Is it even worth it?

First, I hope this response helps and I wish you all of the best and have been in your situation.  I have sympathy and empathy and compassion for you!

1.  If you are advanced enough in your addiction that you are refilling bottles/substituting saline for opiates, you need a partial hospitalization program immediately.  Not in one week, not in two weeks, you need to go within the next few days.  It's that serious.  Trust me.  The data suggests the chances of you stopping on your own for good when you are at this level is basically approaching zero.  Whether you leave nursing all together and have no access anymore to opiates, the data suggests when you are as advanced in your addiction as your behavior shows, you will turn to another substance (alcohol) or food or porn or gambling, or some other addiction to substitute for the opiates, if you no longer have access to the opiates and you don't get treatment. The treatment you need is beyond just meetings.  Yes, you need the meetings, but you need the 6 week partial hospitalization program (PHP) followed IMMEDIATELY (not a 2 week or one month break) but Immediately by intense outpatient program (IOP) which is 6 weeks, then followed Immediately (not a one week or two week break so you can "reset" or "organize your life" or "think about things" but immediately by Aftercare which lasts 52 weeks and is done outpatient.  As soon as you start the PHP program, you will start the 3 recovery meetings per week and continue to that for hopefully, the rest of your life, but at least 5 years.  After 5 years, you don't and will not need 3 meetings per week, but attending at least one until you leave earth or have the physical ability to not do so is the proven method that gives you the BEST chances (by evidence) to not reuse or relapse again in your lifetime.  

2.  Now the legal stuff.  By getting into a PHP program IMMEDIATELY, you aren't just helping yourself from a recovery standpoint and your health, but you are helping yourself with the Board and the potential for Criminal Actions/Charges.  Believe it or not, the decision to bring criminal charges against someone is weighted Sometimes on whether you have began treatment before criminal charges are filed.  The same applies to the Board.  While the BON is doing its investigation, you already receiving treatment and being active in recovery in the form of a PHP program and IOP then Aftercare pays great dividends as to whether your license is suspended or revoked.  If revoked, the chances of practicing nursing again are very, very, very low.  If suspended, the chances of practicing nursing again are nearly 100% IF......IF you comply with the treatment.

3.  In cases of substitution (diverting by filling saline into not yet given to patient vials) is considered very serious.  It's considered far more serious than diverting waste for yourself and when criminal charges are brought against a nurse, it's often in the case of substitution and simply not diverting wasted narcs.  I have seen nurses go to prison for this.  Of those that were charged and then served time, nearly 100% DID NOT GO to a PHP until they were told to go to a PHP by the court and most never went at any point.  At the very worst, the odds of doing jailtime (if you are charged) are dramatically, dramatically LOW if you get into a PHP early......very early on after you were caught.  When you REACT to legal advice or advice by the BON after you have already been charged, it's not looked on as favorably compared to you being PROACTIVE (didn't need to be told to rehab or enter your state nurse monitoring program, as you did this on your own).

4.  If you do what I wrote in Step 1 above, the odds of you doing jailtime and never practicing nursing again are extremely, extremely, extremely LOW.  If you don't, I can tell you from experience (personal experience) that the odds of you practicing nursing again in the form of a revoked license and criminal charges and possibly jailtime, are far from low.  

5.  Any lawyer on earth is going to tell you to get into rehab (which is a PHP program for the starting point).  I'm not a lawyer and I'm not giving you legal advice, but that is basic common sense that anyone would tell you or me or anyone else which lessons the blow criminally and by the BON.  Do not wait to be told this.  Get into a PHP program now.  Also, start keeping a log of your recovery meetings NOW.  Send these to the BON long before.....long before they have finished their investigation with you because the BON does not make a decision on your license until after their investigation is completed, and you want to update your status to the BON BEFORE they make their decision.  You want to tell the BON you have just entered a PHP program and when the 6 weeks are done, you send them your certificate and you also send them the update that you are now in a IOP program and you also want to immediately enroll in your states monitoring program/recovery program for nurses.  These are called different things.  Enroll in that now, get a case manager, form a relationship with this person, update this person on your status and where you are at regarding enrolling in PHP, etc.  

6.  I write all of this to help you and based on experience (many years of it) and I write this based on you being guilty by what you wrote.  You wrote that they had you on camera and you admitted it.  If this is true, you are caught.  There is no arguing it.  The only thing you can do is soften the blow and in these cases such as yours, you are looking for MERCY.  There is no "legal out" or "loophole" or arguing about "whether the cameras are valid" or any of that stuff.  Trust me, don't go there.  You are opening yourself up to the criminal side when you do this and it's not worth it.  

7.  Have HOPE and Do Not Lose HOPE.  You are nurse.  You are a good person, not a bad person.  You committed a bad act or bad actions.  You are human.  All humans do good things and bad things.  You can recover from this. You are ALIVE.  Nothing is more precious than LIFE and you HAVE IT!  Your getting caught was God's plan to save your life and for you to have a better future.  If you don't believe in God, then call it karma, higher power, or whatever, but something supernatural is looking out for you and your life is going to turn for the good from this day forward.  Will the next few years be tough?  Heck yea they will be, but you got this.  You can do this.  If I were you (and trust me, I have been in your situation and was criminally charged), I would do this (and I actually did this).....

