The Florida Statutes are organized into 58 Titles, each with a number of Chapters. Title XXXII—Regulation of Professions and Occupations—contains 39 chapters.
Chapter 456 covers general provisions relating to health occupations and professions, and Section 456.076 specifically addresses impaired-practitioner programs. That section lays out the structure and elements of these programs, including requirements for providers within the programs, services to be offered, and details of confidentiality requirements and disciplinary actions.
Access to Chapter 456 References
Entire Chapter 456: http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0456/0456ContentsIndex.html
Section 456.076: http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0456/Sections/0456.076.html
Chapter 464 specifically focuses on nursing and certified nursing assistants and contains regulations on the practice of nursing in the state of Florida. This chapter is divided into two parts:
The laws contained in Chapter 464, Part I, provide safe parameters within which to work, as well as provisions intended to protect patients from unprofessional and unsafe nursing practice. Florida nurses and certified nursing assistants covered by this chapter are responsible for understanding the laws and rules that govern and define their scope of practice.
Access to Chapter 464 References
Chapter 464, Part I: http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0464/0464PARTIContentsIndex.html
Chapter 464, Part II: hhttp://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0464/0464PARTIIContentsIndex.html
Of particular importance to this course is Chapter 464: “Section 464.018, Disciplinary actions” is referred to as Florida’s mandatory reporting law and it contains the following:
Paragraphs (p) and (q) address additional items specific to practice for advanced practice registered nurses and psychiatric nurses.
Administrative codes are intended to assist state departments and divisions in carrying out certain duties mandated in statute and are organized by department/division/chapter/rule. Administrative code provides a place to codify details to help a department carry out specific activities and does not necessarily cover every item contained in the statute. Important to the discussion at hand are those that concern continuing education requirements (Florida Statutes Chapter 464) and the impaired practitioners program (Florida Statutes Chapter 456).
(under the Department of Health/Board of Nursing)
Rule No. 64B9-5.002 states that, effective August 1, 2017 nurses must complete a 2-hour course on Recognizing Impairment in the Workplace and must do so every other biennium thereafter in order to maintain their licenses.
Rule No. 64B9-5.014 states that the course must cover, at a minimum, the following areas:
(under the Department of Health)
Rule No. 64B31-10.001 contains the following
The American Nurses Association (ANA) Code of Ethics directly addresses impaired practice in two subsections of Provision 3, which reads:
The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.
In subsection 3.5, Protection of Patient Health and Safety by Acting on Questionable Practice, the Code’s interpretive statement says:
Nurses must be alert to and must take appropriate action in all instances of incompetent, unethical, illegal, or impaired practice or actions that place the rights or best interest of the patient in jeopardy.
It further notes that nurses must be familiar with the ANA Code of Ethics, standards of practice, all relevant laws and regulations, and their employer’s policies and procedures (ANA, 2015).
In subsection 3.6, Patient Protection and Impaired Practice, the guidelines note that
Nurses must protect the patient, the public, and the profession from potential harm when practice appears to be impaired.
Nurses must follow the policies of their employer as well as professional guidelines and the law. In situations of impaired practice, they must advocate for fair treatment of and support for colleagues in recovery. If impaired practice threatens the safety of patients, self, or others, a nurse must report this to the appropriate authorities (ANA, 2015).
In a 2017 presentation to the NCSBN-IRE conference, the director of the Florida Intervention Project for Nurses (IPN) emphasized certain elements in discussion of subsection 3.6:
[The need to be] vigilant in protecting patients, the public, and the profession; the duty to protect patients, and the need to assure assistance to nurses needing help.
Other writers emphasize these same ideas (Smith, 2017; Alunni-Kinkle, 2015).