How To Survive In A Diversion Or Monitoring Program

So you've come to the attention of the BON as an "Impaired Nurse"? Don't worry you can survive this. Read on to see what you should do next... Nurses Recovery HowTo


How To Survive In A Diversion Or Monitoring Program

This can be a hard pill to swallow especially if you have never been impaired at work. Some have diverted from work and were caught. Others come in for a variety of mental health reasons that have nothing to do with substance abuse. The last group are those who got a DUI long before they became nurses, have addressed their legal and addiction issue and have been successfully sober since (they never even had a chance to be a nurse - much less and impaired one)!

So now what do you do?

STEP 1: The BON is not your friend.

Their mandate is to protect public safety and your sobriety is their concern because of that mandate. They don't actually care if you don't get better. They will sure keep you from being a nurse if you fail the program.

STEP 2: Consult An Attorney

So do not go before the BON without consulting an attorney who specializes in professional practice issues. A good place to start is The American Assoc. of Nurse Attorneys found at

STEP 3: Decide How To Move Forward

Once you have seen an attorney you can decide what you want to do. You may want to ask for an administrative hearing. Or you may choose an alternative to discipline program. Otherwise you will likely go into a probation program.

STEP 4: Learn The Requirements

All of these programs have similar requirements. They are anywhere from 3 to 5 years long and require an expensive "Evaluation" , costly in-patient treatment followed by several years of mandatory testing, AA meetings and nurse support groups as well as workplace monitoring and a mandatory period where you are not allowed to work. By the time you are through it will cost you upwards of 30K to 40K.

Once you are in a program there is no way out. I have only seen 1 participant successfully petition for early release and win.

STEP 5: Follow The Rules

There will be rules that have to be followed. Any push back or deviation on your part will be seen as relapse behavior and may get you more time so follow the rules.

Most if not all programs require total abstinence: So wrap your mind around that. Don't think you can sneak and occasional drink in without getting caught? Sooner or later you will be found out and there will be repercussions. So just don't drink. Testing is random and I was tested sometimes two days in a row lest I thought I could drink after a test.

STEP 6: Memorize the Alcoholics Anonymous Book

Memorize the book, attend the meetings, and learn to walk the walk and talk the talk even if you don't agree with it. Boards are looking for sincere humility and will accept nothing less.

STEP 7: Don't draw attention to yourself.

As you progress and get more time in as a compliant person in recovery you can ask for stipulations to be removed and privileges granted. I was allowed to go to work at 9 months, got my narc keys after 6 months on the job, Was allowed to take a trip to Hawaii in year three and a car vacation as well both without testing. I did attend a really cool AA meeting on Hanalei Beach on Maui.

When you are given permission to seek work look at places like dialysis clinics and Psych facilities they are more forgiving and understand the value of second chances.

STEP 8: When you are done...

Don't do anything rash until you receive your completion papers and you are no longer required to call in. I still have all my paperwork from my program which I completed in 2007.

When you feel you just can't take it anymore tell yourself "This too shall pass. " Keep on keeping on!" It doesn't last forever.

(allnurses Guide)
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Specializes in OR.

From one who has caught the attention of the board for mental health reasons, this is all excellent advice. The BONs truly don't give a hoot about your sobriety, etc nor should they as they have that public safety mandate thing.

That being said, consulting an attorney BEFORE dealing with the board weather you had the simple DUI prior to school, co-opted the contents of the Pyxis or have fought the fight of depression bi-polar, etc, all or some of the above is a good idea. The attorney may not keep you from the clutches of a program but may be able to soften the blow (ie:steering you to program vs revocation of license, etc.)

As Hppy says, once these things got you, they aren't easily letting you go. The general idea for them is all the same. Some are run more draconian and unethical than others. Some have got to be reasonable to helpful (not sure which but hopefully they are out there) and some are just plain money vacuuming abusive hells that don't care if you ever practice again. Regardless, the method of survival is the same. Put your head down. Follow thier rules. Even the stupid as **** ones. Even if your reason for being there has zero to do with drugs or alcohol, don't drink, don't use. This would be a really bad time to find out about the damage that can do.

As the board is not your friend, neither are these programs. No matter how 'nice and helpful' your case manager might be, be very discerning, check, re-check and sadly do not trust anything anyone says unless you have it in writing. You will be required to adhere to that contract to the very letter but you may find the the program has no problem playing fast and loose with thier end of it. Keep meticulous records of EVERYTHING! From P tests documentation to all correspondence. That will likely be your only defense should anyone get stupid. That stupidity can cost you more time and money.

