Agreeing to Probationary terms as a new nurse ?

Steven Thompson · May 27

Get a lawyer NOW. I am not a fan of getting a lawyer AFTER you are already in trouble with the Board, but you had substance abuse issues BEFORE you became a nurse and have no issues now. This is why it's critical to get an attorney now. Do NOT let the Board put you in a 3 or 5 year monitoring program for something you Never did while you were a nurse and they might try. With an attorney, they will not get over 2 years. 1 Year of monitoring is reasonable, 2 years is doable, but anything more than 2 years would be absurd. This is where the lawyer comes into play.

LMRN2003, MSN, RN · May 27

Steven Thompson said:

Get a lawyer NOW. I am not a fan of getting a lawyer AFTER you are already in trouble with the Board, but you had substance abuse issues BEFORE you became a nurse and have no issues now. This is why it's critical to get an attorney now. Do NOT let the Board put you in a 3 or 5 year monitoring program for something you Never did while you were a nurse and they might try. With an attorney, they will not get over 2 years. 1 Year of monitoring is reasonable, 2 years is doable, but anything more than 2 years would be absurd. This is where the lawyer comes into play.

100% agree. You should not be penalized for going to rehab before you were a nurse. It is none of their business, in my opinion. However, since they are now aware, they will want to monitor you. I'm wondering why you disclosed this info if there wasn't anything legal involved? Did they ask specifically about rehab?

Caroline Strazis · May 30

The board has their share of attorneys and experience with this, so it's unlikely they're breaking any laws or infringing on your rights in their jurisdiction. With the likely precedents, if you did manage to get them off your case with a lawyer, it would be costly in more ways than one. At the very least, you could delay the launch of your career by months or years.

In my state, certain criminal and substance related charges or convictions give them license to monitor you. Resisting this would be unwise in my opinion, as being simply monitored isn't that big of a deal (unless you are using drugs in your leisure time and wish to continue that) and would cost you nothing. Monitoring for substance disorders or charges that occurred off-duty is usually random drug/alcohol screenings that could be done through your organization's employee health discretely.

If your history involves zero criminal charges, it's worth an ask about whether or not this is reasonable. This may sound crazy, but the board themselves may be able to provide clarity. If you choose to consult someone else, make sure they know what they are talking about. Pick through t your states board of nursing website, and if you consult a lawyer, make sure they are legitimate and well versed in your local laws as it pertains to nurses in your state. Look for some past or present affiliation with the board or nursing. Good luck.

Steven Thompson · May 31

I agree with you but disagree some. Being in monitoring is a huge deal. It's not about "not being a problem if you don't use drugs." Not using drugs is the very easy and simple part. Here's the hard part.

1. Check in everyday and one slip, one miss, and u are in trouble.

2. Monthly reports or quarterly reports to the Board sent by you and mandatory therapy and any prescriptions, a report must be sent directly from your Doctor to the Board. If he or she forgets, or one missed keyboard stroke in the email sent, or he's "out of town for 2 weeks" and you are in a mess.

3. Vacation. Got to get permission and better know where the test site is when you travel on vacation.

Did your therapist directly send your report to the Voard each month or quarter? Did they forget? If they hit one wrong stroke for the email and forgot, you are in major trouble. It's these little things people don't think about or realize. Not doing drugs is a tiny fraction of the real issues in monitoring. By the way, you are on a 12 hour shift and got selected to pee that day and it just so happens 2 other nurses called out sick and you are super short staffed, but if you can't get across town (15 minutes, then wait for 1 hour in line to pee, then 15 minutes back to work) which is 1.5 hours total, you are in major major trouble. 99 percent of people in monitoring aren't worried about a "positive drug test." They worry about getting off work to get to the drug test. This absolutely wears on you for 3 or 5 years.

The Board can legally certainly attempt to get you in monitoring or investigate you based on your background even though it was Before being a nurse, BUT....a lawyer well versed with nursing issues can get your case adjusted to the right outcome and here is the right and just outcome.....

You are required to complete a comprehensive substance abuse evaluation and it will show no current issues and based on your past, you still get 1 year of monitoring. That's fair and reasonable. 3 years or more is unreasonable. I'm warning you, it's FAR, FAR, FAR more advantageous to go the attorney route (even if it costs 5K) in this situation and worth delaying you practicing nursing for 6 months or even one year instead of doing monitoring for 3 years. All of this is under the assumption that you are being truthful and have no substance abuse issues.

Steven Thompson · May 31

Another issue with monitoring. Your parent or parents are sick and maybe even dying or a relative is chronically ill and needs you 2 states away. You literally need to move and you've been in monitoring for 2 years. Well, you move and the stste you move to gives you a new 5 year contract and the state you moved from still wants you to meet their requirements to fulfill your 5 year contract with them or they will suspend your license even though you are 2 states away, so now you end up with 7 years of monitoring and for a couple of those years, you are in 2 different programs at the same time. These things happen all of the time to nurses, so just another example of how monitoring is a big deal. You are basically stuck in that state for 5 years.

Again, it's these little things that make monitoring tough and when you ask nurses, they will tell you exactly that. They will tell you the part about " not doing drugs or alcohol" is the simple part. People don't sweat that, it's all of the other things I've written about. Most nurses who don't make it through monitoring and have their licenses suspended don't fail out due to a positive drug test. They fail out because of one of the other things I've written about in this post and the previous one, and this is why monitoring is so tough. You can literally be clean, never come close to drugs, and fail out.

Steven Thompson · May 31

One other issue in monitoring. Female, get a UTI, urine positive for alcohol. This is common. You first get to play the email back and forth phonecard back and forth game and panic sets in. Then, your case manager tells you can get a more extensive hair or nail test for alcohol and you pay 250 bucks and he tells you thst you need to go for a comprehensive substance abuse exam because your case manager didn't fully communicate with the Board of Nursing and so the Board says the exam is needed. That costs about 1500 bucks out of your pocket. After 1 month, it's resolved. Your alcohol test showed negative and by the way your Doctor after 5 calls to his office finally sent a letter explaining your UTI and the script and in this entire time you never touched alcohol. Do u see how monitoring can be stressful? The above scenario is not a rare occurrence. It happens to nurses across the country all of the time. It's an example of how you can be perfectly compliant and clean, yet sometimes things are completely out of your control.

Oh yea another example. You are on a 12 hour shift and got selected to pee and are shirt staffed and your job let's you go to pee which takes an hour or so. You get there and can not pee. Once you check in a testing site you are not allowed to leave until you pee. After drinking water you have now peed but 2 hours went by that you are out of work and now your boss is mad. This happens all of the time. Or you overprepare and drink to much and your urine is dilute because you are panicking about having to get back to work in time only for your case manager to tell you one day later younhad a dilute urine, so now younhave to have a 250 dollar hair test the next day and get to explain this to your boss at work who was mad from yesterday. Happens all of the time.

For ANYONE who tells you monitoring is " not a big deal if you aren't using drugs" do NOT listen to them. They don't know what they are talking about or they are simply not very smart.

Healer555 · May 31

A monitoring agreement is the worst thing I have ever been through. I don't have a substance use disorder so abstaining from a substance is not a problem. It's the many requirements. Check in Monday through Friday before 3 pm. Test when you are randomly selected up to 5x a month. 3 meetings a week. " Therapy and group therapy ", a sponsor. This all costs time and money and your quality of life. Avoid it at any cost if you can

Caroline Strazis · May 31

This must vary widely state to state. The monitoring you guys are describing is indeed an undertaking worth resisting harder as appropriate. The program I'm familiar with is more a like once a 3-4 week phone call to present for a screening. If the nurse will be out of town/off duty, they simply notify the clinic in advance. In some cases, only the substance that gave the person a record is tested for. The goal for most institutions in my state is that the staff are not impaired at work, or diverting narcotics.

Healer555 · May 31

Caroline Strazis said:

This must vary widely state to state. The monitoring you guys are describing is indeed an undertaking worth resisting harder as appropriate. The program I'm familiar with is more a like once a 3-4 week phone call to present for a screening. If the nurse will be out of town/off duty, they simply notify the clinic in advance. In some cases, only the substance that gave the person a record is tested for. The goal for most institutions in my state is that the staff are not impaired at work, or diverting narcotics.

One drug test every 3 to 4 weeks? Only tested for your alleged drug of choice? Not tested while on vacation? Much easier than my state. I'm waiting until my monitoring agreement is over to go on vacation so I can actually enjoy myself.

Totheendandback, ASN, RN · May 31

Caroline Strazis what state are you in? I believe the monitoring programs are different now. I also think that people with your opinions and attitudes hurt nurses in these situations, instead of helping.

Sunflower, please contact a attorney who specializes with the board of nursing. It will cost some money but the monitoring program will cost you thousands of dollars. You have rights. Please protect your rights. Hold your head high and be proud of all of your accomplishments. Remember your experiences from the past will make you a better and more compassionate nurse, which we truely need now.

Steven Thompson · May 31

Like I wrote, get a lawyer. Yes, the Board can legally investigate you and try to get you into monitoring for something that occurred before you were a nurse, BUT.....you can legally get an attorney as well and you have far more power hear from an attorney standpoint because the events occurred BEFORE you were a nurse.

The nurse board for your stste should have requested you do comprehensive substance abuse exam and at most, request 1 year of monitoring. They should NOT have requested you do monitoring for 2 or 3 or 5 years as a first step. That is Wrong and I promise you, a lawyer will get this negotiated to the Comprehensive substance exam followed by 1 year of monitoring at most. You will absolutely REGRET this if you don't get a lawyer and they stick you with 3 years of monitoring and you make the decision to accept it because you just want to practice nursing and get started in your career. In this situation, the 5000 bucks for the lawyer and 6 month delay until your lawyer and the Board hash things out OUTWEIGHS accepting a monitoring agreement and not getting a lawyer.