fessional nurses, also are contributing factors to the development of impaired performance in professional nursing, as is the frustration of professional nurses surrounding the issue of their professional autonomy (Hardie, 1991, p. 13). Thus, the three major issues confronting professional nursing in the 1990s --the nursing shortage, professional autonomy for nurses, and impaired nurses--are all interrelated.
Several states have established structured programs to deal with the problem is impaired nurses. Among these states are Michigan (Michigan Nurses, 1987, p. 8), Florida (Florida's intervention program, 1993, p. 9), Nebraska (Hinchey, 1994, p. 10), Delaware (Seymour, 1991, p. 95), Kentucky (Farley, 1992, p. 48), and North Carolina (Tranberger, 1991, p. 121). Experience has indicated that a rehabilitative orientation in dealing with impaired nurses produces results superior to disciplinary actions that include loss of license (McNeill, 1994, p. 3). Disciplinary approaches ha
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