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

RoastedRN12 · Aug 8

smc26448 said:

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?

I don't know. I haven't a clue. I don't even know if my current job would let me continue to work. I haven't a clue. And if I can work there, IDK what my colleagues would say. They are already talking ***. But I'm seriously contemplating it and have given myself a deadline of next Friday to do it. I know putting it off isn't helping but I don't have the means to not work right now and I don't have a vehicle either so I'm pretty much screwed right now.

smc26448 said:

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.

I'm in the same boat. I have no idea how much it costs and I definitely don't have savings.

smc26448 · Aug 8

RoastedRN12 said:

I don't know. I haven't a clue. I don't even know if my current job would let me continue to work. I haven't a clue. And if I can work there, IDK what my colleagues would say. They are already talking ***. But I'm seriously contemplating it and have given myself a deadline of next Friday to do it. I know putting it off isn't helping but I don't have the means to not work right now and I don't have a vehicle either so I'm pretty much screwed right now.

I'm in the same boat. I have no idea how much it costs and I definitely don't have savings.

Yep, I struggled with the same thing. I live on my own and going back with parents to reduce costs is not an option. I have looked into non-nurse positions, that way when I self-report, I can still work because they can only restrict RN work (I believe). That may be an option for you too, but the pay cut will be significant from the job postings I've looked at compared to RN pay in my area. I wish I could go back in time and avoided this whole thing!

SheelaDavis · Aug 8

It makes sense if you do not have the money to wait until starting monitoring. That's reasonable. I think 40K is too high. I think it's truly more like 25K over 5 years, but it does vary. As for starting a monitoring program, any nurse in America can do it right now at any point. You can literally say, "My mom is scared I will end up doing drugs, so I want to give her extra assurance and do a monitoring program." You don't need permission. The monitoring program will say, "Fine and dandy. You go for an SUD eval and then the monitoring programs says, "you realize you don't have an SUD and haven't had any issues, do you actually still want to do this?" You say, "Yes," and they will usually say, so be it. The above example is voluntary and one would be crazy in my opinion to do a monitoring program if you are not in trouble and have no issues, and MOST states do NOT require you to stop or miss work if you enroll voluntarily. It's very RARE for that requirement to happen. I do NOT know about VA and it could hapoen in VA. I don't know. Remember, the monitoring program has ZERO authority over your license. ZERO. They can only recommend to the BON (the BON usually grants their recommendations.) Now, if you are enrolled INVOLUNTARY which is BON/Mandated, then many BONs in conjunction WITH the monitoring program do make you hold off on work for 3 months or more when diversion occurred, but not all do this.

I wish you the best. I can tell you from talking with literally over 100 nurses in my time the amount of times I heard, "My God, I wish I could have gotten enrolled into monitoring earlier so this whole ordeal would beover with by now."

Do NOT worry about the letter from the BON. Also, you can pick up the phone and call the investigator and say, what is going on? When will the investigation be over? They are humans, not robots. Additionally, if your license was going to be revoked or indefinitely suspended in VA, that would have happened. Obvious Revocation or indefinite suspension offenses or behavior are pushed to the front of the investigations and they hear back very quick. The fact that its been a year means exactly the following and here's what will end up happening the overwhelming majority of the time. Below is just an approximate but very very common example.

1. You will get a 500 dollar to 1000 dollar fine.

2. You will have to complete 2 or 3 online courses that can be completed on the computer in a total of 6 hours.

3. You will be Mandated into the recovery/monitoring program for likely 5 years, which is the drug testing/daily check in part.

4. You will be given a private or public reprimand. Who cares.

5. You will be required to attend so many recovery meetings weekly and you turn in a monthly and quarterly report.

You did not Divert at work so this helps you. Is the above a kick in the butt? Yep. Is it the end of the world? No. So, stop worrying about the letter. It will say or have requirements something very close to the above. Your license would have already been suspended or revoked by now if they were going to do that, so take those 2 (the worst) off the table. License on probation? Yep, very likely. Whoopty Doo. Technically, anyone who is in monitoring that is Mandated by the BON is a form of probation. Some states use the words "probation" outright. Some say you are off probation 2 years into monitoring, but for the remaining 3 years in monitoring, your license is still Technically Encumbered. Probation is a Meaningless word. Encumbered means a lot. Anyone in a BON mandated monitoring program (not voluntary) technically has an Encumbere License regardless of whether the license says "Probation" or not. So, don't be frightened by the word "Probation."

And remember what I told you. Your license will NOT be indefinitely suspended and those are the big 2. Those are the big 2 that could possibly land you in the National Practioner Databank or Medicaid Debarrment List. You can take three two off the table, so try to stop worrying. You got this! Congrats on your sobriety.

