Disclosure and mental illness

Nurses Disabilities

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Hey everyone,

I am in school now but heading toward the finish line. I was told over and over that having mental illness would not be an issue as long as it was controlled- and that employers would help accommodate if it wasn't too outlandish.

Now I keep finding articles saying that almost all state boards require you to disclose any mental illness. I'm seeing some people say yes, do it, and others say don't because they will use it against you.

I have no idea what to do once I get to the end of school. If I need my psych doc to write a note to make sure I don't have to do changing shifts, will that be an issue too? Can they fire me? I mean, obviously I wouldn't apply to a job that said it was all rotating shifts. In my head I was hoping to barter by offering to work lots of holidays and weekends to avoid any additional 'requirement' attached to the end of all day or all night jobs but now I feel like that is not something to even bring up. Almost all new grad jobs have those additions to them and I get needing to pay dues but it isn't just an inconvenience, its dangerous for me- but it sounds like I can't say that and expect to get a job...

Honestly, I think this is pretty messed up. If your doc or NP thinks your safe to work how is that not discrimination?

I've been stable over a year and am doing just fine in school but I don't want to get in trouble with BON and I really don't want to jeopardize my health by setting myself up to fail with sleep disturbances. I love med/surg and my school at least is letting me only do day shifts to keep me healthy for my transitions term. Suggestions on what to do or where to work?

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You need to look at what your state requires. Texas (where I am) requires disclosure and you have to meet certain conditions to get your license. Other states aren't quite as stringent.

As far as keeping it to yourself - if it's specifically mentioned on the list of required disclosures, I wouldn't lie.

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Thanks!

I won't go to Texas then... : (

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Just be honest about your illness. If you lie and they find out it could cost you your job. A good employer will understand. I take anti- depressants and xanax and have to be up front about it. Don't be ashamed or afraid- just be you!!!

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Specializes in LTC, assisted living, med-surg, psych.

There's a difference between being honest with the BON, and being honest with a potential employer.

You always want to stay on the straight and narrow with your state's licensing board. That means you will more than likely have to disclose your mental illness to them. It may or may not pose a problem. I had to disclose my bipolar I diagnosis at my last renewal, and I never heard anything from the board...they didn't even request a note from my psychiatrist. It could be because I wasn't practicing at the time (and haven't since) but even if there had been an issue, I wouldn't have considered lying to the BON. The consequences of getting caught are severe, up to and including denial of licensure.

Disclosing to a potential employer is another story. I would advise you not to, as discrimination abounds---yes, it's illegal, but health care is a business, and businesses have offices full of lawyers who know every way around the Americans with Disabilities Act. Believe me, they'll find other reasons to reject you, or if you do get hired and end up needing accommodations for your illness, you may not be able to get them. So be very careful when you begin applying for nursing positions; don't even look at jobs that require rotating shifts. I know hospital med/surg departments tend to do this, thus I can't recommend it even though you appear to be enjoying your clinicals. You may need to look beyond the hospital for a more stable job, e.g. clinic nursing, which is generally 8-5. Don't risk your sanity...as I'm sure you know, it's hard to get your mental health back once things get out of control. Wishing you the best.

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Specializes in Pediatric Critical Care.

Disclosing it to a potential job = probably not getting hired

NOT disclosing and then trying to get accommodations via the ADA = they will make your life hell if they can

It sucks and there's not a "right" answer because the hospital is looking out for their interests, not yours. However, yes you can succeed as a nurse. Working nights may or may not be possible for you; that is a decision between you and your doctor. However, if it isn't an option, your best bet is to find a job that won't require it in the first place, because trying to get an exception for your medical needs only seems to put a target on your back :(

Honestly, if I knew then what I knew now, I wonder if I would have chosen this career. But here I am. I've been blessed and have had a successful career, and you can too. But there are bumps along the way, and there can even be some significant roadblocks, like you mentioned in your post. Find a job that doesn't hurt your wellbeing. It's not worth it.

P.S. - VivaLasViejas, have I mentioned lately how you are an inspiration to me? Because of you, I know that things will still be "ok" if I ever get to the point where I can no longer work as a nurse because of my health.

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As a nurse of almost 30 years with Bipolar, I've never disclosed to the BON, or to my employer. In my state the BON asks something to the effect of do you have any mental or physical impairments that would prevent you from doing your job? I have Bipolar Disease, but I have a Psychiatrist that keeps close tabs on me, I'm med compliant and I'm able to work. When I get really sick my psychiatrist pulls me out of work, puts me on FMLA and makes sure that I'm stable before I can return to work. It's been a life long battle, but my illness is not my employer's business, and until my psychiatrist says I'm not stable to work I can continue to tell the BON nothing.

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Specializes in ED, psych.
As a nurse of almost 30 years with Bipolar, I've never disclosed to the BON, or to my employer. In my state the BON asks something to the effect of do you have any mental or physical impairments that would prevent you from doing your job? I have Bipolar Disease, but I have a Psychiatrist that keeps close tabs on me, I'm med compliant and I'm able to work. When I get really sick my psychiatrist pulls me out of work, puts me on FMLA and makes sure that I'm stable before I can return to work. It's been a life long battle, but my illness is not my employer's business, and until my psychiatrist says I'm not stable to work I can continue to tell the BON nothing.

