Ack! Paying the price for honesty about Depression Diagnosis

Works2xs · Jul 12, 2005

Here's my problem: the local hospital is waiting on to hear if I will accept the position they offered me....I am waiting on my temp nursing license for this state...today I recv'd information from the board of nursing saying that they need a detailed history of my counseling and something from my counselor saying I am stable and compliant with treatment (for depression and PTSD)...then they can issue the nursing permit...so...my counselor is on holiday all week...but I do not want to reveal to my prospective employer that the board of nursing is waiting on my mental health records.
I want to accept the position but how do I explain the delay in my temp permit?
I wish I had not answered the question on the application regarding being in treatment!

Sorry, I can't comment directly regarding how the nursing field handles information on such matters. However, some feedback on how I'd handle this in any given career field may offer some ideas (I'm sure folks will comment if this is off-base)

First, I'd place any regret about "checking the box" about being in treatment in the "round file." I could see several scenarios where a failure to disclose information could result in grounds for immediate dismissal. Then there's the need to forever guard that sort of information so that a mistaken disclosure on your part didn't spoil the ruse. Any issue regarding the ramifications of being truthful should shrink considerably when stacked against all the baggage you'd have picked up had you done otherwise.

As far as what to tell your prospective employer, I'd say that all you need to do is explain that some additional paperwork was required by the licensing board and that you expect to have all required information submitted by such-and-such date (sounds like shortly after you counselor returns). I'd be surprised to find out that other paperwork snafu's didn't occasionally crop up and cause similar delays. I would think that as long as you gave an expected suspense date for the action, some accommodation would be afforded. Why? Because if the job has been offered, then you know that they believe you are someone they want/need on staff. The hassle in conducting interviews, sending out letters, waiting for responses, etc. would certainly be longer than the short delay you are referring to.

Lastly, I'd stay away from differentiating the type of health issue that you are waiting to clear up (that is, if they should ask). Mental health issues should not be viewed any differently than any other type of health issue. For all your employer knows, they may be waiting on TB Test info (e.g., chest film) or other such health data. As far as the employer goes, equal employment laws do apply and they can't legally discriminate on that basis.

Hope this helps.

Meerkat · Jul 12, 2005

Sorry, I can't comment directly regarding how the nursing field handles information on such matters. However, some feedback on how I'd handle this in any given career field may offer some ideas (I'm sure folks will comment if this is off-base)
First, I'd place any regret about "checking the box" about being in treatment in the "round file." I could see several scenarios where a failure to disclose information could result in grounds for immediate dismissal. Then there's the need to forever guard that sort of information so that a mistaken disclosure on your part didn't spoil the ruse. Any issue regarding the ramifications of being truthful should shrink considerably when stacked against all the baggage you'd have picked up had you done otherwise.
As far as what to tell your prospective employer, I'd say that all you need to do is explain that some additional paperwork was required by the licensing board and that you expect to have all required information submitted by such-and-such date (sounds like shortly after you counselor returns). I'd be surprised to find out that other paperwork snafu's didn't occasionally crop up and cause similar delays. I would think that as long as you gave an expected suspense date for the action, some accommodation would be afforded. Why? Because if the job has been offered, then you know that they believe you are someone they want/need on staff. The hassle in conducting interviews, sending out letters, waiting for responses, etc. would certainly be longer than the short delay you are referring to.
Lastly, I'd stay away from differentiating the type of health issue that you are waiting to clear up (that is, if they should ask). Mental health issues should not be viewed any differently than any other type of health issue. For all your employer knows, they may be waiting on TB Test info (e.g., chest film) or other such health data. As far as the employer goes, equal employment laws do apply and they can't legally discriminate on that basis.
Hope this helps.

What an incredibly kind and compassionate response. Thank you SO much for taking the time to give that advice. It is very appreciated, and you really sound like you have experience with this. Your explanation was very eloquent and it eased my fears greatly. I cannot tell you how thankful I am! This will really help in my conversation with the nurse manager.

I hope that you are in a field in which you advise or counsel because you are VERY good at it!

Thank you!

Angelique

barefootlady, ADN, RN · Jul 12, 2005

Works, as my grandson says, you're the bomb. Wonderful post.

MiaLyse, APRN · Jul 12, 2005

Mental health issues should not be viewed any differently than any other type of health issue >>

So true. I am a big advocate of reducing the stigma related to mental illness. Maybe someday this person wouldn't have to be afraid. One can hope....

Kelly

peaceful · Jul 12, 2005

There are many reasons for license delays. For example my permanent license for California is delayed because i had to redo my fingerprints. The live scan was not accepted by the FBI. I redid the prints on the old style card & waiting for results. Just call the job, be professional and say there is a paperwork delay. Nobody's business why. I am sorry you have to go through this for a diagnosis of depression and PTSD. I can see why a license would be delayed for chemical dependency or alcohol abuse but depression dx? About 1/2 the nursing population has at one time or another had this dx if not a higher number. Out of the ten nurses i work with, 6 of them indicate they are on antidepressant meds. You are not alone and your license should not of been delayed. Let us know how all goes.

