Does your license to practice get taken away immediately when you get letter from the board of nursing?

SheelaDavis · Jun 18

1. Your license isn't going ro be revoked. If you did something so aggregious that is cause for Revoking a license, you would have got a desist order immediately and would have been told within days of the complaint.

2. Is there a chance your license is suspended or put on probation after 9 or 10 months? Yep, there is, but you can continue practicing until the investigation is done and the BON decides what discipline is necessary UNLESS the letter you get tells you to immediately stop practicing. It's unlikely the letter informing you an investigation has been opened will tell you to stop practicing. Is it possible? Yep, it is. Is it likely after 9 or 10 months? Nope, it's not likely.

3. The BON can take up to 2 years sometimes to Inform you an investigation has been opened on you. Yes, 2 years or more in some cases. Usually, it's less than 1 year. Keyword.....usually.

4. They inform you about what you are being investigated for. You can prepare and won't go in blind. The hearing is usually within 60 days from the time you receive the letter. Much of that depends on the BONs schedule/slots available.

5. You sound like..... by the way you are writing, that you are guilty of something and that it's obviousthe BON had enough evidence on you to give discipline. If you deep down know this is true, then you should get into a monitoring program in VA. Why? The BON (assuming you are clearly guilty) will require monitoring if your issue is substance related. Your time with the BON starts and ends from the day you enter monitoring, not from the date of your consent order. Let's say 1 year passes by from today before you get a contract and that contract says you need 5 years of monitoring. You will have wasted 1 year and 9 months. If you start now in monitoring, you get the clock started which means it ends sooner.

RoastedRN12 · Aug 7

I got reported February 2025. I had an opportunity to get on the monitoring program within 30 days otherwise I'd be referred for an investigation. Well I chose the investigation but I'm wondering would I still be eligible to do the monitoring program voluntarily still, or because there's a complaint will I just get in trouble? Also, once you do the contract, do you have to quit your job right away?

smc26448 · Aug 8

RoastedRN12 said:

I got reported February 2025. I had an opportunity to get on the monitoring program within 30 days otherwise I'd be referred for an investigation. Well I chose the investigation but I'm wondering would I still be eligible to do the monitoring program voluntarily still, or because there's a complaint will I just get in trouble? Also, once you do the contract, do you have to quit your job right away?

What state are you in? I would probably reach out to the point of contact (if you have one) to ask if that's an option. My understanding based off of what I have read on my states board of nursing website in the public case decisions and from reading many posts from nurses in diff states rehabilitation/monitoring programs is that you do have to quit work for a period of time initially (few months seems to be the norm), until they deem you safe to resume (usually w/ restrictions) also they usually have you do a psych/substance abuse eval plus inpatient or intense outpatient rehab during that period.

I'm not in a monitoring agreement yet so can't answer specifics, but if you don't mind me asking, how did you get the opportunity to be in monitoring? Did someone from the BON contact you, and how long after you got reported was that? Have they reached out with any update since you elected to be investigated instead?

RoastedRN12 · Aug 8

smc26448 said:

What state are you in? I would probably reach out to the point of contact (if you have one) to ask if that's an option. My understanding based off of what I have read on my states board of nursing website in the public case decisions and from reading many posts from nurses in diff states rehabilitation/monitoring programs is that you do have to quit work for a period of time initially (few months seems to be the norm), until they deem you safe to resume (usually w/ restrictions) also they usually have you do a psych/substance abuse eval plus inpatient or intense outpatient rehab during that period.

I'm not in a monitoring agreement yet so can't answer specifics, but if you don't mind me asking, how did you get the opportunity to be in monitoring? Did someone from the BON contact you, and how long after you got reported was that? Have they reached out with any update since you elected to be investigated instead?

