If you could recommend changes, what would you suggest?

catsmeow1972, BSN, RN · Aug 1, 2016

With a nod toward my last soapbox appearance on the cost and frequency of drug tests (before i toddle off to the THIRD one in SIX days, and that's with a weekend in there!), this has passed insane in both the cost and the impact on my job. The outlay for this month for this junk, counting the group fee and all, is almost $300. I work days and have a position where, like most nurses, I cannot dance off in the middle of my shift to go pee for this. Heck, i barely have time to go pee for myself. I have no choice but to go first thing in the morning. The issue is that the lab (like all of them) doesn't open until the same time i have to be at work. Trust me, that is obscenely early. So once again, i am late for work. Every couple of weeks, i can do this. Not too big of a deal. But every other blasted day!??? I'm running out of ways to tell my co-workers why I'm late. The "I overslept" is really wearing thin.

On the "protecting the public thing?" Yeah, whatever......

RN2364 · Aug 10, 2016

I think they need to do away with the blanket type punishment. And yes it is punishment! My situation is a little different (or so I think). I am on monitoring bcuz I have an injury and take prescribed medication. The thing is is that I like everyone else can no longer treat myself as an adult and have a glass of wine with dinner. I can no longer treat allergies or insomnia with Benadryl. I have to watch everything I put on or in my body ...... Except oxycodone! Have a headache I have to take oxy. Insomnia ... Oxy. Allergies....oxy. With monitoring I do not have to stop the thing that got me here in the first place. No diversion. No impaired on the job no theft or criminal charges. I Did get busted for taking a medication after a year. I don't take all the meds prescribed so I just keep them (that's the way I was raised. Never waste things. I am sure a lot of you were raised the same way. I also got a complaint in their investigation that I started an IV on a Abu without gloves. Really. Am I the only one? The investigator actually laughed when she read it to me and admitted she frequently did the same yet I got reprimanded for it. So I had taken morphinr instead of oxy bcuz I was in a lot of pain that day I wanted to try something different to shock my system. So that's the crimes that got me here. As for this program the only thing it has done is make me have to take the oxy more bcuz I can't take anything else. I have to go to AA or NA twice a week and call myself an addict or alcoholic for what idk. I am not even addicted/dependent on the oxy. I can stop without any symptoms at all yet I am labeled an addict. I had to sit in IOP for 12 weeks and listen to them call me an addict. I am now in an aftercare program being called an addict regularly. It certainly could be worse and with all I have learned I have much love and respect for the recovering addict. I do feel they are trying to make me fit their investigation just so they can be right. I did learn a lot about substance abuse and met some amazing people. I have a year narcotic restriction even tho I never diverted and I have plenty narcotics at home. I drug test twice a month to get a positive every time. I can't help but wonder if they are trying to make sure I am taking it. With all the "blanket" type punishments the BON hands out be up they are LAZY and uneducated makes me feel like it's not about recovery at all. It's about money and power and a "show" to put on to make the public think they are protecting them. So with that there are many changes needed:

Monitoring geared to each nurse individual

AA/NA being manditory for everyone is not appropriate

Narcotic restrictions for everyone are not warranted

IOP is NOT. Required in every situation

Drug testing on weekends/holidays is unnessary (you can wait a day and still bust people)

Drug testing while someone is on vacation is not appropriate

Trying to fit drug testing into a 12 hour day with minimal 24 hour testing sites cause more risk then benefit

Drug tests being so sensitive you can't even use hand sanitizer. Really. What are you protecting vs what are you spreading

Positive reinforcement goes much farther then fear, shame and threats

Stop charging us so damn much while doing everything possible to keep us from working

Better trained/educated case managers. (When I give you a letter from my Dr on the 15th of the month it's good until the 15th of the next month. Don't call or email at the 1st of each month requesting a letter for the month. I don't see the Dr every two weeks folks

For non controlled meds like lisinopril I shouldn't need to see my Dr monthly for a note. He is getting sick of it and so am I as well as my insurance. The BON is wanting to make me say to hell with my BP...

There are so many other things. So many. I think it could be solved if the BON investigators did their jobs and came up with a plan based on the individuals reason for being on monitoring and plan for a successful recovery vs this all to common blanket style punishment they use being lazy.

Again in I appreciate and respect everyone and their circumstance and have been truly blessed in finding y'all and this site!

