Eval from the BON

PaddedCellLPN, LPN · Jun 17

You won't know specifics. They could do a standard 14 panel, a custom one, or a 14 panel with add ons.

SheelaDavis · Jun 20

Kratom is legal in most states and you are NOT in a monitoring program. A 14 panel hair test is unlikely to have Kratom as an add on because you are allowed to do Kratom, unless you are one of the very few states where Kratom is illegal, so.....since you are not in a monitoring program, it doesn't matter if they find Kratom.

ADN244 · Jun 21

Tbh it's crazy to me that just because you wrote an order that another provider didn't agree with that all of a sudden they are going to investigate you LOL. That seems dumb to me. I feel like a better way to go around this would be to just discuss why there was a difference in orders.

Anyways, like others have said, you're not even in monitoring. You said you don't drink alcohol or do other drugs so that won't show up on your screening. Not sure why Kratom would matter to this situation, unless the patient had an adverse drug reaction because you were high or something from it while seeing this pt/writing orders for them.

Healer555 · Jun 21

I'm guessing you ordered a controlled substance. Kratom is legal and so is marijuana in many states. Doesn't apply to those in health care. Impossible to say what they will test for

SheelaDavis · Jun 21

Marijuana will be a problem if they test for it. Marijuana is Federally Illegal in 50 states and Federal Law supercedes State Law. In New York, Mass, Cali, many and most employers will not test for weed, BUT....that's when APPLYING for a job. If you are in one of their monitoring programs, or you are given a test at work that is For Cause (Suspicion of possibly being impaired), then watch how fast the test for Marijuana occurs with everything else. It Will be tested for, just like Alcohol is tested for because BOTH can inpair you. If you are in NY, Cali, or Mass, and are going for an SUD eval, are in a monitoring program, or get a "For Cause" Suspicion Drug test at work, you will be tested for THC and if you show up positive, you got big problems, even though it's legal in those 3 states. The Federal Government and substance abuse evaluators don't care if Marijuana is "Legal" in that state. Just like Alcohol is legal in those states. If you have a problem with that substance, you can figure on problems with the BON more times than most.

kbrn2002, ADN, RN · Jun 23

Unless you are an advanced practice nurse with prescribing privileges writing an order is outside your scope of practice. Since you are being investigated for writing a med order I am guessing you probably don't have those privileges. I would imagine a drug screen is just part of the BON investigation.

mdsRN2005, ASN, BSN, RN · Jun 25

kbrn2002 said:

Unless you are an advanced practice nurse with prescribing privileges writing an order is outside your scope of practice. Since you are being investigated for writing a med order I am guessing you probably don't have those privileges. I would imagine a drug screen is just part of the BON investigation.

This is my assumption as well. I'm curious what the medicine in question was. Assuming it was for a narcotic, then it becomes not only a scope of practice issue but also a diversion one.

Patricia Ordnung · Jun 25

I'm not sure I understand why they're investigating you, rather than a write up or another disciplinary action by your employer.

Career Columnist / Author · Jun 25

Recovery Trek or the testing facility you are using should be able to provide you with a list of the exact substances they are screening for in the test. Try reaching out to them directly to confirm, especially regarding Kratom.

If Kratom was part of your past use, it's important to know that it can potentially show up on specific drug tests, depending on the substances they screen for. It's a good idea to be transparent with the BON about this if asked, as full disclosure could work in your favor during the investigation.

SheelaDavis · Jun 25

No offense Beth, but I disagree, respectfully disagree and want to give another take based on years of experience with BON's. Do NOT be transparent. Transparency works in the overwhelming majority of situations, but in my experience helping others with BON's for a decade, it doesn't work the majority of the time because when we are transparent, we are ASSUMING the entity we are being transparent with is reciprocating honesty, integrity, and your best interests. Unfortunately, due to the culture, most BON's simply are not honest, do not have your best interests in mind, and don't display great integrity.

In This Situation, the nurse has not been found guilty of anything yet. I would deny ANY and ALL substances like Kratom, Neurontin, Weed. The overwhelming odds are that Kratom will not be tested for and in this situation, I would play those odds because...If the nurse turns up positive for Kratom, she can say she totally forgot to disclose it and didn't even think about it and simply forgot. The punishments or outcome for "Forgetting" will be no different than the punishment or outcome for disclosing it or testing positive for it. Absolutely NO different outcome whatsoever. Play the odds in this situation and I'm telling you, Kratom is overwhelming unlikely to be tested for in a hair test in a 14 panel screen. They would have to do an add on and they don't do add on's for Legal substances in which the nurse is Not yet in a recovery program, they do add on's for Illegal Substances.

I think the nurse is opening up a can of worms by disclosing it. Automatically, even though it's legal, it's treated like Weed and when the BON sees "Kratom," they will robotically orgasm with joy and think to themselves, "we got her." Do NOT disclose to the BON any Kratom use, and if the nurse tests positive (she will not be tested for it anyway) but if tested for (not a sure thing it will be positive) but....If positive, simply stating she forgot to disclose it and did it one time is Exactly the same outcome as disclosing it up front. No difference in outcome. The can of worms is opened when the nurse discloses it to anyone. Again, TOTALLY DIFFERENT scenario here if we are talking about a nurse who is already in a monitoring program and in recovery. You dang for sure better disclose it and disclose it quickly and disclose it every time! But, this situation is different.

The overwhelming Odds are.....Kratom will not be tested for. Play those odds and everything is over with after the eval-drug test and the nurse moves on. The nurse will get a discipline-warning, possible reprimand for the prescription-order writing, but that will pass. If the nurse discloses it, you can be sure the testers WILL add Kratom as an add on, and EVEN IF the nurse tests negative for the drug, they SUD evaluator potentially already has her and so does the BON because she admitted it and there's a year or 2 of monitoring as likely.

When I first read her post, I thought she was simply going for a drug test only. It appears she is going for an SUD eval and Drug Test if I read correctly. When going for an SUD eval and knowing you have done nothing wrong and the only substance you used was a legal one, don't tell them anything. Legal drugs are legal for a reason and they have no business knowing. They are fishing. If the nurse discloses Kratom, the outcome of that discloser is not increased or decreased if she did Not disclose it and they tested for it and she tested positive. No difference in outcome. The potential for monitoring is already on the table the second she discloses it and the monitoring would not be Increased if she tested positive and didn't disclose it and she had to go back and explain why. The amount of time would be the same. Best option and Only option to be 100% sure of avoiding a monitoring agreement is to Not disclose it, take the drug test-hair test-which Kratom is RARELY tested for in hair tests and Kratom is NOT part of a 14 panel drug test-it would require an add on and they are not going to do that) but even in the Very Rare circumstance that they did, the nurse is better off playing the odds above and absolutely Not disclosing it. If she does this, betcha when she returns with an update, they will have not tested for Kratom, and if she did not disclose it, she escapes a monitoring program.

Just my opinion.

Career Columnist / Author · Jun 26

@SheelaDavis

Thank you so much for sharing your experience and insights. Your perspective on transparency and handling the Board of Nursing's process is valuable, and I can see how your years of experience have shaped your approach to these situations.

I understand where you're coming from, and I appreciate the alternative viewpoint you've presented regarding the disclosure of substances like Kratom. It's complex and your advice to carefully consider the potential outcomes is valuable. While I may have a slightly different perspective based on my understanding, I acknowledge that numerous variables are at play in these circumstances, and each case has its unique nuances.

It's always helpful to hear from someone with your expertise.