A.  Immediately enroll in a PHP program.  B.  After you get off the phone and have a timeframe and when you have to get there, pick up the phone and enroll in your state's nurse monitoring program and get your paperwork completed.  C.  Immediately get a defense attorney and update them on your status.  D.  GO TO THE PHP program and complete it. E.  Keep your attorney and your nurse monitoring program case manager and the BON updated on your status and make it well known to all 3 of them that you are in a PHP program and you will follow with IOP then Aftercare.  F.  Start doing the 3 meetings per week as soon as you are in the PHP (the PHP program will require it anyway).  

By doing the above (IN MY OPINION and EXPERIENCE) you give yourself the best chances to never use drugs or to give into addiction again and you give yourself the best chances to practice nursing again, and you give yourself the best chances at avoiding criminal charges and even if you do get criminal charges, the overwhelming odds are that if doing the above, the charges are either dropped or they are reduced to a misdemeanor (of which you can still practice nursing-trust me, I know).

Last reminder and I will warn you of this and you can go one of two ways.  Somebody in this thread is going to tell you to WAIT and immediately get a lawyer and do NOTHING until the lawyer tells you do it.  That's fine, but I'm warning you of this, WAITING to get into a PHP program is the wrong choice.  It's a bad one.  If you want to see a lawyer and then take all commands from the lawyer and do everything they tell you from that point on, this is fine, with one exception.....do NOT wait to get into a PHP program. You are on the clock with the BON and a State Attorney who is going to make a decision on what to do with you.  That decision is HEAVILY weighted on how soon you get into a PHP program, trust me on that.  

You asked for advice.  I gave you mine.  I gave my opinion of what to do based on experience.  I am not a lawyer and I am not giving you legal advice.  I wish the best for you.  This is not the end for you.  Don't believe the internal lie that will tell you that is, because it's not.  It's a new chapter and your future chapters will be solid, but part of that is recovery.  True recovery, not scheming, not lying, not trying to figure out a way to "beat the BON."  True recovery, for those that truly do have a substance use/abuse disorder is not a "2 week dry out rehab."  True recovery is 6 weeks of PHP, followed by 6 weeks of IOP, followed by 1 year of Aftercare and the 3 meeting per week starts as soon as you enter the PHP.  Give it a try!  You will be amazed at the people you meet and the lifelong true-deep friendships you form and you will find yourself shocked at how happy you are.  Trust me on that one also. 

FYI.  I was suspended, criminally charges with felonies, and facing 15 years in state prison.  I'm now practicing nursing again and not just a recovery participant, but I help others in recovery daily and it's about as fulfilling as one can imagine.  Hope this helps.

What does your brother do that pays well? If you can see yourself doing something else, do it and don. You don't think you can easily not drink for a few years?  

You can go camping and vacation.  I don't even have a SUD and this is absolutely the worse time of my life. I'm doing this for the money I earn as a nurse.  If I could walk away and make as much doing something else I absolutely would. 

GA nurse here on monitoring for diversion... my best advice, start with GNAPAP immediately. My final consent order states I can come.off probation after 3 years of proven sobriety, which I started the program the next day. My final consent order came in July, and so I cut my time down by 7 months and had all the hard parts over with while waiting for the BON to decide my fate. 

When the AG paralegal emails you the draft of the final consent order, you can change the wording to a degree, if you have evidence to back you up. 

Legally, it looks better if you start a program NOW, and at least go to the IOP. I don't have much to complain about with my case manager and program, and my BON contact is very helpful. I've read/heard horror stories, but it's not horrible compared to prison. 

ETA: I've been employed the whole time I've been on Probation this year, and actually starting a new job that pays higher! What you're going through now was the worst part for me, but it does get better. You will find a job, it's not impossible. Give yourself some grace, so many do it and never get caught. You will find your bearings, I swear. 

JB C said:

First, I hope this response helps and I wish you all of the best and have been in your situation.  I have sympathy and empathy and compassion for you!

1.  If you are advanced enough in your addiction that you are refilling bottles/substituting saline for opiates, you need a partial hospitalization program immediately.  Not in one week, not in two weeks, you need to go within the next few days.  It's that serious.  Trust me.  The data suggests the chances of you stopping on your own for good when you are at this level is basically approaching zero.  Whether you leave nursing all together and have no access anymore to opiates, the data suggests when you are as advanced in your addiction as your behavior shows, you will turn to another substance (alcohol) or food or porn or gambling, or some other addiction to substitute for the opiates, if you no longer have access to the opiates and you don't get treatment. The treatment you need is beyond just meetings.  Yes, you need the meetings, but you need the 6 week partial hospitalization program (PHP) followed IMMEDIATELY (not a 2 week or one month break) but Immediately by intense outpatient program (IOP) which is 6 weeks, then followed Immediately (not a one week or two week break so you can "reset" or "organize your life" or "think about things" but immediately by Aftercare which lasts 52 weeks and is done outpatient.  As soon as you start the PHP program, you will start the 3 recovery meetings per week and continue to that for hopefully, the rest of your life, but at least 5 years.  After 5 years, you don't and will not need 3 meetings per week, but attending at least one until you leave earth or have the physical ability to not do so is the proven method that gives you the BEST chances (by evidence) to not reuse or relapse again in your lifetime.  