NikkiClark · Jan 11, 2017

I find it insane that they can stick a new grad into a monitoring program when they have done nothing wrong in their career as a nurse. I find it ludacris to think that because someone had a DUI three years prior yet finished nursing school, clinicals (while being supervised by instrustors), and passed boards should have their charges put on their practicing record and be placed in a monitoring program. I understand if you drive drunk to work...show up drunk...or even if you are being unprofessional after receiving your license and drive drunk. But after the thousands of dollars it costs along with all the court required counseling to even get your drivers license back, it seems insane that they could place you into a monitoring program through BON. Just my opinion

Tnccriley · Sep 27, 2017

Beginning with an actual investigation is step #1!

Secondly, why have an option to appeal if a judge orders a license be reinstated and you are going to have a monitoring agreement anyway?

There are not nearly enough caseworkers

Caseworkers should be changed again and again

Board members should be accountable for their decisions and have appropriate reasons for making them

It is unacceptable for boards to only meet, for example, the second Tuesday of every month!

Previous completion of a monitoring agreement should not be considered (in the nurses favor of a healthcare professionals or against the favor of a healthcare provider) if a new complaint is lodged

Narcotic administration upon returning to a work environment should not be required nor banned. Only the person in the monitoring agreement knows if they can or cannot ever dispense narcotics without it causing temptation. Furthermore, it creates a burden on the other care providers, causes delay of appropriate treatment for patients and creates an unnecessary breach of confidentiality for the professional in a monitoring agreement. It is not necessary for the entire unit to know when someone is in recovery and is counterproductive!

Having to log meeting attendance create a lot of paperwork for caseworkers when there is no possible way to discern whether or not signatures are even legitimate.

And finally, two things...if or when things finally change, the thousands healthcare professionals that refused to participate in the shenanigans should have a way to become informed of this, as many may revisit the possibility of returning to a profession already facing a critical shortage and finally if said healthcare professional determines they should not return to a clinical setting, they should not be forced to do so in order to remain in compliance with a monitoring agreement.

SpankedInPittsburgh, DNP, RN · Sep 28, 2017

Wow!!! I honestly think somebody could write a book on this. I'll offer a few suggestions but after living this hellish experience I could ramble forever about it:

1) Make the punishment fit the crime / Get a smaller net: Currently these programs all seem to be a one-size-fits all thing. It doesn't matter if you got a DUI years ago or you were stealing pain meds at and passed out on patient in your care. This is non-sense. It seems to me that programs for impaired nurses ought to be aimed at just that. These programs should be aimed at Nurses who have a substance abuse problem with evidence of that problem affecting their ability to practice. In other words, if you are high / drunk at work then you are going to be given the choice of getting some help or surrendering your ability for be an RN. I have to go to a idiotic nurse support group weekly. Of the seven nurses who attend; three had DUIs neither on the way to or from work, one tested positive for weed she wasn't smoking at work, one used and old left over Percocet to deal with tooth pain and had a random test afterwards, one checked herself into a rehab for her Ambien abuse after 25 years of working nights and was reported to the BON by the facility. Finally, one was diverting meds and was using 24/7 as he put it. Of the seven in my opinion only the last should be in this program & even then this person should be helped and treated with respect & not like some criminal.

2) Cut the profit motive out: When I got my DUI I was evaluated by a "treatment professional" (AKA social worker) who was employed by a treatment facility. Guess what she recommended? As much "treatment" as my insurance would pay for so I was subjected to 24 days of inpatient then 12 weeks of intensive outpatient treatment. These "treatment" facilities are money mills. I was with 60+ other people while inpatient and most days we spent in a giant room listening to one talk after another given by AA / NA volunteers or supervised by a single staff member. The quality of this experience was not therapeutic at all (we spent a lot of time doing arts & crafts) and almost everyone was there because they didn't want to go to jail or were forced to by an employer. After that I spent 12 weeks in IOP where we watched movies and did brainless exercises. There were usually about 20 of us supervised by a single lowly paid (boy would he tell you) counselor. I'm sure all this made piles of money for the facility but it broke me financially and was simply a waste of time in every sense of the word.

How about this for an alternative? Lets have the impaired nurse evaluated by an impartial medical professional. Most of us nurses have medical insurance that will pay for treatments and test's deemed medically necessary. So let's have the Nurse start with his or her Doc. If the Doctor thinks the nurse has a substance abuse problem they can be referred to either an addiction specialist in the hospital or sent straight to rehab. Once released from the rehab (if they are even referred) the MD has the option of ordering continuing DAUs or any other screening test they find medically necessary to aid in this Nurses recovery. If the test is deemed medically necessary the Nurse in treatment should be subject to no more than a co-pay not the hundreds of dollars each month many of us are forced to pay.

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