A genuine question ... I have bipolar 1 and am about to take the NCLEX in about a month yadda yadda. I've been worrying about this a lot lately.

So, my question here is: you're telling your BON nothing because your bipolar disorder isn't preventing you from doing your job. But, your psychiatrist will pull you out of work because of your bipolar disorder and place you on FMLA. So, wouldn't this count as your bipolar disorder preventing you from doing your job?

I've gotten burnt at a former employer so I get my illness not being my employers' business. I have no intention of telling any employer anything. But if it's worded that my mental disability may prevent me from doing my job (and I have indeed taken FMLA in the past, but at my other job), this makes me uncomfortable. Yes, I take great meds and am under incredible care. I've been stable for a very long time. Butttttttt.... unfortunately yes -- my bipolar disorder HAS prevented me from doing my job. I had to take FMLA because of it.

Thoughts?

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Specializes in Pediatric Critical Care.
A genuine question ... I have bipolar 1 and am about to take the NCLEX in about a month yadda yadda. I've been worrying about this a lot lately.

So, my question here is: you're telling your BON nothing because your bipolar disorder isn't preventing you from doing your job. But, your psychiatrist will pull you out of work because of your bipolar disorder and place you on FMLA. So, wouldn't this count as your bipolar disorder preventing you from doing your job?

I've gotten burnt at a former employer so I get my illness not being my employers' business. I have no intention of telling any employer anything. But if it's worded that my mental disability may prevent me from doing my job (and I have indeed taken FMLA in the past, but at my other job), this makes me uncomfortable. Yes, I take great meds and am under incredible care. I've been stable for a very long time. Butttttttt.... unfortunately yes -- my bipolar disorder HAS prevented me from doing my job. I had to take FMLA because of it.

Thoughts?

Well, I mean, my diabetes doesn't prevent me from doing my job effectively. Unless I have a serious episode of hypoglycemia or go into DKA, at which time I can't work because of the flare-up from my disease.

My coworker's fibromyalgia and migraine headaches don't prevent her from doing her job effectively, except for during flare ups and those are the days that she uses her FMLA to stay home ill.

Every disease can have "flare-ups", but on a typical day-to-day basis when she is not having a "flare-up", if AMN74 is able to be a safe and effective nurse at work, I think that counts.

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Specializes in ED, psych.
Well, I mean, my diabetes doesn't prevent me from doing my job effectively. Unless I have a serious episode of hypoglycemia or go into DKA, at which time I can't work because of the flare-up from my disease.

My coworker's fibromyalgia and migraine headaches don't prevent her from doing her job effectively, except for during flare ups and those are the days that she uses her FMLA to stay home ill.

Every disease can have "flare-ups", but on a typical day-to-day basis when she is not having a "flare-up", if AMN74 is able to be a safe and effective nurse at work, I think that counts.

I'm talking more about having to take FMLA for weeks, not a day here or there. A "flare up" for me with bipolar disorder would involve more than a day; in the past, it could be a few weeks to a month or more. At one time this resulted in FMLA for 5 weeks.

i have a bad history with this with a past employer, hence why I'm asking. My bipolar disorder is very well controlled with meds and therapy, etc like AMN74 and your diabetes. However, if you have a history of taking FMLA of extended leave (not just a day here or there, but a week or more) would that count as having your illness interfere with your job? I would consider that a serious episode; the last time it happened was 2007, so it's all good, but it can happen.

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Specializes in Pediatric Critical Care.
i have a bad history with this with a past employer, hence why I'm asking. My bipolar disorder is very well controlled with meds and therapy, etc like AMN74 and your diabetes. However, if you have a history of taking FMLA of extended leave (not just a day here or there, but a week or more) would that count as having your illness interfere with your job? I would consider that a serious episode; the last time it happened was 2007, so it's all good, but it can happen.

I would say no, that still doesn't count as having your illness interfere with your job. In my book, anyway. Whether it is a day, a week, or a month - when you are on medical leave, you are not at work. And more importantly, you and your doctor are in control of your symptoms enough to be AWARE of when you need to take leave. The BON wants to know that you are not going to harm a patient, steal drugs, burn the hospital down. Not whether you can guarantee to never have a rough day, medically.

Now, on slightly different subject: You probably already know this, but just to make sure that you do - you will not be eligible for FMLA coverage until you have been at your workplace for over 1 year. So do everything that you can to take care of yourself during that first year, because it will be stressful. But if you can make it through nursing school, you can make it though that first year, I promise. :)

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Specializes in Nursing Professional Development.

Pixierose: I think you should talk to an attorney with knowledge of such issues in your state. What you are asking is a legal question, not a nursing one. You need someone with legal expertise.

You don't want to get on the "wrong side" of the BON. Play it straight and safe with them.

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