Monitoring program

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Hello everyone, I'm just looking for advice. I'm considering reporting myself to the monitoring program since  I diverted a Norco at work, got terminated and I'm pretty sure I will be reported to the BON even though my urine drug test was negative. The ones of you who have reported to monitoring what was that like and what requirements did you have to meet like did you have to go to rehab or do any intensive outpatient? I really don't think I would qualify for rehab since I only took. One pill in my urine drug screening was even negative. It was a horrible mistake and I know one is too many and 1000 is never enough. I just don't know what my chances are with the board of nursing if I don't go through monitoring.. I know it takes a while for the board of nursing to get to a case, but I feel like if I don't report to monitoring then when they do get to my case, my license would be suspended or revoked. Any input would be greatly appreciated. Thank you.

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Waiting for the BON to act can take months or even over a year. The problem is that if you wait for the board to reach your case, the options they give you are usually more punitive like public discipline, suspension, or probation.

What actually protected my license long-term was getting ahead of it and self-reporting to monitoring program THE SAME DAY my incident happened. When you self-report, most states allow a non-disciplinary path through a monitoring program. That route usually avoids a public mark and keeps your license intact.

Also, just because you diverted a single pill doesn't automatically mean you'll be sent to treatment or inpatient rehab. Monitoring programs don't use a "one size fits all" approach. In my case, even with multiple months of stress and burnout behind my situation, I wasn't sent to inpatient rehab and they looked at my history, evaluations, clean drug screens, and the fact that it was a one-time lapse, and they focused instead on mental health support, therapy, and accountability.

Most of what monitoring required from me included things like:

1. regular toxicology tests

2. individual therapy (weekly or biweekly) 

3. weekly group therapy

4. weekly peer-support groups (NA or AA)

5. daily check-ins through the portal

6. a worksite agreement once I was ready to return (this agreement includes having a liaison at work who is willing to send quarterly reports on your behalf, and 6 months of narcotics restriction).

I know it sounds like a lot, but most programs allow you to virtually attend therapy. 

It wasn't easy, but it absolutely prevented my license from being publicly disciplined.

If you're worried about suspension or revocation then, YES, reporting yourself and entering monitoring is often the safest option. It shows insight, honesty, and willingness to address whatever led to that moment. Boards respond much better to that than to silence or waiting for them to take the lead. A lot of nurses wait for the board to act, and by the time the BON does it's too late. Believe me, I have read so many stories of nurses who wish they reported early.

You're not alone. A lot of nurses have made a one-time mistake during extreme burnout or stress. What matters most is how you handle things from here. If you decide to self-report, it might feel scary at first, but it can genuinely protect your career and your long-term license status. In the beginning, it'll feel like your world has been shattered, but you do get used to it! 

Best of luck! 
 

PS: you can always call the monitoring program anonymously with questions 

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Thank you so much, I feel like I do need to report to the monitoring program. The first time I dealt with addiction in nursing, I didn't report to monitoring and I waited for the board to get up with me and it took 2 1/2 years and by the time they got to me, I had already been through inpatient rehab because my first time with drugs and alcohol was worse than this time. My probation was public, and I will always have a history of probation on my license. 
I do have a question about monitoring though. Can you apply for a job right away while you're in the monitoring program or do they have a waiting period?  I am in the process of applying for jobs so I probably need to make sure it is one that is monitoring friendly like nothing unsupervised such as home health. Thank you for taking the time to respond. I appreciate you.! 

 

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mississippiRN71 said:

Thank you so much, I feel like I do need to report to the monitoring program. The first time I dealt with addiction in nursing, I didn't report to monitoring and I waited for the board to get up with me and it took 2 1/2 years and by the time they got to me, I had already been through inpatient rehab because my first time with drugs and alcohol was worse than this time. My probation was public, and I will always have a history of probation on my license. 
I do have a question about monitoring though. Can you apply for a job right away while you're in the monitoring program or do they have a waiting period?  I am in the process of applying for jobs so I probably need to make sure it is one that is monitoring friendly like nothing unsupervised such as home health. Thank you for taking the time to respond. I appreciate you.! 

 

Most programs have a short period at the beginning where you're considered "not yet cleared,” and then they issue your practice restrictions.

When I entered monitoring, I wasn't allowed to work for about 3 months until they completed my evaluation, set up my treatment plan, and gave me the okay to return. Once you're approved, you can apply to jobs that are monitoring-friendly and able to accommodate restrictions.

Since money is always an issue, I would weigh your options.

PS. usually you're not allowed to work until your evaluated by a medical professional who "oks" you to return to practice 

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Does the monitoring program cost anything to enroll?

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mississippiRN71 said:

Does the monitoring program cost anything to enroll?

I paid 600. Usually it's around that price. You also pay for all of your therapy, and tox screens. 

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Specializes in Critical Care, ER and Administration.

I have experience from an administrative point of view. Hospitals are required to report diversions to the BON, they may also report to LEO. I've seen them do both although LEO was with IV narcotics. The MBOA used to be aimed more at rehab than punishment. My experience is from several years ago. With any BOA, honesty and accountability is always the best policy and it will get better results for you.

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Thank you John. I had a negative drug screen though . I wonder if that will make a difference- maybe prove I couldn't haven taken much. That 1 pill got out of my system faster than I expected. I do take bp med they has hctz in it and I had coffee , water and also an energy drink they day so I'm suprised my urine wasn't invalid . I figured I would have to retest the next day but I didn't . 

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John - what is the LEO? Is that legal action? 

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mississippiRN71 said:

John - what is the LEO? Is that legal action? 

Law Enforcement Officer/Officials. "LEO" is the criminal side/case being reported to the police/detectives/District-Prosecuting attorney for potential prosecution. Because a case/incident is reported to law enforcement doesnt mean its going to be prosecuted. Basically, anytime a nurse diverts, it gets reported to law enforcement of some type such as DEA because its a reportable offense. DEA is a regulatory agency, but has a law enforcement arm. The federal government (DEA) doesnt like to get involved with the criminal-prosecutory side of things and prefers to defer to the States, unless you have 1 of 2 situations described below.

Who is More likely to be Prosecuted? If you sold the diverted medication. If you tampered with large amounts of vials. For example, you open 5 or 10 Fentanyls, remove the medication for yourself, and you replace with Saline for patient care. These are the big two and when nurses serve time, 95 plus percent are involved in one of these 2 areas above.

Sometimes, nurses are charged for diversion when its clear the nurse is an addict, but its self use (diverting the waste), pixis overpulls, and the nurse doesnt do major tampering as described above. In these cases that are charged (which is less likely than more likely), the nurse will be given a way out by the court system. For example, "if nurse completes rehab, x, y, z, and does a drug treatment program over a 4 or 6 month period, etc, then charges are dropped, or charges are reduced to misdemeanors." 

Very, very, very, very rarely are nurses acrually convicted of felonies and actually do time in prison when they diverted and used for themselves. It's rare. The overwhelming majority of nurses in prison for diversion did not simply divert. They sold it on the street/ran a business OR they were involved with major tampering of vials.

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