Drug addicted nursing

bill4745, RN · Aug 2, 2007

Not a legal expert, but spent years running a business, and learned a fair amount.

The laws in your state may require you to disclose this your addiction. Even though you aren't giving direct care, your decisions at the insurance company may have an impact on quality of care, and the quality of your decisions may be affected if you begin to use drugs again.

CAR1962 · Aug 2, 2007

Thank you for your reply Bill. I do appreciate it. I'm wondering if anyone knows for sure the state of Wisconsin law on disclosing. If addiction is a disease, and I am told that it is recognized by the American Medical Association as one and further it can be classified as a disability thereby making it a little more difficult in my mind to determine if it is even legal to make a person disclose an addiction especially when an active rehab program. My stipulations state that I must be in a program, I must be in touch daily with the drug testing to randomly test no less than 54 times a year. I must attend counselling at least twice a month and NA meetings twice a week. The Board of Nursing will know immediately if I have relapsed. I'm not saying reporting is right or wrong, I'm just wondering about privacy. I am actually glad I was caught, I believe it saved my life. I have been clean for 10 months now and as long as I stay away from the ability to obtain controlled substances, I will never test positive again in my life. It feels good to be healthy!:balloons:

Jo Dirt · Aug 2, 2007

What stinks about having to disclose such personal information about yourself is that the employer can find a slew of other reasons not to hire you and it will be virtually impossible to prove the real reason they don't want to hire you.

On the bright side you may get a kind-hearted soul who understands everone deserves another chance.

I'm totally useless here, I don't know if it's legal or not, just want you to know I hope things turn out okay.

CAR1962 · Aug 2, 2007

Thank you so much motorcycle mama for the well wishes. It is tough to try and regain what you have lost. I have read other posts and like many other addicted nurses, I was well respected in my field. I had so much support from coworkers and friends I was beyond words. It doesn't help though when you are looking to move forward and trying to get past the awful stigma of being addicted. I know all will be well in the end though. Thanks again!

woody62, RN · Aug 2, 2007

I oversaw a nurse who had her license suspended for signing scripts with a physician's name, in an attempt to help him manage a crowded clinic. Another staffer stole several of the sign scripts, had them filled and was caught. She was not a licensed nurse so she only suffered criminal charges. Whatever a state makes part of their law and regulations related to impaired nurses, the impaired nurse must abide by their wishes. Also, even though you do not work in a clinical area, your employer is responsible for any of your actions. Failure to notify an potential employer of your impairment allows them to terminate you.

Woody

TazziRN, RN · Aug 2, 2007

All of us, from different states, who have gone through recovery and license reinstatement have had to disclose to employers that we are on probation and that we have to follow certain guidelines for a while. It's a part of the process. The fact that you are an addict is private information, yes, however the public has a right to know that medical staff are safe to practice. If your privacy is that important to you, keep it quiet and give up your license. If nursing is important to you, no matter in what capacity, then jump through ALL the hoops that are held in front of you.

CAR1962 · Aug 2, 2007

Thank you for your honesty. You are right, I realize I have to face the consequences. I'm not looking for anyone to say "oh, poor you, you shouldn't have to tell", I am new to this and just really wanted some guidance. My RN license means so much to me that I will do what is required and I will succeed but educating myself through people who have been through it or who are aware, can never hurt. I would have never known that each state can determine what exactly is required to get reinstated regardless of what the Americans with Disabilities Act (ADA) says. I understand that licensed individuals are held to a different standard and rightly so, afterall, patients put their trust in us. Thank you for your comments. I appreciate all of them. Keep 'em coming! : )

jrnursey · Aug 2, 2007

In order to work with the IPP in the state of WI, your Nurse Manager will need to send in quarterly report to the state about your performance. I believe that is the case even if your job is not in nursing. If you want to keep your license thats the way it is. If you do not want to comply with this you can always surrender your license.

