initial license question

  1. Hi all,

    I have a question for anyone who knows the answer. I have a good friend who is about to apply for initial licensure in the state of Tennessee and take their test. I can't answer the question for him because it's been awhile and I can't remember...

    Do they ask on the application in Tennessee if you were treated for alcohol or drugs in the past 5 years? They have the application in hand and said the application for licensure doesn't ask that question. It just asks about criminal offenses. Does the NCLEX application ask? Well, apparently they underwent outpatient treatment about a year ago with the intention of being 100% "rehabilitated" with no issues. The fact that this question might come up is a new revelation that's causing a lot of stress.

    I'm assuming if the application for licensure doesn't ask then it probably won't come up. I wouldn't think the test registration would ask that as that's something I would expect for the actual BON application to ask. I don't know for sure though. I read a little around the site and saw some people say that not every state asks that question. Anyone know for sure?

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    About JSlovex2

    Joined: Apr '11; Posts: 229; Likes: 266


  3. by   wish_me_luck
    No, Pearson Vue does not care. They are a testing company. It's the BON that issues the license.
  4. by   goofeegirl
    That's great that this person had intentions of being "rehabilitated" but there is no such thing. The first 5 years are considered the most critical to recovery in the eye of many BONs and their program may be strong but they are still susceptible at any time to relapse and this is an issue to the BON. They are looking to protect patients and make sure that they are being cared for non-impaired individuals.

    I can't remember if my application asked this but I do know that this may be a consideration for the BON to discuss. If it makes your friend feel any better, a girl in my BSN program got a DUI while in school and then had to report that on her application. She was approved by the BON to take the boards and she did. Heck, she took the boards before I ever got the paperwork to take mine! So all is not lost on your friend.
  5. by   JSlovex2
    Well, the DUI thing makes sense because most all employers want to know your criminal history and it's public information so it will show up on your background check.

    Asking if you've ever been treated for drug/alcohol addiction in the past FIVE years is right up there on the "isn't that a violation of HIPAA" list as "have you ever been treated for any psychiatric issues in the past five years." I don't see how it's any of their business, really.

    Doesn't everyone who gets a DUI have to go to some sort of treatment class? You would think every person who had a DUI would then have to say they've been treated within the past 5 years and then start their careers off being tortured by the recovery police.

    I'm guessing it won't be any issue anyway since it's not on the application.
  6. by   wish_me_luck
    JS, I am not trying to be mean when I say this, but it is not a HIPAA violation. Some states (VA being one, I am not sure about TN) actually make info. public (including dx) because the public has the right to know who is taking care of them. My info. is public (don't like it), but I undestand that it's not the BON being mean, it's the law in VA (and some other states). I would tell your friend to call the BON and make sure they don't have to disclose because if something happens and they find out about that (through investigation), then it's worse.
  7. by   JSlovex2
    Didn't you say in another post that you only disclosed your mental health dx because you interpreted the question wrong? And it actually only meant if your dx was an impairment to your current ability to work?

    By the logic that everyone who has had a mental health dx or substance abuse issue within the past 5 years then every single person diagnosed with depression, anxiety, bi-polar or who ever had a DUI and sought treatment bc it was ordered by the court would be required to be in a monitoring program where they have to check in every day, take tests, etc..etc..

    There's no way that someone who has never had a record and never had any trouble with an employer has to go through this grueling process where they have to attend meetings, take tests, etc. just because they went to rehab 4.5 years ago or had a bout with depression.

    I can see having to seek treatment if you are active in an addiction or if there was an incident r/t addiction or mental health, but it seems like a violation of ADA to order people with no adverse consequences of addiction/mental health to disclose their history and treat them differently because of it. Did your doctor say he didn't think you were fit to practice?
  8. by   wish_me_luck
    It's different in VA, but I talked to someone who is in TN and they said it asks if you are of sound mind (i.e. mental illness); they said to put yes, you are of sound mind. Unless you have something that can show up on a criminal background investigation (DUIs, drug charges, etc.) you need not put your mental health hx down. If you lie about DUIs and drugs though, that can get you in more trouble.

    My psychiatrist did not say that I was not fit to practice. He didn't know me at all (one appt with me) and he put a generic course of tx (which half of what he put did not apply to me and my prognosis ended up being very mild to what he put.) I don't have DUIs, drug diversion, charges/record, employment problems, etc. I just have a mental illness and hx of alcohol abuse (I will be 7 months sober in 6 days.) Still got "approved contingent upon entering Health Practitioners' Monitoring Program". I just go with the flow and try and make the best of it. At least I know that if I get hired, my employer must have really wanted me (and is okay with me having a mental illness. Some people can't deal with mental illness. It's not my problem, it's theirs, but it's okay.)

    I don't like that I can't use high quality hair products now, no Listerine, certain deodorants are out, no lotion, and salad dressings, I have to watch along with other food. I am exhausted with hating being in HPMP. I understand why the BON does it and I am happy that I have a license (and didn't get denied). I am not thrilled with being in it, but I am trying to make the best of it.

