Can I be a registered nurse if I have bipolar disorder?

meljonumd · Jan 26, 2014

A diagnosis of anything isn't a reason why a person cannot get a license.

However, if that diagnosis prevents a person from functioning safely or professionally, then a licensing board might have more of a reason for acting, IF there is a viable complaint.

As always, check with your state licensing board.

RunBabyRN · Jan 26, 2014

Definitely check with the resources in your area, but as far as I know, as long as you're properly managing it, you should be okay.

ShelbyaStar · Jan 26, 2014

I think it's a question of whether it's under control or not, and that's a question that only you and your doctor can answer.

It seems to be a very strange thing to say to me. Obviously a MI person MAY have difficulties with nursing but that is a case by case basis. This seems borderline discriminatory to me and I've never heard of anything like that. To be honest, if you think you can handle it I dont think I'd say anything about it.

If it makes you feel better, I've had severe chronic depression but also feel it's under control. There's quite a few articles on nursing with BPD around here, too.

Long Term Care Columnist / Guide · Jan 26, 2014

I'm a longtime RN with bipolar 1 who's had some major struggles with nursing jobs over the course of my career, but would still encourage you to pursue nursing as long as you're being treated and can remain stable. You are no more of a risk to patients than anyone else if your disease is properly managed; in fact, it can even be an advantage, as having a mental illness often makes people more compassionate, especially toward patients who are marginalized in some way. I know that after I was diagnosed, I became a lot more empathetic with the poor guy at my assisted-living facility who heard voices and threatened suicide every couple of days, and I fought hard for him long after his doctor, his case manager, and even his psychiatrist gave up on him.

That said: nursing is a stressful job even for "earth people", and it is doubly so for us. I ended up retiring from clinical nursing last year because I could no longer handle it either mentally or physically (I have a moderate amount of memory loss due in part to meds, repeated bipolar episodes and normal cognitive changes associated with aging). But what I learned from all that is that you have to take care of yourself. Take your meds on time, every time. Eat well and do some at least some physical activity on most days of the week. And do whatever you have to in order to protect your sleep!

There are a number of bipolar nurses here at AN who I hope will weigh in here, as well as a number of posts and articles on this topic in both the Nurses With Disabilities and Health and Stress Management forums. Welcome!

AMN74 · Jan 29, 2014

The previous posters are correct. You must be stable and continue to assess yourself to make sure you are stable and on top of your disease in order to be a nurse and care for your patients. Rest is very important as well as good communication with your MD and taking your medications. Some states do have stipulations about having mental health diseases and getting a nursing license so you may need to research the state that you live. As a person with BPD you must be able to recognize your own symptoms at times in order to keep you and your patients safe.

MeAndArmini · Jan 30, 2014

Thanks for your input and advice!

So your bipolar made your job a lot more stressful? If I may ask, in what ways did it make it more stressful?

Sam J. · Jan 30, 2014

Some states now now require an applicant to disclose any type of mental illness, including depression, and also to disclose the meds the applicant takes. This can cause the applicant to be required to attend counseling or psychiatric evaluations, and ongoing monitoring, to determine and monitor their stability, safety, and ability to function as a nurse. And like per usual, once one state gets an idea, the rest almost always follow the leader. I don't recall the one state I found particularly offensive about this subject, but the requirements they had listed for a nurse with a disclosed mental health issue were much like the requirements for a nurse that had diverted drugs from the workplace- random drugs tests, ongoing evaluations, and the like. I really couldn't believe it. I've also heard that some psychiatrists now only accept cash payments and advise their patients to pay cash for their meds, as an attempt to keep their mental health issues out of the digital/public world, because it is harming the very people that have realized they have a problem, and have taken steps to deal with their problem. I hope, OP, this information doesn't add to your anxiety, it just is what it is. It'd a good topic to bring up with your doctor, the fact that your BON may require disclosure of your diagnosis, or treatment, or condition. Tred lightly, and protect your privacy at all costs, is my two and a half cent's worth.

Long Term Care Columnist / Guide · Jan 30, 2014

Texas is really obnoxious about this. What they put nurses with MI through in order to get or keep a license is ridiculous---they treat them like criminals. So I'd avoid TX like the plague if I were you.

My state's wording is ambiguous, like a lot of other states ("do you have a physical or mental condition that impairs or might impair your ability to practice nursing safely?"). In any case, talk to your state's BON before you make any commitments; as far as your school is concerned, your medical history is none of their business.....it's protected health information that they have no right to.