RoastedRN12 · Aug 8

SheelaDavis said:

It makes sense if you do not have the money to wait until starting monitoring. That's reasonable. I think 40K is too high. I think it's truly more like 25K over 5 years, but it does vary. As for starting a monitoring program, any nurse in America can do it right now at any point. You can literally say, "My mom is scared I will end up doing drugs, so I want to give her extra assurance and do a monitoring program." You don't need permission. The monitoring program will say, "Fine and dandy. You go for an SUD eval and then the monitoring programs says, "you realize you don't have an SUD and haven't had any issues, do you actually still want to do this?" You say, "Yes," and they will usually say, so be it. The above example is voluntary and one would be crazy in my opinion to do a monitoring program if you are not in trouble and have no issues, and MOST states do NOT require you to stop or miss work if you enroll voluntarily. It's very RARE for that requirement to happen. I do NOT know about VA and it could hapoen in VA. I don't know. Remember, the monitoring program has ZERO authority over your license. ZERO. They can only recommend to the BON (the BON usually grants their recommendations.) Now, if you are enrolled INVOLUNTARY which is BON/Mandated, then many BONs in conjunction WITH the monitoring program do make you hold off on work for 3 months or more when diversion occurred, but not all do this.

I wish you the best. I can tell you from talking with literally over 100 nurses in my time the amount of times I heard, "My God, I wish I could have gotten enrolled into monitoring earlier so this whole ordeal would beover with by now."

Do NOT worry about the letter from the BON. Also, you can pick up the phone and call the investigator and say, what is going on? When will the investigation be over? They are humans, not robots. Additionally, if your license was going to be revoked or indefinitely suspended in VA, that would have happened. Obvious Revocation or indefinite suspension offenses or behavior are pushed to the front of the investigations and they hear back very quick. The fact that its been a year means exactly the following and here's what will end up happening the overwhelming majority of the time. Below is just an approximate but very very common example.

1. You will get a 500 dollar to 1000 dollar fine.

2. You will have to complete 2 or 3 online courses that can be completed on the computer in a total of 6 hours.

3. You will be Mandated into the recovery/monitoring program for likely 5 years, which is the drug testing/daily check in part.

4. You will be given a private or public reprimand. Who cares.

5. You will be required to attend so many recovery meetings weekly and you turn in a monthly and quarterly report.

You did not Divert at work so this helps you. Is the above a kick in the butt? Yep. Is it the end of the world? No. So, stop worrying about the letter. It will say or have requirements something very close to the above. Your license would have already been suspended or revoked by now if they were going to do that, so take those 2 (the worst) off the table. License on probation? Yep, very likely. Whoopty Doo. Technically, anyone who is in monitoring that is Mandated by the BON is a form of probation. Some states use the words "probation" outright. Some say you are off probation 2 years into monitoring, but for the remaining 3 years in monitoring, your license is still Technically Encumbered. Probation is a Meaningless word. Encumbered means a lot. Anyone in a BON mandated monitoring program (not voluntary) technically has an Encumbere License regardless of whether the license says "Probation" or not. So, don't be frightened by the word "Probation."

And remember what I told you. Your license will NOT be indefinitely suspended and those are the big 2. Those are the big 2 that could possibly land you in the National Practioner Databank or Medicaid Debarrment List. You can take three two off the table, so try to stop worrying. You got this! Congrats on your sobriety.

smc26448 said:

Yep, I struggled with the same thing. I live on my own and going back with parents to reduce costs is not an option. I have looked into non-nurse positions, that way when I self-report, I can still work because they can only restrict RN work (I believe). That may be an option for you too, but the pay cut will be significant from the job postings I've looked at compared to RN pay in my area. I wish I could go back in time and avoided this whole thing!

I too agree with going back in time but I can't beat myself up playing the shoulda, coulda, woulda game. I think I'm going to self report. And also let my employer know on Thursday at the end of the day. IDK if they will allow me to continue to work. I'd love to give you my number so we can text and stay in touch....if you're willing.

smc26448 · Aug 9

RoastedRN12 said:

I too agree with going back in time but I can't beat myself up playing the shoulda, coulda, woulda game. I think I'm going to self report. And also let my employer know on Thursday at the end of the day. IDK if they will allow me to continue to work. I'd love to give you my number so we can text and stay in touch....if you're willing.

Yes, it seems like we are struggling with the same anxiety and somewhat similar situations. I'll send u a msg

SheelaDavis · Aug 11

smc26448 said:

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?

Part of the whole truth by the nurse monitoring program given regarding Methadone, but not the Whole Truth. Another BEAUTIFUL tactic by BON'S and monitoring programs. Join, Join, Join the monitoring program. YES, you can continue taking all those wonderful Methadone pills if prescribed by a license provider. Just join! But......

There's always a catch or "the rub" as they say in Jersey and NYC. You can continue to tske Methadone for.......3 or 4 or 6 months and you have to stop and transitioning to Suboxone and/or...your 5 year sobriety time doesn't start until you are off Methadone. I've seen this over 20 times. I'm giving you fair warning.....Methadone is OFF the table. Suboxone is doable and this is where they will push nurses on Methadone (towards Suboxone) and they SHOULD do that. They should do it for all patients across the country. So, what I'm saying is, aside from the "purposely vague" answer the monitoring program gave saying as long as prescribed, you can continue to take it. That is TRUE, but also a LIE. They purposely did not say How Long you can continue to take it. Plan on transitioning from Methadone to Suboxone.

Trust me on this. In the USA in 2025, nurses do not complete monitoring while taking Methadone. They may enter that program starting on Methadone, but maybe 1 in 1000 and thats a special case such as the nurse had stage 3 or 4 cancer, etc will graduate while still being on it. They will not let you walk out of a monitoring program on Methadone. As for Suboxone? Absolutely you can.