I don't want to say the state in case coworkers are reading this. I realized I was reported in Jan 2025 and was contacted Feb 2025 because I had not responded to an email telling me about the complaint. I had been given 30 days from date of complaint to let them know my response. I said investigation. They said they were forwarding my info but I have yet to hear anything. So I was just trying to see if it was something I could still do. I sent an email to my point of contact and when they respond I'll let u know.

smc26448 · Aug 8

RoastedRN12 said:

I don't want to say the state in case coworkers are reading this. I realized I was reported in Jan 2025 and was contacted Feb 2025 because I had not responded to an email telling me about the complaint. I had been given 30 days from date of complaint to let them know my response. I said investigation. They said they were forwarding my info but I have yet to hear anything. So I was just trying to see if it was something I could still do. I sent an email to my point of contact and when they respond I'll let u know.

Wow, they contacted you right away. Have you continued to work as a nurse? It has almost been a year since I was reported and I have yet to hear from the board of nursing (I'm in Virginia). I'm constantly in fear of the letter coming in the mail, and the uncertainty of the whole situation is so stressful. I'm never relaxed and it's always on my mind. Like you, I'm wondering if I shouldve just self-reported and started a monitoring agreement instead of waiting for an investigation. I stopped drinking after I was reported so have almost 1 year sober, so should've just gone ahead and done it. I'd at least have a year down. At this point, I don't know what to do.... My states monitoring program is 5 years!!

RoastedRN12 · Aug 8

smc26448 said:

Wow, they contacted you right away. Have you continued to work as a nurse? It has almost been a year since I was reported and I have yet to hear from the board of nursing (I'm in Virginia). I'm constantly in fear of the letter coming in the mail, and the uncertainty of the whole situation is so stressful. I'm never relaxed and it's always on my mind. Like you, I'm wondering if I shouldve just self-reported and started a monitoring agreement instead of waiting for an investigation. I stopped drinking after I was reported so have almost 1 year sober, so should've just gone ahead and done it. I'd at least have a year down. At this point, I don't know what to do.... My states monitoring program is 5 years!!

Ours is 5 with option for 3 if completed everything like we should. How do you know you were reported?

smc26448 · Aug 8

RoastedRN12 said:

Ours is 5 with option for 3 if completed everything like we should. How do you know you were reported?

OMG, I WISH three was even an option. I have never seen 3 years in my state, and I heard that moving to a diff state for their monitoring program isn't a way around it, the new state ends up doing whatever the prev. agreement was.

When I was fired from my job last year, I had issues related to alcohol and they said they had to report me. I work for a large hospital system so id imagine they followed through, unless someone forgot to do it.

SheelaDavis · Aug 8

Going to repeat. Get into monitoring now and get the clock started. You can enter monitoring on your own, voluntary and when VA finally comes around to discipline, the time that you started monitoring is the start date for when the discipline and entire process ENDS. The investigation will likely conclude with.......you having to do monitoring. Again, if you know deep down you diverted or was impaired at work, stop delaying the inevitable. Get the clock started so all of this ends earlier, and you will get a sense of some anxiety relief because you will know that it doesnt matter when the investigation ends or how long it takes, you already have an END date for this to be all over with, and that lowers anxiety some. If you enter monitoring voluntary and VA finishes the investigation and converts your status to involuntary or Board mandated monitoring, who cares. It doesnt matter. You already will have started the clock for this to have an END Date from the day you entered monitoring.

Trust me on this having read tons of posts and talking with well over a hundred nurses over the years who delay monitoring. They ALL kick themselves by waiting for the investigation to conclude before they started monitoring and the investigation can sometimes take 2 years, then the nurse enters monitoring and completes 5 years and around the 2 or 3 year mark into monitoring, they are kicking themselves because they didn't start earlier, so the whole process turns into a 7 year ordeal of stress when it could have been a 5 year ordeal of stress.

You have ZERO control over the investigation or timeframe for the BON to finish the investigation. What can you control? When it all ends and that starts with the first day you enter monitoring.

Again, ALL of the ABOVE only applies to nurses who know deep down, they are caught. They deep down know the Pixis had major errors, or they diverted, or they were impaired or hungover at work, or there are multiple witnesses or all of the above. In these situations where you deep down know that you are caught, you are guilty, stop drawing out the inevitable and get into monitoring so the inevitable ends earlier. Now, for nurse who absolutely didn't do anything wrong, you need to fight back, lawyer up, do not enter monitoring.

