Abstract
Recent estimates suggest that as many as 1 in 5 nurses in the U.S. are chemically dependent. In some states, the board of nursing requires an impaired practitioner to go through a disciplinary procedure. In others, the board refers the nurse to an alternative-to-discipline program providing treatment and rehabilitation, sometimes shielding him or her from further disciplinary action. While the American Nurses Association has recommended that state nursing boards adopt alternative programs, as of 2007 not all states have complied. This article reviews the literature on both disciplinary procedures and alternative-to-discipline programs and then compares the two. It concludes with a set of recommendations that, while supporting the rehabilitation of impaired nurses, encourage the profession to pursue more substantive research on best practices in order help retain valuable healthcare professionals.