Bipolar in and of itself does not make nursing stressful. Uncontrolled bipolar makes it hellish. Nursing is inherently stressful given the nature of the work, but when you throw in a serious mental illness that's not managed well, it becomes all but impossible. I think that's why states have cracked down so much on nurses with MI......occasionally, there comes a time when a nurse becomes unsafe at any speed and cannot properly care for patients. So it's crucial to use whatever means are at your disposal to keep your disorder under control, including good self-assessment skills (taking into consideration the fact that we tend to lack insight during mood episodes) and going in for a 'tune-up' when the engine starts running rough. :yes:

Nineteen84 · Jan 30, 2014

For what it's worth here are my two cents:

I am a nurse with mental illness and I think the main thing to note is that you have to be really really aware of how you are. If you can't do that, then you can't be a nurse with mental illness. It's not safe. For example, I have a wonderful psychiatrist who knows that my job is my all in life. He knows I do better when I'm working. Yet he also knows when to tell me to take a break. A couple of years ago (while I was a nurse) I underwent electroconvulsive therapy. Being under anesthesia and seizing 3x/week and trying to work would not be safe. In fact, after I returned from my leave for ECT I had to go through orientation again - I had forgotten some major aspects of my job. Likewise, being at work when I was very acutely suicidal was not safe - too much access to too many things. But working with my psychiatrist closely and having my family remind me of when I wasn't functioning at par has allowed me to be the nurse I had always wanted to be. You know yourself the best. If you can (honestly, 100%) stay on top of your illness even when you're at the worst point to make sure you're not harming patients then I see no reason why you shouldn't become a nurse.

AMN74 · Jan 30, 2014

OP you asked how BPD affects work as a nurse. First, BPD affects every part of your day to day life. When life or when work is stressful it is difficult for anyone to manage, with BPD symptoms can easily slip into something more acute. If I am having a particularly down mood day, then it is difficult for me to keep my chin up, smile and provide care to patients without looking like I'm having a horrible time myself. If I'm having a "too good" day (manic-hypomanic) then I have to be extremely careful about what comes out of my mouth. I often will say inappropriate things or offer way too much information. When work is extremely stressful, especially if it is over a period of time, I have to be very careful to not get too consumed to the point I have nothing else left in me to live the rest of my life. For example, I work as a hospice nurse now. We had a nurse quit last July. The nurse did not get replaced until January. I picked up the slack and tried to do my job and her job. I could do it for a short time, but as my agency saw tht I could do it, I don't think they were in a hurry to hire anyone else. Suddenly I found myself in a crisis around Christmas time. I was becoming obsessed with work. I couldn't sleep at night because I was in constant motion trying to keep up. When I did sleep I would wake up and be frantic about stuff I forgot and would start making lists in the middle of the night. I could not keep a stable personality at work anymore. I was not on an "even keel". I went for almost a week with chest pain from constant panic, not sleeping and started to crash. I felt myself start to want to quit everything, shut down and go to bed. I wanted to escape life. I knew that would put me in a deep depression. I do better when I work, but not when it's rediculous hours and too much work. I went to see my doctor. She told me she was putting me out of work until I could get better control. I begged her to help me adjust my meds and let me talk to my supervisor and let her know what is going on. I did not tell my supervisor I had BPD. I told her I went to see my doctor because I was over stressed about being over worked and my doctor wanted me out of work, but I told my doctor that I would see if my supervisor realized what she was doing to me. When I talked to my supervisor by the end of the conversation we both had tears in our eyes. She got me help and things are slowly resuming back to "my normal" and I'm tapering off some of the higher doses of meds.

That was an instance of a "successful time" that work and BPD meshed for me in my life. I have had many times I've ended up hospitalized, suicidal, and very sick over work. I am learning to recognize my symptoms and communicate more with my doctor. This is what makes BPD/being a nurse work for me.

Long Term Care Columnist / Guide · Jan 31, 2014

That was a great post! It's taken me two years to get healthy, and even so I still feel a little shaky. I started a new job a month ago that's FAR more involved than I had any idea it would be, and while I'm reasonably sure I can learn it, I'm also a little afraid the stress could provoke my own bipolar illness. I've had many problems with work because of it, so I'm pretty gun-shy about taking chances......and what did I do but take the biggest career-related chance of my entire life?

Thankfully I wised up after my last two jobs ended badly and did not inform my new employer of my condition, which is being managed with a combination of meds, strict sleep hygiene, therapy, and regular visits to my (awesome) psychiatrist. It took a long time to get everything right, but it all finally came together and I've been completely asymptomatic for a couple of months now. I know, it doesn't sound like much, but as unwell as I've been for the past few years, two solid months of stable mood are a gift. :yes: