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Do I have to disclose mental illness

Nurses   (4,321 Views 47 Comments)
by NurseChaiPls NurseChaiPls (New) New

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pixierose is a BSN, RN and specializes in Neuro-ICU, psych.

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Oh hell naw.

Mental illness still carries a very real stigma, even out here in the nursing world. Even in the psych unit I work at per diem, there are some amazing, understanding folks ... but judgment is there.

I’m not about to tell my NM about my endo, or my migraines, my bipolar disorder or now my multiple sclerosis because it’s really, truly none of their damn business. As of right now, none of it affects my job and its performance, and I very rarely (if ever) call out.  All is well treated and maintained; I’m doing the best I can to keep it that way.

When I did apply to my jobs, however, a list of my medications were asked and dx and I did provide those with no regret. This was not relayed to my NM.

If I tell my boss that I have diabetes no one would look at me sideways ... but say one word about a psychiatric disorder and others look askance. 

 

 

 

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ruby_jane has 10 years experience as a BSN, RN and specializes in ICU/community health/school nursing.

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39 minutes ago, pixierose said:

 

If I tell my boss that I have diabetes no one would look at me sideways ... but say one word about a psychiatric disorder and others look askance. 

 

Amen. If everything is under control, why open the can of worms? If it is not under control, however, be aware that nursing school with its various stressors (both internalized and very real) will make things worse.

Best of luck!

 

 

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ShadowNurse has 4 years experience and specializes in Pediatrics.

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I would say don't tell, OP. Not because it would impact your readiness as a nurse, but because it is nobody's business. I had the same anxiety about disclosing when I was admitted to my LPN program. I had an abusive childhood and have a depression/PTSD diagnosis as an adult and have been treated as an inpatient before.

However, almost 4 years into my nursing career and it has not impacted my ability to provide good care. You are doing all that you need to be successful. I read about PTSD using the term "moral injury" and that has always spoken to me. What we deal with is a kind of traumatic brain injury that heals on its own time and usually requires some assistance, but it doesn't mean we are "mentally ill." I keep my diagnoses private so I can heal at my own pace without judgment or interference from others. I think you deserve the same chance to be seen for your abilities, not your wounds.

As far as I know, you do not have to disclose this. It has no bearing on your physical ability to perform nursing duties, which is all the school has the right to care about.

A low dose of an SSRI does well for me, but trauma therapies have been equally as helpful for more long-term, stable healing like EMDR, DBT, and so on. There are lots of options; keep seeking help and good luck.

Edited by ShadowNurse

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ocean.baby has 25 years experience and specializes in corrections and LTC.

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If you did not have a psychotic break I would not disclose this.  It is my opinion (for what that is worth), that they are looking more for psychosis, schizophrenia, etc.  

If everyone with PTSD and/or depression could not get into school or work our country would be in a sad state.  

With what you have been through I believe that you will be a great patient advocate when it comes to mental health issues -- good luck to you!

 

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brandy1017 is a ASN, RN and specializes in Critical Care.

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I've read on here some state nursing boards will ask if you have had any mental illness and if you've been hospitalized.  I remember one person who admitted they were hospitalized for a suicide attempt that was in the past and the person was stable, yet forced into a treatment program as if they had been caught diverting drugs.  It was interfering with that person's ability to get a job because of restrictions on the license, not to mention the expense of treatment programs.  I believe she was even drug tested at her own cost, even though it had nothing to do with diversion!

Personally, I would advise you not to disclose your protected health information so it wouldn't be used against you by the board when it's time to get a job.  But if you are taking controlled substances you will need to disclose as everyone is drug tested now, some places take a hair sample vs just urine as it can check back months at a time.

I wish the legal nurse on this site would weigh in to this matter.

I can tell you depression and anxiety are very common among nurses especially given the stress of the job.  Also many people suffer from PTSD as well whether from war or from rape or child abuse.  I'm sure it is under reported and under treated.   Whatever you decide to do keep reaching out for the help you need whether meds or therapy and know you are not alone.

Edited by brandy1017

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

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Both nursing boards and hospitals can legally ask about pertinent mental health histories, you can quibble over the exact wording of how it asked and how you have to answer, but generally for those in "safety sensitive" rolls such as nurses (and nursing students), mental health history is legally considered a pertinent to the role of a nurse. 

Since nursing programs have to abide by the requirements of the facilities where students will be doing clinical rotations, usually the same requirements as an employed nurse at the facility, this may require things like drug testing (which can legally include prescribed medications) and mental and physical health screenings.