2.  Now the legal stuff.  By getting into a PHP program IMMEDIATELY, you aren't just helping yourself from a recovery standpoint and your health, but you are helping yourself with the Board and the potential for Criminal Actions/Charges.  Believe it or not, the decision to bring criminal charges against someone is weighted Sometimes on whether you have began treatment before criminal charges are filed.  The same applies to the Board.  While the BON is doing its investigation, you already receiving treatment and being active in recovery in the form of a PHP program and IOP then Aftercare pays great dividends as to whether your license is suspended or revoked.  If revoked, the chances of practicing nursing again are very, very, very low.  If suspended, the chances of practicing nursing again are nearly 100% IF......IF you comply with the treatment.

3.  In cases of substitution (diverting by filling saline into not yet given to patient vials) is considered very serious.  It's considered far more serious than diverting waste for yourself and when criminal charges are brought against a nurse, it's often in the case of substitution and simply not diverting wasted narcs.  I have seen nurses go to prison for this.  Of those that were charged and then served time, nearly 100% DID NOT GO to a PHP until they were told to go to a PHP by the court and most never went at any point.  At the very worst, the odds of doing jailtime (if you are charged) are dramatically, dramatically LOW if you get into a PHP early......very early on after you were caught.  When you REACT to legal advice or advice by the BON after you have already been charged, it's not looked on as favorably compared to you being PROACTIVE (didn't need to be told to rehab or enter your state nurse monitoring program, as you did this on your own).

4.  If you do what I wrote in Step 1 above, the odds of you doing jailtime and never practicing nursing again are extremely, extremely, extremely LOW.  If you don't, I can tell you from experience (personal experience) that the odds of you practicing nursing again in the form of a revoked license and criminal charges and possibly jailtime, are far from low.  

5.  Any lawyer on earth is going to tell you to get into rehab (which is a PHP program for the starting point).  I'm not a lawyer and I'm not giving you legal advice, but that is basic common sense that anyone would tell you or me or anyone else which lessons the blow criminally and by the BON.  Do not wait to be told this.  Get into a PHP program now.  Also, start keeping a log of your recovery meetings NOW.  Send these to the BON long before.....long before they have finished their investigation with you because the BON does not make a decision on your license until after their investigation is completed, and you want to update your status to the BON BEFORE they make their decision.  You want to tell the BON you have just entered a PHP program and when the 6 weeks are done, you send them your certificate and you also send them the update that you are now in a IOP program and you also want to immediately enroll in your states monitoring program/recovery program for nurses.  These are called different things.  Enroll in that now, get a case manager, form a relationship with this person, update this person on your status and where you are at regarding enrolling in PHP, etc.  

6.  I write all of this to help you and based on experience (many years of it) and I write this based on you being guilty by what you wrote.  You wrote that they had you on camera and you admitted it.  If this is true, you are caught.  There is no arguing it.  The only thing you can do is soften the blow and in these cases such as yours, you are looking for MERCY.  There is no "legal out" or "loophole" or arguing about "whether the cameras are valid" or any of that stuff.  Trust me, don't go there.  You are opening yourself up to the criminal side when you do this and it's not worth it.  

7.  Have HOPE and Do Not Lose HOPE.  You are nurse.  You are a good person, not a bad person.  You committed a bad act or bad actions.  You are human.  All humans do good things and bad things.  You can recover from this. You are ALIVE.  Nothing is more precious than LIFE and you HAVE IT!  Your getting caught was God's plan to save your life and for you to have a better future.  If you don't believe in God, then call it karma, higher power, or whatever, but something supernatural is looking out for you and your life is going to turn for the good from this day forward.  Will the next few years be tough?  Heck yea they will be, but you got this.  You can do this.  If I were you (and trust me, I have been in your situation and was criminally charged), I would do this (and I actually did this).....

A.  Immediately enroll in a PHP program.  B.  After you get off the phone and have a timeframe and when you have to get there, pick up the phone and enroll in your state's nurse monitoring program and get your paperwork completed.  C.  Immediately get a defense attorney and update them on your status.  D.  GO TO THE PHP program and complete it. E.  Keep your attorney and your nurse monitoring program case manager and the BON updated on your status and make it well known to all 3 of them that you are in a PHP program and you will follow with IOP then Aftercare.  F.  Start doing the 3 meetings per week as soon as you are in the PHP (the PHP program will require it anyway).  

By doing the above (IN MY OPINION and EXPERIENCE) you give yourself the best chances to never use drugs or to give into addiction again and you give yourself the best chances to practice nursing again, and you give yourself the best chances at avoiding criminal charges and even if you do get criminal charges, the overwhelming odds are that if doing the above, the charges are either dropped or they are reduced to a misdemeanor (of which you can still practice nursing-trust me, I know).