Here's my problem: the local hospital is waiting on to hear if I will accept the position they offered me....I am waiting on my temp nursing license for this state...today I recv'd information from the board of nursing saying that they need a detailed history of my counseling and something from my counselor saying I am stable and compliant with treatment (for depression and PTSD)...then they can issue the nursing permit...so...my counselor is on holiday all week...but I do not want to reveal to my prospective employer that the board of nursing is waiting on my mental health records.
I want to accept the position but how do I explain the delay in my temp permit?
I wish I had not answered the question on the application regarding being in treatment!

Meerkat · Jul 12, 2005

Thank you again everyone...I admit I was afraid even to post this information...because of the stigma. I thought I might get responses like 'If you are in counseling you shouldn't be in nursing".

As for the depression diagnosis delaying my permit, I agree with you. I've never had a substance abuse problem. The application for a temporary permit, however, required me to answer questions about mental health treatment. I do not understand why depression should be a 'red flag' to people issuing my license, and in fact, I personally believe it is discrimanatory and an invasion of privacy to have to answer those questions. It's not as if I have ever had a disciplinary action or violent history.

The nursing board is requesting a written 'detailed explanation' of what put me into therapy, what progress I have made and how far into the future I expect to be in therapy. I don't feel I should have to give a 'detailed explanation' of being sexually assaulted and beaten. I currently have an Order for Protection From Abuse (restraining order) against my husband, who I am divorcing. But I need a job so I can support myself and my new baby, so I guess I have to play by Alabama's rules.

Thanks again for your support.

sgent · Jul 13, 2005

The sad reality is that if you have "garden style" depression, you will often be lumped into a category of psychotic depressive. As someone suffering from mental illness myself, I can relate (Bipolar II). The reality is that nursing boards, physician boards, and attorney boards all have a right to know that the professionals patients/clients will be treated by someone who is mentally competent to do so -- which you may not be if you were in a severe psychotic depression.

I've rarely heard of any problems getting the license (other than delay), assuming you give full disclosure. Often boards will require that you have your counselor/psychiatrist report to them if they believe you are no longer capable of performing professional duties, or if you become non-compliant.

I don't have a problem with this in theory, but I have to wonder why insulin dependent diabetics or migraine sufferers aren't treated the same way.

Tweety, BSN, RN · Jul 13, 2005

Great posts here. Good luck to you. :)

grannynurse FNP student · Jul 13, 2005

The sad reality is that if you have "garden style" depression, you will often be lumped into a category of psychotic depressive. As someone suffering from mental illness myself, I can relate (Bipolar II). The reality is that nursing boards, physician boards, and attorney boards all have a right to know that the professionals patients/clients will be treated by someone who is mentally competent to do so -- which you may not be if you were in a severe psychotic depression.
I've rarely heard of any problems getting the license (other than delay), assuming you give full disclosure. Often boards will require that you have your counselor/psychiatrist report to them if they believe you are no longer capable of performing professional duties, or if you become non-compliant.
I don't have a problem with this in theory, but I have to wonder why insulin dependent diabetics or migraine sufferers aren't treated the same way.

You would be surprised at the problems that anyone who suffers from a chronic illness or disability undergoes. Please do not assume that mental illness is the only problem.

Grannynurse :balloons:

sgent · Jul 13, 2005

Granny...

I did not mean to diminish others in any way shape or form.

Your comment about "problems that anyone who suffers from a chronic illness" was exactly my concern. If they suffer from a physical impairment, which could affect their ability to perform their job, why are they not required to the BON, why those with mental impairments are? It is this unequal treatment that I have a problem with.

That being said, this disparate treatment is of course not unique to this situation.

student4ever · Jul 13, 2005

To the OP - I'm sorry you're dealing with such difficult situations and that the state is being so unhelpful to getting your life back together. I'm not a nurse yet, so I'm not an expert by any means, but I'm guessing that it's the PTSD dx rather than the dx of depression that may be giving them concern. The ER I work in has a frequent flier who suffers from PTSD after being a POW in Vietnam. Any sudden movements, noises, bright lights, etc. set him off, and I can see that without any explaination of what caused your PTSD, there might be concerns about how you might react to the stress of a nursing job. This is not to say that I personally have concerns. You sound like a wonderful person who has the strength to get through difficult times, and that is a quality that nurses need. It's a shame that your paperwork is delayed, but I agree with the other posters that a simple paperwork delay notification should be all you need to give to your new employer. There are tons of reasons why paperwork is delayed, and many times people aren't necessarily given a reason why their paperwork is delayed, so your employer shouldn't need a reason for the delay. If they do ask, a simple "I'm not sure exactly" would suffice... And it's totally truthful... you're not sure why they need the information from your counselor, and you're not sure which diagnosis needs explaining for your license to come through. Good luck, and I wish you all the best in your new job.