There is certainly the chance that such information will be used to discriminate against a student, although this can be legally challenged, but lying about it or failing to disclose this type of information is reportable to the BON which can prevent you from ever getting a license at all.

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Luchador has 5 years experience as a CNA, EMT-B.

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1 hour ago, MunoRN said:

 pertinent mental health histories

I can't think of many "pertinent" mental health histories-- addiction; that's about it.   Paranoid Schizophrenia, I suppose, too.   But depression?  PTSD?  Bi-Polar? No way 

Short of a subpoena, how will they find out, anyway?  And if somebody does have reason to subpoena a person's records, I'd say they have bigger troubles than being in-patient for depression years ago. 

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Thank you for your service. I would not disclose that information to them.

You are ok now and that is what matters. They aren’t going to ask you to provide medical records. Your past is your past and you have obviously recovered some from that period in your life. Don’t be one of those people that are too honest. That’s personal information to me and none of their business. Just provide your overall health history. 

In nursing, you need to have all of your senses like sight, hearing, smell, etc., be generally healthy, and able to perform physical duties. You will also need to be emotionally and mentally stable. We all know ourselves best so go be a nurse. 

 

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Katillac has 18 years experience as a RN.

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This is about state boards, not schools.
"As you know, the obligation of any state board of nursing is to protect the public by ensuring that those who are licensed are competent and safe practitioners. As a result, they have the authority to ask applicants, and those who renew their licenses, a great deal of information, including if the applicant has any criminal convictions and has had psychiatric care."

https://www.nurse.com/blog/2017/10/11/rn-concerned-about-disclosing-psychiatric-treatment-to-state-board/

 

Edited by Katillac

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On 3/18/2019 at 10:30 PM, Kooky Korky said:

Part of the issue is that you lied, it sounds like.

I don't know what the school could and could not ask, but it sounds a little late for you to be deciding.

I think you need to talk to a couple of attorneys to find out what your options are.

I am glad you are doing well with school, but it sounds like your conscience is troubling you or you are worried that someone might learn the truth.

Thank you for serving and I wish you all the best.

Omission in this case is not a lie. This person was protecting their privacy. Right to privacy is still a thing, especially in the case of disability. Fact check me, but I'm fairly certain I am on to something here...

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Luchador has 5 years experience as a CNA, EMT-B.

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1 hour ago, Katillac said:

This is about state boards, not schools.
"As you know, the obligation of any state board of nursing is to protect the public by ensuring that those who are licensed are competent and safe practitioners. As a result, they have the authority to ask applicants, and those who renew their licenses, a great deal of information, including if the applicant has any criminal convictions and has had psychiatric care."

https://www.nurse.com/blog/2017/10/11/rn-concerned-about-disclosing-psychiatric-treatment-to-state-board/

 

But how would they find out short of a subpoena for medical records? And if they have a good enough reason to do that, no doubt the individual is in deep, deep trouble anyway. 

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AutumnApple has 12 years experience and specializes in M/S, Pulmonary, Travel, Homecare, Psych..

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As one who had to seek treatment post rape, I can share my experience with this topic with you:

 

The answer you seek doesn't exist.  It's in that proverbial gray area.  

 

One person may decide to reveal their history, and have no regrets.  The next person who does reveal their history could very well likely end up wishing they hadn't.  

 

What I find it all boils down to is:  Will not knowing ever become a problem for the facility?  If yes, be certain they will point out that  you didn't tell them your history after something happens.  If no, then no harm in not telling and probably best not to give others a front row seat to the theater of "my life".  That rule, in general, applies to life universally, not just with this specific issue.

 

I've never revealed the history I mentioned above to any perspective employer.  I never regretted not doing so. BUT the reason it never became a problem is because..........my past never became a problem for them post hire.  

 

The little dirty secret about not revealing you past is (whether asking you in the first place was appropriate or not has no weight on this):  Once we decide to keep that part of things to ourselves, it's ours and ours alone to manage.  If problems arise post hire, it's up to you to handle them without any accommodations from them.

 

I did once, after my incident, find myself slipping back into depression.  I had gone into travel nursing and it was great for me in a lot of ways, but not in others.  Being so far from home, away from the familiar and comfortable, had more of an effect on me than I suspected.  

 

I had not revealed my history to the company I worked for (and yes, they asked specifically, just like your facility did) nor the hospital they placed me in at the time (yes, they asked as well).  So.........I was on my own.  I had to seek help but at the same time keep things under the radar.

 

That's the reality we accept when we choose not to give perspective employers the whole truth.

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