time4meRN · Aug 2, 2007

Hang in there it will get better. I don't know if you have gone to AA meetings or not , (works for drugs too). But, for recovery there needs to be honesty and there need to be humility. It's not easy but needed. There are medical professional AA meetings out there. Many times they can be a good support system. Like some one stated above. Most states require a monthly report from the nurse as well as the employer. The boards know how addicts lye, steal and cheat (they see it every day), so , they require the nurse to be up front so to speak , on their daily activities, that includes work. The way I look at it is, the board has delt with addicted nurses long before you became one, they know what a nurse in good recovery has done to become healthy again. If your new in recovery the best advice would be , take their help, go to AA meetings and let them help you start a life sober that you could have never imagined. Another take on this is the board doesn't have to have these programs , they could just slap you in jail, take your license and say good luck, but they don't. They know that as a nurse you can go back to work in any area they want: if they're in good recovery. So, like I said , get some support, hang in there and "one day at a time". I know it's a lonely place to be but it will get better if you take hints from those who have traveled the path before you. You'll be in my prayer. If you need more info E-mail me. :loveya:

TazziRN, RN · Aug 2, 2007

Thank you for your honesty. You are right, I realize I have to face the consequences. I'm not looking for anyone to say "oh, poor you, you shouldn't have to tell", I am new to this and just really wanted some guidance. My RN license means so much to me that I will do what is required and I will succeed but educating myself through people who have been through it or who are aware, can never hurt. I would have never known that each state can determine what exactly is required to get reinstated regardless of what the Americans with Disabilities Act (ADA) says. I understand that licensed individuals are held to a different standard and rightly so, afterall, patients put their trust in us. Thank you for your comments. I appreciate all of them. Keep 'em coming! : )

Think about this: when non-medical people are arrested for drug/alcohol-related offenses, it becomes very public news, right? People arrested for DUI are often, as part of their sentence, required to attend AA/NA meetings and show proof of attendance to the court. Those court proceedings are not private.

The ADA says that we cannot be discriminated against for our addictions. It does not say that we can do whatever we want because we are addicts. An employer cannot fire you for being an addict, but they can fire you for violating P&P for showing up for work under the influence, or theft (diverting drugs), etc. As for our licenses, being a nurse and having a license to practice nursing is a privilege, not a right. The public is entitled to have nurses who are safe to practice. The state BONs are required to gaurantee that we are safe to practice. If a nurse is not safe to practice then the license is revoked.

You are still very early in recovery but there is something that we have all learned over time: yes, the fellowship is based on anonymity, but after a while it doesn't matter much who knows about us. I am very open about the fact that I am an addict in recovery and I often share my story. In the beginning it was the opposite: I protected my anonymity fiercely and was afraid of anyone finding out. Now I don't care who knows. After 13 years of sobriety, if someone has a problem with the fact that I am an addict in spite of my years clean, then I don't need to be working for/with them.

jackstem · May 14, 2008

i would have never known that each state can determine what exactly is required to get reinstated regardless of what the americans with disabilities act (ada) says. i understand that licensed individuals are held to a different standard and rightly so, afterall, patients put their trust in us. thank you for your comments. i appreciate all of them. keep 'em coming! : )

car1962,

the ada prevents you from being discriminated against because of your diagnosis (chemical dependency). but, if you are actively using or have other disqualifying circumstances, the ada does not apply. the following is from a brochure about the ada and those with substance abuse disorders:

"who is not protected?

[color=#231f20]* people who currently engage in the illegal use of drugs are

[color=#231f20]not protected under these non-discrimination laws, except

[color=#231f20]that individuals may not be denied health services (including

[color=#231f20]drug rehabilitation) based on their current illegal use of

[color=#231f20]drugs if they are otherwise entitled to those services.

[color=#231f20]* people whose use of alcohol or drugs poses a direct

[color=#231f20]threat--a significant risk of substantial harm--to the

[color=#231f20]health or safety of others are not protected.

[color=#231f20]* people whose use of alcohol or drugs does not significantly

[color=#231f20]impair a major life activity are not protected (unless they

[color=#231f20]show they have a "record of" or are "regarded as" having a

[color=#231f20]substance use disorder--addiction--that is substantially

[color=#231f20]limiting).

[color=#231f20][color=#231f20]* remember: people who pose a direct threat to health or safety, or have committed misconduct warranting job discipline, including termination, are not protected."