Last reminder and I will warn you of this and you can go one of two ways.  Somebody in this thread is going to tell you to WAIT and immediately get a lawyer and do NOTHING until the lawyer tells you do it.  That's fine, but I'm warning you of this, WAITING to get into a PHP program is the wrong choice.  It's a bad one.  If you want to see a lawyer and then take all commands from the lawyer and do everything they tell you from that point on, this is fine, with one exception.....do NOT wait to get into a PHP program. You are on the clock with the BON and a State Attorney who is going to make a decision on what to do with you.  That decision is HEAVILY weighted on how soon you get into a PHP program, trust me on that.  

You asked for advice.  I gave you mine.  I gave my opinion of what to do based on experience.  I am not a lawyer and I am not giving you legal advice.  I wish the best for you.  This is not the end for you.  Don't believe the internal lie that will tell you that is, because it's not.  It's a new chapter and your future chapters will be solid, but part of that is recovery.  True recovery, not scheming, not lying, not trying to figure out a way to "beat the BON."  True recovery, for those that truly do have a substance use/abuse disorder is not a "2 week dry out rehab."  True recovery is 6 weeks of PHP, followed by 6 weeks of IOP, followed by 1 year of Aftercare and the 3 meeting per week starts as soon as you enter the PHP.  Give it a try!  You will be amazed at the people you meet and the lifelong true-deep friendships you form and you will find yourself shocked at how happy you are.  Trust me on that one also. 

FYI.  I was suspended, criminally charges with felonies, and facing 15 years in state prison.  I'm now practicing nursing again and not just a recovery participant, but I help others in recovery daily and it's about as fulfilling as one can imagine.  Hope this helps.

You seem exceptionally knowledgeable about this. In your opinion, what do you think will happen to a Texas nurse I know who mixed pills and alcohol and attempted suicide by shooting herself in the wrist while her children were home with her?

She only got a 72 hour hold in a psych ward, because she lied to her psychiatrist and said she shot herself by accident. Our CPS investigator told us the police report clearly stated she drew a target on her wrist and told her adult friend she was "going outside to smoke a cigarette, and if she hears a gunshot to call 911" She was in her next to last semester of nursing school and I didn't know I could've reported her then. I reported her in July after I realized she got her license and her first nursing job, because I was terrified of her hurting anyone from her severe drug and alcohol abuse. I was honestly shocked she finished nursing school with her swirling mass of mental health issues (she regularly passes out from her eating disorder, and actually passed out during a clinical shift and sliced open her chin during the fall).

First, does the Texas Board know? Did they open an investigation? Lots of variables here. You said you were aware that she passes out at work. If you are aware, then I assume her work is aware.

I will answer your question based on the ASSUMPTION that Texas is aware and opened an investigation. Based on this assumption only, part of the investigation will begin with an investigator meeting/contacting her Supervisor, Human Resources/Risk Management, and Pharmacy at her work and do an extensive review of narcotic pulls to look for discrepancies and I'm talking about discrepancies that suggest a substance abuse problem, not a discrepancy which is a 1 time thing that is due to two nurses squabbling over who should have wasted what, etc. The Omnis and Pixis's have software that can now literally predict a substance abuse problem by comparing a nurses drug pulls with all of the other staff. They are looking for that, not a one time missed Percocet waste or being off on Demerol by 5mg of which every nurse in America has had a discrepancy (at least one) if practicing long enough. They aren't looking for legalistic childish female nurse jealousy relationship BS as the investigators knows nurses love to set each other up and dramatize. They are looking for clear-cut substance abuse pattern narc withdrawals and They Can Tell the difference in a substance abuse pattern compared to nurse A hating nurse B because nurse A thinks nurse Bs hair is prettier, etc.

After they get the above data, they now go to the nurse supervisor and look for any signs/behavioral/mental health/possible substance use displays of behavior, and finally, they go directly to the nurse for her interview. They question her and if anything whatsoever turns up in all of the above, the first thing the BON will do is 1 of 2 things. If major discrepancies with drug pulls, then license temporarily suspended pending mandatory substance abuse eval and mental health eval. If no major narc discrepancies and no clear cut signs of behavioral issues at work, and the nurse denies any history of mental health issues, then likely a warning letter only and no discipline. If no narc discrepancies, but the nurse admits to past mental health issues, then mandatory substance abuse and mental health eval and license not suspended pending the results of the evals. If mental health or substance abuse is found out, nurse will go on contract/consent order. If nurse had no issues at work but had them only at home, likely it will not be disclosed to the public, but Put on consent order for 3 years with mandatory treatment.

Investigators are savvy! For example, here would be the typical question.

   "Nurse Smith, keep in mind how you answered your RN license application upon completing your nursing program and you were asked about any possible mental health issues and keep in mind that answering any of these questions with intentional dishonesty is considered a Class D felony in Texas punishable by up to 1 year in state prison. You answered no and we have a copy of your application. Here is your copy. Please take a look at your answers.  We have the ability to go back and verify if the answers you gave were fully true and if they were not, you could be criminally charged. We understand that many nurses are stressed out and all of us can have issues and we want to save your career and you can save it right now. We will let the answers to the questions you gave slide and we want to help you and there will be no actions taken based on those answers you gave if you simply tell us the truth now. Please use this as a turning point in your life and let us help you if needed and we only ask for the truth. Did you have mental health issues in the past and how about in the present"

See how the above goes for probably 90 plus percent of nurses who have no idea of what is coming and one day, they are pulled from the floor doing patient care and within 60 seconds they are in an office with 4 people they have never seen in suits and one is wearing a badge and they have a stack of papers in front of them? Most nurses, not all, but most are scared to death and they confess. 