As far as the recovery they act like they try to force down your throat? We've had that discussion in other threads. Give them the "humility" they want to see. Attend the meetings. wether you get anything from them or not, get your paperwork signed, etc. Go through the motions. Give them what they want to see to get you through and out of this **** show. If somewhere in the process, you find recovery, be it through 12 step meetings, a great church group or nekkid bonfire dancing or what have you, that is fantastic. True recovery can not be forced into a person. If you are ready and willing, you will succeed and it will be from your strength and desire. My personal feeling is that very little of the accolades go to these programs.

As I think is obvious, my beef is not with the BON, but with the programs...

I am very sorry to say that I have nothing positive to say about my time stuck in this miserable nightmare. What I can say is that should I encounter a troubled nurse in the future, the last thing I would do is encourage them to seek help this way. Isn't that the anthesis of what these programs were supposed to alternative to discipline....a way to guide a troubled nurse back into safe practice...not a whipping post and stocks in the town square?



65 Posts

Whaa nekkid bonfires?? I've been doing everything wrong.

All of what has been said is good stuff but what really struck me was the documentation of everything. The not believing anything unless you have it in writing. That they will play "fast and loose". Being meticulous and keeping documentation of every interaction is a must (and everything else as well, i'm sure).

I'd like any new comers facing this to know that they need to do this for themselves. You can't sit back and think that these people are going to give a hoot enough to even behave professionally and ethically.

As a graduate nurse, that was/is facing a monitoring contract due to alcoholism before I pursued nursing. After telling the woman I had the means to complete the evaluation and was awaiting direction on how to proceed, I was told by the woman over the monitoring program that she would be calling me back the following week. Which was coincidentally spring break. I never heard from her and my graduation walk and pinning ceremony were fast approaching and I be ****** if i I was going to find myself in what I was told would be an inpatient 5 day eval and miss those experiences that I worked hard for. And I figured as with everything else, they were just taking their sweet slow time.

Anyway, I was finally contacted smack in between those two events and told that my case had landed on the disciplinary side of things bc I had REFUSED an eval. Was told i had been given 14 days to get eval scheduled and never followed through. I get a hold of Ms.Monitoring (with her bon attorney at her side) and she tells me herself that she had given me 14 days. It was one thing hearing she had said it from a messenger, it was another hearing her say it to me personally with her lawyer on the call. And I couldn't do anything for myself! Except to sound like a fool. "You called me what day? Ok, well I'm looking now and i don't see--"

Blah blah blah

"No, i have not received any voicemails." I looked like an idiot. A lying, fumbling, tiny idiot- or that's what it felt like. It didn't matter that she never told me to set it up within 14 days, that she had in fact said I'd be hearing from her the following week. It didn't matter that I was looking in my call log and could clearly see that that this ***** was lying. Checked my voicemail after call and nothing. None of it mattered.

Yessss document, document, document. Times. Dates. Names. What was said. I think I read a post by Cats a while back where she said if there was a phone call, she followed up with an email. I tell you what. I started doing that, after the near career-homicide with Ms. Monitoring. Now, granted I haven't had to deal with her that much through the eval/outpatient process but I can say there has been NO more BS. I hit her with digital documentation of soo many call dates and times and left messages (especially those attempts to establish contact with her ;] )through the process of trying to get my eval going. I think I made it more than clear that I would NOT be playing her effin phone games and make myself vulnerable to her manipulations.

Point being- because I was naive and simply didn't know better the powers that be were going to discard my hard work and livelihood into the trash. Why?? I'm still not sure. I had never been disrespectful or the like. But just like that, bc of someone else's dropping the ball and blatantly lying and placing it on me-- I was losing all opportunity to play their monitoring game and come out with a clean license. A graduate nurse that had never worked impaired or been licensed for that criminal history or other charges/convictions...just possessed the humility and honesty from my journey to be honest (naively so) and that doesn't count for anything. I was still treated like it was prosecution and to some extent still feel that it is.

But, I atleast learn (thanks to you guys) different ways to survive this. To fight for myself in whatever way I can. Because, I really feel that one must be paranoid and distrustful through all of this. I don't know if i would be handling this nightmare in the same way if not for you resilient, intelligent, and witty individuals on this forum.

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