[color=#231f20][color=#231f20]you can obtain a free copy at this link:

[color=#231f20][color=#231f20]http://ncadistore.samhsa.gov/catalog/productdetails.aspx?productid=16968

one of the problems recovering nurses (i'm a recovering crna) discover after being diagnosed with this disease is that there is a lack of continuity by the state boards of nursing. what happens in one state can be dramatically different than what happens in another. the only state(s) you need to be concerned with are those in which you hold a nursing license.

the first priority of a nursing board is to protect the public from unsafe nurses. fortunately, approximately 38 (this changes, so i'm not sure if that number is still accurate) have passed legislation that protects a nurses license if the enter a "diversion" program. this program is as individual as each board of nursing (there are no national guidelines). these programs define what is required to enter the program, complete the program, and what prevents someone from entering the program or to be released from the program.

generally speaking, most require you to voluntarily surrender your license for a prescribed period of time, be evaluated by an approved clinician, enter an approved treatment program if it is deemed appropriate by the evaluating clinician, complete the program and any aftercare program(s), be randomly screened for controlled substances, attend a specified number of support group meetings (typically aa or na or something similar), one of which may be a group specific to health care professionals (nurse support groups or caduceus groups), sign a re-entry contract with the board or monitoring service for a specified period of time (2 - 5 years is pretty common).

as someone else pointed out, the board is used to dealing with nurses who are substance "misusers". a recovering physician who is now a board certified addictionologist made a comment at a peer assistance workshop i attended last year. she said addicts never abuse their drugs, they take excellent care of their "lover" (the drug of choice). it's the people around them that get abused. so it is to be expected that the board will "assume" you (me, we) are lying because that is one of the signs of this disease. looking back over my own struggles with this disease proves her statement to be true. a person with this disease in it's active phase will do whatever it takes to obtain and use their drug of choice. nothing else matters. most health care professionals divert from their place of employment, which violates the nurse practice act, and is a felony. because there are states with legislation to protect the license of an individual who enters treatment and monitoring, more health care practitioners are able to continue to practice their profession safely. do exactly what the impaired professionals program (ipp) tells you to do and you will eventually get back to practice.

wisconson's impaired professionals program information can be found here:

http://drl.wi.gov/dept/ipp.htm

wisconson has the nurse practice act (npa) available online here:

http://nxt.legis.state.wi.us/nxt/gateway.dll?f=templates&fn=default.htm&vid=wi:default&d=code&jd=top

chapter 7 of the wisconson npa deals specifically with conduct issues and states:

n 7.03 negligence, abuse of alcohol or other drugs or mental incompetency.

n 7.03 - 2 (b) an act or omission demonstrating a failure to maintain

competency in practice and methods of nursing care;

(it could be argued that using a controlled substance for other than the prescribed reason is a demonstration of nursing incompetence)

n 7.04 misconduct or unprofessional conduct.

(1) violating, or aiding and abetting a violation of any law substantially related to the practice of professional or practical nursing. a certified copy of a judgment of conviction is prima facie evidence of a violation;

(2) administering, supplying or obtaining any drug other than in the course of legitimate practice or as otherwise prohibited by law;

(3) failing to report to the board or to institutional supervisory personnel any violation of the rules of this chapter by a licensee. (it could be argued you are in violation of this section by not reporting yourself)

i'm not an attorney, so none of this should be seen as legal advice (legal disclaimer). and i no longer practice nursing or nurse anesthesia, nor do i have a nursing license (i voluntarily surrended my license forever because i knew i would die of i returned to clinical practice after several relapses), so none of this medical advice (my non-medical disclaimer).

as a nurse with the chronic, progressive, potentially fatal disease of chemical dependency, it is you responsibility to know as much as possible about the disease and how to remain in recovery. it also your professional responsibility as a nurse to know all there is to know about your practice of nursing and the rules and laws that govern your practice. use your time away from practice to do those 2 things. obtain whatever legal and medical advice you need to obtain that knowledge. think of the colleagues you will be able to help in the future by going through all of this. some day you will ralize this is the best thing that ever happened to you.

with much love and respect,

jack