Healer555 said:

What does your brother do that pays well? If you can see yourself doing something else, do it and don. You don't think you can easily not drink for a few years?  

You can go camping and vacation.  I don't even have a SUD and this is absolutely the worse time of my life. I'm doing this for the money I earn as a nurse.  If I could walk away and make as much doing something else I absolutely would. 

 

No offense here. I respect your advice on what she should do regarding whether to stay in nursing or leave nursing. But, to ask whether a person "can drink or not drink" for two years after they literally just admitted to removing opiates from secured bottles, using them, and then refilling them for patient use suggests a highly highly progressed substance abuse disorder. SUD is like hypertension or Diabetes. Some people need 1 med for BP. Some need 4 units of insulin daily. Some people need 200 units of insulin daily and they are having limbs cut off. Her SUD is the later. When you are at this level, you are flirting with overdose type situations. A person at this level has ZERO chances of stopping usage without inpatient (PHP) help. Beginning an IOP (intense outpatient program) is not enough when this advanced. To ask if this person can "stop drinking for 2 years" is not even close to possible.

Look, I respect your take on the BON. We all get it. They are corrupt and yes, something needs to be done and hold them accountable and many on here don't have an SUD and have been unjustly placed in this unjust program such as yourself. I get it, and I really do, but this isn't the time for one of those posts.

This person needs help on the spot. I respect the opinions of those who give insight that do NOT have an SUD such as yourself and matters that relate to it, but it's also important for you and some others that do NOT have SUDs to respect the opinions of those that DO have SUDs, especially as it relates to recovery principles. This person can't simply "walk away" and not do substances of some sort just because they leave nursing. Leaving nursing for good is fine and that's a valid opinion, but the first and foremost thing in this person's life needs to be help immediately....as in....PHP program.

When this advanced with an SUD, these are the people that unfortunately, so many times, are not around in 6 months to even make a post on this Board. She is at major major risk for literally death/OD. As nurses, our compassion has to be first and foremost for other people and sticking it to the BON is fine. I get it. I truly do, but in this case, it's not time for that right now. This person's life is at risk.

Right now, forget about her brother or what she is going to do career wise or the BON. Go straight to a PHP program as I'm telling you, I am warning you my nursing friend, I have compassion for you and love you your life is at risk. Your condition is THAT advanced (as was mine). The good news and hope? It's actually fixable, but not without a PHP program. 

When you look at SUD for nurses and speak with therapists and addictionologists and counselors, SUD is considered SEVERE as in.....near end stage, of a nurse is using opiates and refilling the bottles for patient use with saline. It makes a therapist drug counselor/addiction logistical jump out of their chair in level of alarm and the very very first step is inpatient treatment as they consider it an actual medical emergency.....and it is. This is why I'm writing so forcibly to the nurse. 

JB C said:

No offense here. I respect your advice on what she should do regarding whether to stay in nursing or leave nursing. But, to ask whether a person "can drink or not drink" for two years after they literally just admitted to removing opiates from secured bottles, using them, and then refilling them for patient use suggests a highly highly progressed substance abuse disorder. SUD is like hypertension or Diabetes. Some people need 1 med for BP. Some need 4 units of insulin daily. Some people need 200 units of insulin daily and they are having limbs cut off. Her SUD is the later. When you are at this level, you are flirting with overdose type situations. A person at this level has ZERO chances of stopping usage without inpatient (PHP) help. Beginning an IOP (intense outpatient program) is not enough when this advanced. To ask if this person can "stop drinking for 2 years" is not even close to possible.

Look, I respect your take on the BON. We all get it. They are corrupt and yes, something needs to be done and hold them accountable and many on here don't have an SUD and have been unjustly placed in this unjust program such as yourself. I get it, and I really do, but this isn't the time for one of those posts.

This person needs help on the spot. I respect the opinions of those who give insight that do NOT have an SUD such as yourself and matters that relate to it, but it's also important for you and some others that do NOT have SUDs to respect the opinions of those that DO have SUDs, especially as it relates to recovery principles. This person can't simply "walk away" and not do substances of some sort just because they leave nursing. Leaving nursing for good is fine and that's a valid opinion, but the first and foremost thing in this person's life needs to be help immediately....as in....PHP program.

When this advanced with an SUD, these are the people that unfortunately, so many times, are not around in 6 months to even make a post on this Board. She is at major major risk for literally death/OD. As nurses, our compassion has to be first and foremost for other people and sticking it to the BON is fine. I get it. I truly do, but in this case, it's not time for that right now. This person's life is at risk.

