Chemical dependency is a chronic, progressive, and potentially life threatening disease. Nurses who are impaired due to chemical dependency should be cared for and supported in ways that are similar to nurses who have other chronic, progressive diseases. Namely, all efforts should be made to provide these nurses with the health care resources that are required to stop the progression of this disease and promote successful rehabilitation and return to work.

Concerted efforts should be made by all nurses in Kentucky to identify impaired colleagues, and facilitate their rehabilitation. Of primary concern is patient safety and protection. Also of concern is the preservation of Kentucky's nurse resources. Both of these concerns are promoted when each health care facility has identified a formal system of support for impaired colleagues that leads to successful rehabilitation and return to work. This system needs to be one that protects the rights of the patient, the impaired nurse, and the employer.

Chemical Dependency is a chronic, permanent and progressive disease. It has predictable symptoms and can be fatal if left untreated. It consists of repeated use of psychoactive or mood altering drugs, narcotics, tranquilizers, or alcohol until there is an addiction (Catanzarite, 1992). Chemical dependency is characterized by an individual being physically, and/or psychologically dependent on alcohol or drugs to the degree that it has personal and/or social, and/or work place consequences.

Impairment results when a nurse is unable to meet the requirements of a professional code of ethics and standards of practice because cognitive, interpersonal or psychomotor skills are affected by excessive drug or alcohol use (ANA, 1984).

Intervention consists of a presentation to the impaired nurse of specific facts regarding the impaired nurse's behavior and the effects of this behavior. This presentation is direct, objective, nonjudgmental and caring (Catanzarite, 1992).

Impairment Assessment is the initial assessment that is done within a few days after the intervention. It should be done by a professional who specializes in chemical dependency and who has the skill and experience required to do competent in-depth assessments and evaluations. The skill and experience may be evidenced by specialization in chemical dependency or a certification in chemical dependency.

Rehabilitation/Recovery is an ongoing process of recovery that begins with the immediate treatment program.

Continuing Care or After Care is a phase of rehabilitation that follows the immediate, more intense in or out patient treatment program. It often consists of weekly group meetings, Alcoholics Anonymous or Narcotics Anonymous meetings two to four times per week, individual counseling sessions, and other components recommended by the supervising counselor. This phase of rehabilitation usually lasts one or two years and precedes the maintenance phase of recovery.

Peer Assistance is a statewide program for locating, contacting, and offering assistance in obtaining rehabilitative help for nurses who have become impaired due to the abuse of alcohol or drugs. In some states it is used as an alternative program to disciplinary action taken by the state board of nursing.