BONs don't have a strong burden to prove to give you monitoring. The standard is not high. It's not like a court where someone is being tried for murder. They don't need much evidence compared to a court and when the evidence is fairly reasonable or just enough, even most lawyers hired by the nurses end up agreeing to you doing monitoring because they know they aren't going to win. Now, when evidence is weak (fee pixis discrepancies, or no witnesses or no positive at work drug tests) and you have a substance abuse eval that says no substance use disorder, this is where a lawyer can win. But, many nurses try to convince themselves of the following....they diverted or used or where impaired and the evidence is there and they go under investigation by the BON and the nirse immediately becomes sober and then a year or 18 months later, the BON investigation says the nurse needs to do a substance abuse eval and the eval says, "No SUD,". The nurse thinks they are in the clear, but in cases where the evidence of diversion or impairment and/or witnesses, pixis pulls, etc was so great 1.5 years ago against you, you will STILL end up doing monitoring. Nurses think it all comes down to the SUD eval results. It doesnt. The SUD eval results have great weight, but the other things I mentioned also have great weight Regardless of what the SUD eval result is.

Get into monitoring which gives you some control. The day you enter, you get an END Date, an absolute, a finality on when all of this ends. That lowers anxiety some. Trust me, if the BON said they are investigating you, they don't forget. Trust me. 18 months could go by or even 2 years. At some point, Trust me, they will make contact with you and the process will begin. Getting into monitoring NOW takes the sting out of the anxiety about when they will get back to you.

RoastedRN12 · Aug 8

smc26448 said:

Wow, they contacted you right away. Have you continued to work as a nurse? It has almost been a year since I was reported and I have yet to hear from the board of nursing (I'm in Virginia). I'm constantly in fear of the letter coming in the mail, and the uncertainty of the whole situation is so stressful. I'm never relaxed and it's always on my mind. Like you, I'm wondering if I shouldve just self-reported and started a monitoring agreement instead of waiting for an investigation. I stopped drinking after I was reported so have almost 1 year sober, so should've just gone ahead and done it. I'd at least have a year down. At this point, I don't know what to do.... My states monitoring program is 5 years!!

This is the response I got:

Good Morning

if a nurse has been reported, and the nurse initially chooses to complete the investigation, can they then months later decide to do the monitoring program? Y
Yes, the program is a voluntary program and they may enter, but usually the investigation will continue.

Are nurses allowed to be on suboxone or methadone while in the monitoring program? And can they still work while on these meds? Or do they have to quit their nursing job to start the program?
Yes, if prescribed by a licensed provider, nurses can use the medications listed and continue to work while being monitored for safe practice. No, they do not need to quit a nursing job that fits into the parameters of the ATD Program.

smc26448 · Aug 8

SheelaDavis said:

Going to repeat. Get into monitoring now and get the clock started. You can enter monitoring on your own, voluntary and when VA finally comes around to discipline, the time that you started monitoring is the start date for when the discipline and entire process ENDS. The investigation will likely conclude with.......you having to do monitoring. Again, if you know deep down you diverted or was impaired at work, stop delaying the inevitable. Get the clock started so all of this ends earlier, and you will get a sense of some anxiety relief because you will know that it doesnt matter when the investigation ends or how long it takes, you already have an END date for this to be all over with, and that lowers anxiety some. If you enter monitoring voluntary and VA finishes the investigation and converts your status to involuntary or Board mandated monitoring, who cares. It doesnt matter. You already will have started the clock for this to have an END Date from the day you entered monitoring.

Trust me on this having read tons of posts and talking with well over a hundred nurses over the years who delay monitoring. They ALL kick themselves by waiting for the investigation to conclude before they started monitoring and the investigation can sometimes take 2 years, then the nurse enters monitoring and completes 5 years and around the 2 or 3 year mark into monitoring, they are kicking themselves because they didn't start earlier, so the whole process turns into a 7 year ordeal of stress when it could have been a 5 year ordeal of stress.