Right now, forget about her brother or what she is going to do career wise or the BON. Go straight to a PHP program as I'm telling you, I am warning you my nursing friend, I have compassion for you and love you your life is at risk. Your condition is THAT advanced (as was mine). The good news and hope? It's actually fixable, but not without a PHP program. 

When you look at SUD for nurses and speak with therapists and addictionologists and counselors, SUD is considered SEVERE as in.....near end stage, of a nurse is using opiates and refilling the bottles for patient use with saline. It makes a therapist drug counselor/addiction logistical jump out of their chair in level of alarm and the very very first step is inpatient treatment as they consider it an actual medical emergency.....and it is. This is why I'm writing so forcibly to the nurse. 

 Her question wasn't should I go to rehab? , it was is it worth it?   I addressed her question.  She said she's going to go to treatment as she sees fit. I got the impression she already figured  out the treatment she was going to pursue from her post but she just had questions about whether or not to continue nursing. I never said she didn't need a php or iop. It sounded like she was looking beyond that as in I'm getting treatment and what do I do about my career after. 

I agree it's concerning she is questioning not being able to drink for a few years. 

Obviously her life is the most important thing.  I'm not against rehab .  I was typing my reply before your reply was posted and mine was just meant to address the basic question not to be against rehab. I'm sorry if my post came across as being against rehab.  Things don't always translate well online.  

Hopefully she's in rehab now and will read thus when she's released  

JB C, thank you for your multiple responses, to my question and other people's. I do think you may have misunderstood. I never in my post said I wasn't going to go to rehab. I'm currently in rehab. As Healer555 correctly read, I was asking about not going back to nursing. The stress, time away from family, relatively low pay compared to years spent in the job, and many other factors have created a general disillusionment with it. Certainly not all, but many older nurses I know, (many in the groups I'm currently attending and many I've known from my work experience) aren't healthy emotionally or physically to be honest, addict or not. If it's not alcohol or narcs it's food, or caffeine, or nicotine, or sex, or gambling, etc. I am not blaming medicine for my poor choices, but I don't think it's crazy to wonder if some of the intense trauma (10 years ICU and ER), covid pandemic, understaffing, overcrowding, lack of debriefing, etc. all present in critical care have played a role. I don't think it's crazy to consider doing something else. Nursing is what I do, not who I am.
 

As far as the alcohol goes I can and have gone a long time without drinking. I got a pEth blood test on entrance to the rehab and it was completely negative (shows alcohol use over a month-negative usually means 2 or less drinks in the past month). I'm just saying I don't know if I want to get 6 months added to a consent order because I have a glass of wine on vacation in France, and I'm not sure I want to not have that wine because some board of some job I don't know if I love says I can't. It seems like a lot of monitoring for a job I'm not sure I love, or at times even like. My issue was pharmaceutical grade Fentanyl specifically, which is not uncommon (per the doctors in my rehab). I think if I were to remove the risk of being around the substance at all I would feel safe.

I can tell you're very passionate about what you believe, and I appreciate your concern. It is frustrating to hear that you think I'll relapse or overdose if I don't follow what a nursing board who doesn't know me at all, who isn't actually following evidence based practice or using individual care plans in their consent orders, says I should do. My doctors in the rehab I'm currently in are saying either choice is OK, as long as I get treatment and pursue what I would like to do. I also understand the cognitive dissonance that plays into this, if someone does spend years jumping through hoops to get their nursing license back/off parole, they probably can't allow themselves to think of a world where someone didn't choose to do that and could also be healthy. I do think there are more ways to be healthy and sober than doing exactly what the BON says. I'm learning all about addiction and based on the notion that putting pressure on an addict could trigger a relapse, I do wonder how much the nursing boards care about us as individuals because those programs are full of pressure. Their job is to protect the public though and I understand that. One day at a time. It seems like there is just as much judgement in the world of recovery based on how you choose to recover. If I go to a rehab that fits me but isn't PHP, and I stay sober for 5 years, or 10 years, or 15 years, does that not prove I can do it? I'm trying not to become bitter about it, but so many nurses say "there's hope" and then tell you the only hope is to do it exactly their way, adding to my disillusionment with the field even more. 

I did speak with a lawyer, he said criminal charges are always a possibility, consent order or not, but if you have been getting treatment (because the BON told you to or because you chose to), most prosecutors won't pursue them because it won't be a very impressive case. Especially if you're in a monitoring program OR if you make your license inactive and are in treatment. Either you're being monitored daily and can't practice in certain areas of high risk, or you don't have a license and are therefore not a risk. He was a DA and he said the DA's job is to get the bad guys off the street and most wouldn't want to pursue a case that will probably become a misdemeanor or be settled in fines. That's not really considered a "big win" for them. 
 

Healer555, my brother has a bachelors degree and had a job in his field (business), but got laid off a little after lockdown. He got a "data analyst" certification through Google. There are a lot of jobs in that area now. He works remote 4/5 days. He started at 80K 2 years ago and is already at 94K, way past me and my 10 years of back breaking labor. Lowe's wants the cert mainly but they want you also to have a degree (of any kind-BSNs included). He's being head hunted by 2 other companies now, both offering him 6 figures and full benefits. He said on his first day his boss told him "hey if you ever get too stressed or anything just let me know and take a personal day, no one is going to die if this is turned in late". I mean, can you imagine?

