During this time when the nurse is working under supervision, random drug tests are administered and attendance at 12-step meetings is mandatory. According to Cadiz, et al., (2012), a special program, called Fit to Perform, has been developed in Oregon that trains nurses responsible for monitoring nurses' return to work. The supervising nurse must be able to quickly identify signs and symptoms of relapse and address any concerns related to unsafe practices. It is critical that the supervising nurse has a good understanding of addiction as a disease, as well as the attitudes of his or her colleagues related to substance abuse. Lack of this knowledge can “lead to bias and discrimination against nurses who return to work after seeking treatment for substance use disorder” (Cadiz et al. 2012, p. 136). Another goal of the program is to build the supervisor's confidence, improve their communication skills and teach them constructive discussion. Constructive discussion is essential to appropriately address issues related to unsafe or unprofessional behavior and “can lead to greater employee acceptance of treatment and subsequent improvement in overall job performance” (Cadiz et al., 2012, p.141). Adequate training of supervising nurses is essential to ensure patient safety and to build a positive team approach towards colleagues who are recovering from