title: SUBSTANCE USE RELATED LICENSURE DISCIPLINE IN NURSES
title: FACTORS AND TRENDS IN THE RETURN-TO-WORK PROCESS
titleType: Subtitle
Creators: name: Ferris, Jordan G.
Publisher: name: Washington State University
Year: 2026
Subjects: barriers
facilitators
return-to-work
substance use
workforce development

description: Background: Substance use among Registered Nurses has significant consequences that can extend into their workplace and patient care delivery. Limited research has explored substance use in nurses and the return-to-work process that RNs must engage in after licensure discipline related to substance use. With the looming nursing shortage, it is critical to understand the factors that may be associated with substance use related licensure discipline and the barriers that RNs encounter when attempting to return to work. More research is needed to create evidence-based pathways that can facilitate successful reintegration to the workplace for RNs.
description: Aims: 1) Describe the current state of substance use related licensure discipline among RNs in the United States in 2018-2023; 2) Describe and analyze RN self-reported barriers in returning to work after licensure discipline related to substance use; 3) Describe and analyze RN self-reported facilitators in returning to work after licensure discipline related to substance use
description: Methods: The multi-method research, which was guided by the Neuman Systems Model, includes three studies: a retrospective analysis of substance use-related licensure discipline trends and characteristics using the National Practitioner Data Bank (Manuscript 1) and two Group Concept Mapping studies exploring the self-reported barriers (Manuscript 2) and facilitators (Manuscript 3) in the return-to-work process for nurses after licensure discipline related to substance use.
description: Results: Comparisons of licensure discipline trends and characteristics between 2018 and 2023 found census region, age, and years of nursing experience to be significant variables across statistical tests. Substance use monitoring, as a disciplinary outcome, was the only action to have a statistically significant increase over the time period studied. In examining barriers and facilitators in the return-to-work process for nurses with a substance use monitoring agreement, 11 distinct themes emerged through the Group Concept Mapping studies. The five themes within the barriers were Work-Related Challenges, Financial Burden, Administrative Challenges, Impact on Mental Health, and Peer and Co-Worker Support. The six themes within facilitators were Monitoring Recommendations, Autonomy and Self-Efficacy, Caring for the Caregivers/Prevention, Nurses Helping Nurses, Reintroduction to Practice, and Positive Employer Factors.
description: Significance: These results demonstrate significant regional differences in the application of licensure discipline, suggesting inequities likely exist for RNs regarding substance use. Using the voice and experiences of nurses affected by disciplinary actions, this research allowed for examination of their perceptions and values while also identifying ways to support their priorities. These studies lay the foundation for continued policy examination to support equitable disciplinary actions for nurses after substance use as well as programmatic evaluation and development for effective monitoring programs.