CoffeeYogaNurse said:

JB C, thank you for your multiple responses, to my question and other people's. I do think you may have misunderstood. I never in my post said I wasn't going to go to rehab. I'm currently in rehab. As Healer555 correctly read, I was asking about not going back to nursing. The stress, time away from family, relatively low pay compared to years spent in the job, and many other factors have created a general disillusionment with it. Certainly not all, but many older nurses I know, (many in the groups I'm currently attending and many I've known from my work experience) aren't healthy emotionally or physically to be honest, addict or not. If it's not alcohol or narcs it's food, or caffeine, or nicotine, or sex, or gambling, etc. I am not blaming medicine for my poor choices, but I don't think it's crazy to wonder if some of the intense trauma (10 years ICU and ER), covid pandemic, understaffing, overcrowding, lack of debriefing, etc. all present in critical care have played a role. I don't think it's crazy to consider doing something else. Nursing is what I do, not who I am.
 

As far as the alcohol goes I can and have gone a long time without drinking. I got a pEth blood test on entrance to the rehab and it was completely negative (shows alcohol use over a month-negative usually means 2 or less drinks in the past month). I'm just saying I don't know if I want to get 6 months added to a consent order because I have a glass of wine on vacation in France, and I'm not sure I want to not have that wine because some board of some job I don't know if I love says I can't. It seems like a lot of monitoring for a job I'm not sure I love, or at times even like. My issue was pharmaceutical grade Fentanyl specifically, which is not uncommon (per the doctors in my rehab). I think if I were to remove the risk of being around the substance at all I would feel safe.

I can tell you're very passionate about what you believe, and I appreciate your concern. It is frustrating to hear that you think I'll relapse or overdose if I don't follow what a nursing board who doesn't know me at all, who isn't actually following evidence based practice or using individual care plans in their consent orders, says I should do. My doctors in the rehab I'm currently in are saying either choice is OK, as long as I get treatment and pursue what I would like to do. I also understand the cognitive dissonance that plays into this, if someone does spend years jumping through hoops to get their nursing license back/off parole, they probably can't allow themselves to think of a world where someone didn't choose to do that and could also be healthy. I do think there are more ways to be healthy and sober than doing exactly what the BON says. I'm learning all about addiction and based on the notion that putting pressure on an addict could trigger a relapse, I do wonder how much the nursing boards care about us as individuals because those programs are full of pressure. Their job is to protect the public though and I understand that. One day at a time. It seems like there is just as much judgement in the world of recovery based on how you choose to recover. If I go to a rehab that fits me but isn't PHP, and I stay sober for 5 years, or 10 years, or 15 years, does that not prove I can do it? I'm trying not to become bitter about it, but so many nurses say "there's hope" and then tell you the only hope is to do it exactly their way, adding to my disillusionment with the field even more. 

I did speak with a lawyer, he said criminal charges are always a possibility, consent order or not, but if you have been getting treatment (because the BON told you to or because you chose to), most prosecutors won't pursue them because it won't be a very impressive case. Especially if you're in a monitoring program OR if you make your license inactive and are in treatment. Either you're being monitored daily and can't practice in certain areas of high risk, or you don't have a license and are therefore not a risk. He was a DA and he said the DA's job is to get the bad guys off the street and most wouldn't want to pursue a case that will probably become a misdemeanor or be settled in fines. That's not really considered a "big win" for them. 
 

Healer555, my brother has a bachelors degree and had a job in his field (business), but got laid off a little after lockdown. He got a "data analyst" certification through Google. There are a lot of jobs in that area now. He works remote 4/5 days. He started at 80K 2 years ago and is already at 94K, way past me and my 10 years of back breaking labor. Lowe's wants the cert mainly but they want you also to have a degree (of any kind-BSNs included). He's being head hunted by 2 other companies now, both offering him 6 figures and full benefits. He said on his first day his boss told him "hey if you ever get too stressed or anything just let me know and take a personal day, no one is going to die if this is turned in late". I mean, can you imagine?

Sounds like your brother has a great job. 

So glad you are doing well. 

I'd see how things are going for you after rehab and see what exactly you're required to do. The powers that be may make you repeat rehab or iop at one of their facilities or may not. A drink of wine in France may land you hack in rehab per the BON. A lot of programs require negative peth and drug tests the last 2,3 years so depending on when your trip is it could be extra years not months.  I am dying to be done with this.  An extra day would be torture and the punishment is always months or more not days. 

You have to decide what is right for you. It's a very rigid one size fits all program that is full of rules.  It's definitely doable but I for one really feel my quality of life is definitely diminished and these are wasted years.  See what your state requires maybe and go from there. Good luck to you. 

Healer555 said:

Sounds like your brother has a great job. 

So glad you are doing well. 

I'd see how things are going for you after rehab and see what exactly you're required to do. The powers that be may make you repeat rehab or iop at one of their facilities or may not. A drink of wine in France may land you hack in rehab per the BON. A lot of programs require negative peth and drug tests the last 2,3 years so depending on when your trip is it could be extra years not months.  I am dying to be done with this.  An extra day would be torture and the punishment is always months or more not days. 

