Registered Nurses in Recovery:
BRN's Diversion Program
What is the Board of Registered Nursing?
The Board of Registered Nursing (BRN) is a State agency within the Department of Consumer Affairs that licenses and regulates registered nurses (RNs) in California. The Nursing Practice Act details the functions of the Board, including a program for RNs suffering from substance use disorders or mental illness. This program is known as the Diversion Program.
What is the BRN's Diversion Program?
The Diversion Program is a voluntary, confidential, rehabilitation program for registered nurses whose nursing practice may be impacted due to substance use disorder or mental illness. The goal of the Diversion Program is to protect the public. It does this by promoting early identification of RNs with substance use disorders and by providing these nurses intervention and treatment.
What services does the BRN’s Diversion Program provide?
For the public
- Early intervention into the lives of nurses with substance use disorders, providing an effective alternative to a more time-consuming disciplinary process.
- Confidential consultation with the concerned public, employers, coworkers, family members, friends, and consumers of nursing care.
- Assistance in preparing to talk to an RN about an observed problem.
- Consultation with employers to assure a safe and smooth transition back to nursing practice for a nurse who participated in the program.
For the RN
- Confidential consultation when considering entering the program.
- Assessment and referral for detoxification or treatment as needed.
- Development of an appropriate rehabilitation plan for chemical dependency or mental illness.
- Monitoring and reassessing the nurse’s progress and modifying the rehabilitation plan as necessary.
- Observed drug testing.
- Referrals to local support services.
- Encouragement, support, and guidance as an effective alternative to disciplinary action.
- Determining when the RN is able to resume nursing practice.
Why is the program needed?
Registered nurses are not immune to substance use disorders or mental illness. Healthcare professionals, including registered nurses, may be particularly susceptible to substance abuse due to the job stresses and access to controlled substances. Mental illness, such as major depression, is not as prevalent, but also may affect a registered nurse’s ability to practice safely.
Substance use disorder is a treatable disease; unfortunately, most people suffering from this disease or mental illness deny the problem. Many times they are the last to recognize and admit they need help. If mental illness or substance abuse problems are left untreated, they may eventually jeopardize patient health and safety and threaten the life of the person afflicted.
For those reasons, it is imperative that others who suspect a substance abuse problem or mental health problem in a registered nurse take action. Without intervention, these conditions 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.
RNs are eligible for the Diversion Program if they:
1. Are licensed and reside in California;2. Are mentally ill or abuse alcohol or drugs to the extent that their nursing practice may be affected; and
3. Voluntarily agree to enter the program and consent to appropriate medical or psychiatric evaluations.
RNs are not eligible for the Diversion Program if they:
1. Were disciplined by the BRN for substance abuse or mental illness;
2. Were terminated from any diversion program for noncompliance;
3. Sold drugs; or
4. Caused a patient harm or death.
How does an RN get into the Diversion Program?
Nurses enter the program either through:
- Self-referral – RNs contact the program directly for assistance.
- Board referral – RNs are referred to the Diversion Program by the BRN as a result of a complaint that the RN may be suffering from a substance use disorder or mental illness. If a nurse does not agree to enter the program, the complaint is referred to the BRN Enforcement Division for investigation and possible disciplinary action.
Is the Diversion Program successful?
Yes! More than 1,700 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 at least 24 consecutive months of clean, random, observed drug tests. A nurse with a history of mental illness must demonstrate the ability to identify the symptoms or triggers of the mental condition and be able to take immediate action to prevent an escalation. The success of the Diversion Program is due to close monitoring of participants for an average of three years; but more importantly, it is due to the encouragement, support, and guidance provided by other nurses.
Is the Diversion Program confidential?
Yes. Confidentiality is protected by law. Once nurses enter the program, the information gathered to develop a rehabilitation plan, and all other information in their record is confidential, unless the RNs are found to be a threat to themselves or to the public. In that instance, the nurse's name and records will be turned over to the BRN Enforcement Division. When a nurse successfully completes the Diversion Program, the nurse’s record is destroyed. If a nurse does not successfully complete the program, the original complaint, if any, is investigated by the BRN Enforcement Division.
Where can I get more 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 (800) 522-9198.
For other questions about the Diversion Program or the BRN, call (916) 322-3350, or go online to www.rn.ca.gov. Click on the "Diversion" tab at the top.
The mission of the Board of Registered Nursing is to protect the health and safety of consumers by promoting quality registered nursing care in California.
To accomplish this, we:
- Establish and uphold competency standards, provide guidance and interpretation, prevent patient harm, and intervene with discipline and rehabilitation.
- Serve the public in a customer-oriented, well-managed, and respectful manner.
- Provide employees with the opportunity for satisfying work in an atmosphere of shared commitment.