    I have a count down going now. One is of the days (approximately) until I am eligible for healthcare employment and the other is the days until I will be done with HPMP. One day at a time, but hopefully, this too shall pass. Anyway, I hope I was able to give you clarification. I cannot speak personally for TN, but that's what someone who teaches nursing education told me.

    But, just to comment on what you said about health hx in previous post; it is not protected by HIPAA. If it can have an effect on patient care, then it is not protected. Quick story--I am also certified as a pharmacy tech and originally, I was denied registration/licensure in VA. I requested IFC and sent a letter to the appropriate people and without an IFC, a committee approved my licensure upon staying in compliance with my HPMP contract (my letter was given to the committee.) So, ADA, yes and no. Yes, you would have protection that unless they had evidence that you are a harm where you are working (I had never worked as a pharmacy tech, so they didn't have evidence), but no if the law in the state says they can deny you for that. Hence, the outcome of approval upon staying in compliance with the contract. It's a happy medium. I am getting my license and they have something that assures them in protecting the public.
    Last edit by wish_me_luck on Nov 3, '12
  9. by   JSlovex2
    How long is it until you are eligible for employment? And how long until you're finished with the program?

    Why were you denied licensure as a pharmacy tech? Did they ask questions about mental health for that licensure also?

    That really sucks to have to deal with all that. I can understand having to be in a program if you've been caught diverting or been impaired on the job, but being put into a program because of a medical diagnosis that hasn't posed a problem seems unfair.

    Did the school you went to help you with the application process or not? Someone had to sit down and go over the form with us. Did you know what would happen by answering that you had a mental health issue?

    Apparently as a nurse you just have to keep your medical problems and any medications you might take TOP SECRET and never, ever let anybody know - especially if it's a controlled substance.
  10. by   wish_me_luck
    I have to wait three months at least until I can be eligible for employment in health care. I don't know if that's from signing the participation contract or the date I went for orientation. There's a month and a half difference in time between the two. That's can be three to six months though. I am also a new grad, so it's a double whammy. It is five years until I finish the program--in 2017.

    I was denied licensure as a pharmacy tech because I have a mental illness. In VA, they can deny people licenses in health care due to mental illness (Code of VA). I was going to site the ADA, etc. because in that case, I had not done anything in the pharmacy at all. I sent a letter requesting the IFC and the IFC wasn't needed. A committee decided to overturn the decision and approve me contingent that I stay in compliance with my HPMP contract. Yes, it is the same questions as on the nursing application. I was told that I had to put the same thing that was put on the nursing application (i.e. they have to match).

    No, my school didn't go through the application with us. We were given info. regarding what was needed for application based on the state we lived in, on a sheet of paper.

    Yes and no on the question about did I know what would happen. I didn't think it would be that big of a deal because I was treated. But, for me, lying wasn't an option. The mental illness I have, I have a huge issue with trusting people (yes, I am working through that). The basis of trust is in honesty and truthfulness. I try my best to treat others the way I want to be treated. I wouldn't want to be lied to, so I am pretty honest in my dealings. It is best to be above board and lay it all out there and receive the Board's blessing/approval knowing what you have than to be deceptive. Also, it's not a crime to have a mental illness. I am not too open about what I have, specifically (maybe one day I will disclose what I have, but for right now, I will leave it at "mental illness"), but I don't think I should be treated as less of a person. Ironically, the same reason why your friend/you do not want to disclose is one of the reasons why I did. I hope that despite having a mental illness, that I can be just as good of a nurse as anyone else who does not have a mental illness. I want to try and give a little hope to those people who think it is not possible to be a nurse (or anything in health care) and have a mental illness (and to be, eventually, more open about it). That's my feelings on it anyway. I, too, was encouraged by a couple of people to not disclose. But, I didn't feel right lying/not disclosing it (in addition to my trust issue, I have a terrible guilty conscience if I do anything wrong). As time went on and I waited for the decision (a few weeks or so), I thought if I did get approved, I would have to do the monitoring program based on the criteria that one would meet for the program. There was the moment when I did receive the letter with approval contingent I went into HPMP, that I really thought I wanted to have an IFC. I called one of the Deputy Executive Directors and asked her about the possible outcomes. When she told me that I could be denied after an IFC, I started thinking long and hard about it...I did all this work to get a nursing degree and it was possible that I wouldn't have been able to get a license. But, if I agreed, then I at least had that chance (obviously, I had to pass NCLEX, which I did the first time I took it). I had some time to think about it before I received my consent order (it takes around 6 weeks to receive the consent order after the decision letter--I don't know about TN, this is in VA). I signed it before a notary and sent it back. Entered into HPMP. I didn't go for orientation until after NCLEX. You do get into a routine once you are in the monitoring program--check in every morning to see if you are selected for testing (if you have a drug/alcohol issue that requires screening. The reason for my screenings is for alcohol abuse, but I get tested for everything anyway), go to AA meetings (or NA depending on what issue you have), Caduceus, and appts with psychiatrist and therapist. Then you fill out the forms and send them in monthly. When you get health care employment, your employer will have to fill out forms as well. Oh, and when seeking employment, the monitoring program has to review the job description and such before you can apply.

