We have boards to protect the public, not to be soft touches," Ms. Cooper said. "I know how bad the drug problem is. And so I really think that the first priority should be to the patient's protection."

4. Janice Izlar, RN, CRNA, who has been president of the nursing board since July 2016, said patient protection is the priority. However, the secrecy helps get nurses more quickly under the board's supervision so the board can monitor them and hold them accountable, Ms. Izlar said.

If the board gets into a battle over trying to revoke nursing licenses, it can be stuck in legal battles for several years, which means these nurses would still be caring for patients without any monitoring from the board, Ms. Izlar said. The lengthy investigative process frequently ends up with an addiction specialist certifying a nurse in recovery is safe to practice, with conditions to keep the nurses under closer supervision, she added.

5. Instead, the board often offers private orders as a way to negotiate this process. "Many times, the nurse does not want their name on a public Board of Nursing website that there has been discipline action," Ms. Izlar said. "And so they will accept the order and actually get under monitoring and under appropriate care that has been determined by their physician. And they will actually sign this order much quicker, and they will go ahead and get into the programs and into monitoring much quicker."

Among other requirements, drug-addicted nurses are required to enter aftercare treatment, submit to random drug screens, notify employers, submit quarterly reports from employers and the nurse's physician and steer clear of jobs with access to drugs. However, these terms end as soon as the order ends, so the drug history of nurses who received private orders remains concealed.

6. Out of 333 disciplinary orders the Georgia Board of Nursing issued in 2017, over half (54 percent) were private, according to statistics the AJC obtained through an open records request. Ms. Izlar said just under half of last year's private orders were alcohol- or drug-related. She could not say how many of the cases involving opioids, she said.

"We encourage consumers to do their homework about their hospitals and providers," said Beth Stephens, a senior policy director for Georgia Watch, the state's leading nonprofit consumer advocacy organization. "So if information about provider discipline is shielded from the public, it makes doing that research very difficult."

More articles on opioids: 
FDA innovation challenge seeks devices to prevent, fight opioid abuse
Congress 'too scared to take on the AMA' in fighting opioid crisis, senator says
How Philadelphia's EDs are combating the opioid crisis

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