You have to decide what is right for you. It's a very rigid one size fits all program that is full of rules.  It's definitely doable but I for one really feel my quality of life is definitely diminished and these are wasted years.  See what your state requires maybe and go from there. Good luck to you. 

So sorry to hear you feel that way right now. My kids are little and I just want to be happy and healthy for them, and also be able to be mentally present and not always stressed about the BON Big Brother of it all. I do think I'm going to go inactive and go from there. I hope your monitoring will end quickly and you'll start feeling better! 

JB C said:

First, does the Texas Board know? Did they open an investigation? Lots of variables here. You said you were aware that she passes out at work. If you are aware, then I assume her work is aware.

I will answer your question based on the ASSUMPTION that Texas is aware and opened an investigation. Based on this assumption only, part of the investigation will begin with an investigator meeting/contacting her Supervisor, Human Resources/Risk Management, and Pharmacy at her work and do an extensive review of narcotic pulls to look for discrepancies and I'm talking about discrepancies that suggest a substance abuse problem, not a discrepancy which is a 1 time thing that is due to two nurses squabbling over who should have wasted what, etc. The Omnis and Pixis's have software that can now literally predict a substance abuse problem by comparing a nurses drug pulls with all of the other staff. They are looking for that, not a one time missed Percocet waste or being off on Demerol by 5mg of which every nurse in America has had a discrepancy (at least one) if practicing long enough. They aren't looking for legalistic childish female nurse jealousy relationship BS as the investigators knows nurses love to set each other up and dramatize. They are looking for clear-cut substance abuse pattern narc withdrawals and They Can Tell the difference in a substance abuse pattern compared to nurse A hating nurse B because nurse A thinks nurse Bs hair is prettier, etc.

After they get the above data, they now go to the nurse supervisor and look for any signs/behavioral/mental health/possible substance use displays of behavior, and finally, they go directly to the nurse for her interview. They question her and if anything whatsoever turns up in all of the above, the first thing the BON will do is 1 of 2 things. If major discrepancies with drug pulls, then license temporarily suspended pending mandatory substance abuse eval and mental health eval. If no major narc discrepancies and no clear cut signs of behavioral issues at work, and the nurse denies any history of mental health issues, then likely a warning letter only and no discipline. If no narc discrepancies, but the nurse admits to past mental health issues, then mandatory substance abuse and mental health eval and license not suspended pending the results of the evals. If mental health or substance abuse is found out, nurse will go on contract/consent order. If nurse had no issues at work but had them only at home, likely it will not be disclosed to the public, but Put on consent order for 3 years with mandatory treatment.

Investigators are savvy! For example, here would be the typical question.

   "Nurse Smith, keep in mind how you answered your RN license application upon completing your nursing program and you were asked about any possible mental health issues and keep in mind that answering any of these questions with intentional dishonesty is considered a Class D felony in Texas punishable by up to 1 year in state prison. You answered no and we have a copy of your application. Here is your copy. Please take a look at your answers.  We have the ability to go back and verify if the answers you gave were fully true and if they were not, you could be criminally charged. We understand that many nurses are stressed out and all of us can have issues and we want to save your career and you can save it right now. We will let the answers to the questions you gave slide and we want to help you and there will be no actions taken based on those answers you gave if you simply tell us the truth now. Please use this as a turning point in your life and let us help you if needed and we only ask for the truth. Did you have mental health issues in the past and how about in the present"

See how the above goes for probably 90 plus percent of nurses who have no idea of what is coming and one day, they are pulled from the floor doing patient care and within 60 seconds they are in an office with 4 people they have never seen in suits and one is wearing a badge and they have a stack of papers in front of them? Most nurses, not all, but most are scared to death and they confess. 

So she will most likely deny any mental health issues, but I attached EXTENSIVE evidence of her mental health/substance abuse issues in my email to TPAPN dating back to 2017, so will that have any pull if she is currently pretending to be a goody goody at her new job? I'm assuming she's on her best behavior so as to not get fired, but when I reported her, I included the cps report that stated they found a "reason to believe" that "neglectful supervision" occurred. In addition to a video of her passing out on a YouTube live while drinking a mikes harder lemonade, pictures of her busted up face when she passed out during clinicals, an email she sent me back in 2018 where she admits to being so mentally ill that she doesn't think she can be around her kids, and dozens of screenshots from her social media where she admits to passing out and falling from starving herself.

If she is having no issues at work and had no mental health issues at the TIME of applying for her license thst would preclude her from doing in her job and there are no issues at work and no major discrepancies, then NO. Nothing will be done as the passing out and child issues are concerning the Board will still consider this off duty personal squabble stuff and overwhelming odds nothing happens. 

Additionally, since over 5 years have passed since the email you have I doubt nothing is done. If she still has mental health issues and has a substance abuse issues IT WILL come to light sooner or later and it will present itself sooner or later at work. You have done your job and reported it and did the right thing. It's out of your hands now and I would move on