    I have no idea if people in TN have to wait for employment...for whatever reason, I don't think they do (could be wrong though). It's something that VA does. I do know that if you are in a monitoring program in another state and want to work in TN, you can't. TN law does not allow people compact privileges or licensing when in a monitoring program already in another state. You can't even move to TN and apply for licensing until you are done. By that time, you would have your multi state compact privileges back (if you live in a compact state, which TN and VA both are) anyway and could move to whatever state within the compact you want.

    I am still in the beginning of HPMP (and being a new nurse), so I feel like I contact the BON, BOP (Board of Pharmacy), and HPMP about what I can and can't do and ask other questions quite a bit. I feel obnoxious asking so many questions, but I am trying to stay within the contract/regulations. By the time I am done with HPMP, I could probably write a book on everything. LOL.

    Good luck!
  11. by   JSlovex2
    My goodness....I feel bad for you. I guess I never even thought of this or payed attention to what kind of questions were asked since it didn't pertain to me, but if a questions asks, "Have you been treated for mental illness within the past X years" then I would assume everyone who sought treatment for depression or anything would have to answer yes. That just seems a little overboard!

    Not to mention...if I were a nursing student with mental illness or substance abuse issues and I knew that would be a question...I would NOT seek treatment in order to be able to answer that question honestly! Really, it seems like they should be more worried about the ones who haven't sought treatment within the past X years as opposed to the ones who have. Lesson to nursing students who are addicted...keep on keeping on if you want to get a job! How crazy.
  12. by   wish_me_luck
    Well, to me, the depression thing depends. If it's situational depression (i.e. like a spouse dying and you would expect depression), then I would answer no, you haven't been treated for a mental illness. But, if it was due to nothing situational and it was a chemical imbalance and it was bad enough to impact your life--major depressive disorder, then the answer is yes (in my book, anyway). They are mainly talking about a serious mental illness (major depression, Bipolar, personality disorders, schizophrenia, etc.) that can affect patient care. The BON is there to protect the public.

    As far as addiction tx, I would disclose that because they (employers) can test you for drugs and if someone is addicted, they are probably not going to wake up one day, on their own, and say "well, I guess I am not going to use anymore". If someone tests positive for drugs in the workplace, they can lose their job, be put in the monitoring program, and might even have to go before the board if any sort of investigation happens (and they find out the person had been treated for drugs in the past and they lied.) It can run you into a lot of money--many times you would have to get an attorney as well. It's opening Pandora's Box in lying, in my opinion.

  13. by   JSlovex2
    Actually, people can and DO wake up one day and decide they don't want to do drugs anymore! That's usually when they seek treatment...which is why it should be irrelevant to what's happening today. I get that the board is meant to protect the public, but in some cases, there is nothing to protect the public from. If you've had a lot of drug related charges and things like that then that's one thing. If your record is spotless and you voluntarily sought help then that is another. Chemical dependence and addiction are two VERY different things, btw. I'm sure as a nurse you know that. Even if they are concerned about someone who is addicted to illegal drugs, it's still shocking that they single out people who WERE dependent (NOT addicted) to prescribed drugs and then punish them because they sought treatment.

    If someone decided they were sick of doing drugs, went to treatment, turned their life around so much that they were able to make it through nursing school...including clinicals and internships...with NO problems...and no trouble with the law EVER then i don't see why they should be put into a monitoring program where they are treated like a criminal. In fact, it's the same program that people who HAVE done something criminal are in. What's even more shocking is that they do the same thing to people with mental illness.

    In this case...he won't be lying because the application doesn't ask about past treatment. Heck, if it did, then I might just suggest moving to another state that doesn't! I'm just shocked that this is legal..that's all. I've never heard of anything like it. Oh well.
  14. by   wish_me_luck
    That's fine, JS. You don't have to be defensive. I understand there is a difference (my dx as far as alcohol was alcohol abuse, not alcoholism--still go to AA. My point is the BON does not differentiate.) If your friend is clean and fine, then he shouldn't put it down. But, I was giving you a heads up on what can happen to your friend. I think this discussion is kind of done. I think you know the answer to the initial question by now.

    It's shocking that they treat mental illness like that, but society also acts like that. When we change the way of thinking as a society, then things will change. I just "accept the things I cannot change". I can't change having a mental illness nor can I change being in HPMP.

    Also, what I was talking about is being addicted, people typically have days where they crave the drug. It's not well I went through tx, I am done. It is a process. So, I think I am done.