You have ZERO control over the investigation or timeframe for the BON to finish the investigation. What can you control? When it all ends and that starts with the first day you enter monitoring.

Again, ALL of the ABOVE only applies to nurses who know deep down, they are caught. They deep down know the Pixis had major errors, or they diverted, or they were impaired or hungover at work, or there are multiple witnesses or all of the above. In these situations where you deep down know that you are caught, you are guilty, stop drawing out the inevitable and get into monitoring so the inevitable ends earlier. Now, for nurse who absolutely didn't do anything wrong, you need to fight back, lawyer up, do not enter monitoring.

BONs don't have a strong burden to prove to give you monitoring. The standard is not high. It's not like a court where someone is being tried for murder. They don't need much evidence compared to a court and when the evidence is fairly reasonable or just enough, even most lawyers hired by the nurses end up agreeing to you doing monitoring because they know they aren't going to win. Now, when evidence is weak (fee pixis discrepancies, or no witnesses or no positive at work drug tests) and you have a substance abuse eval that says no substance use disorder, this is where a lawyer can win. But, many nurses try to convince themselves of the following....they diverted or used or where impaired and the evidence is there and they go under investigation by the BON and the nirse immediately becomes sober and then a year or 18 months later, the BON investigation says the nurse needs to do a substance abuse eval and the eval says, "No SUD,". The nurse thinks they are in the clear, but in cases where the evidence of diversion or impairment and/or witnesses, pixis pulls, etc was so great 1.5 years ago against you, you will STILL end up doing monitoring. Nurses think it all comes down to the SUD eval results. It doesnt. The SUD eval results have great weight, but the other things I mentioned also have great weight Regardless of what the SUD eval result is.

Get into monitoring which gives you some control. The day you enter, you get an END Date, an absolute, a finality on when all of this ends. That lowers anxiety some. Trust me, if the BON said they are investigating you, they don't forget. Trust me. 18 months could go by or even 2 years. At some point, Trust me, they will make contact with you and the process will begin. Getting into monitoring NOW takes the sting out of the anxiety about when they will get back to you.

You're right. The reason that I did not initially self report is because I figured it would only take a couple months at most for them to reach out, and I wanted to ensure I had income, at least some savings, and health insurance by the time they got to me. I read that the program itself costs around 40k in total (counting drug tests, rehab, therapy appts, etc), this was just an estimate someone gave so not sure how true this is. I also knew I could not afford out of pocket rehab/eval. I had absolutely no money at all and the not working scared me a lot. Didn't realize it would drag on so long, there has not been a single day where this has not been on my mind. Every time I check my mailbox, I anticipate the dreaded letter. I think you're right that it would make more sense and actually provide a sense of relief. I do know that I was impaired at work, although they don't have proof, they have witnesses, so the program is inevitable. Thankfully, I am sober now (I don't even drink caffeine or take any meds) so know I can get through the program with no issues, but the cost, potential inpatient rehab, and finding a job that will hire me on restriction is scary, but its going to have to happen at some point. Why not start the process, as you said.

smc26448 · Aug 8

RoastedRN12 said:

This is the response I got:

Good Morning

if a nurse has been reported, and the nurse initially chooses to complete the investigation, can they then months later decide to do the monitoring program? Y
Yes, the program is a voluntary program and they may enter, but usually the investigation will continue.

Are nurses allowed to be on suboxone or methadone while in the monitoring program? And can they still work while on these meds? Or do they have to quit their nursing job to start the program?
Yes, if prescribed by a licensed provider, nurses can use the medications listed and continue to work while being monitored for safe practice. No, they do not need to quit a nursing job that fits into the parameters of the ATD Program.

Thanks for this update. This is all good info to have. However, in Virginia, when I called the monitoring program, I was told that stopping work for a few months (they said it varies but average is ~3 months) is required during the substance abuse/psych eval part in the very start before they come up with restrictions and approve you to work. I wonder if they would make you stop working for a period of time, not necessarily quit?