Moving after completion of program

LMRN2003, MSN, RN · Jul 10

No, you should not have to complete another program in another state since it's already been completed. I have a friend who completed probation in CA and then moved to TN with no issues.

Steven Thompson · Jul 11

Having worked and known well over 100 plus nurses in recovery and having set on the California Board, I've never heard of ANY case (not one time) where a nurse moves to another state after Completing a monitoring Program and is then sanctioned or punished or has to do another monitoring program in the new state. With that said, this is under the assumption the nurse is fully completed/finished their monitoring program and the Board updates the license showing no restrictions/fully restored. Doesn't matter if someone is in a 5 year program for diversion, when they are done and complete it, then they move to a new state, they will NOT be restricted or required to do a new monitoring program.

The answer to your question is a very clear cut...No

Healer555 · Jul 11

Steven Thompson said:

Having worked and known well over 100 plus nurses in recovery and having set on the California Board, I've never heard of ANY case (not one time) where a nurse moves to another state after Completing a monitoring Program and is then sanctioned or punished or has to do another monitoring program in the new state. With that said, this is under the assumption the nurse is fully completed/finished their monitoring program and the Board updates the license showing no restrictions/fully restored. Doesn't matter if someone is in a 5 year program for diversion, when they are done and complete it, then they move to a new state, they will NOT be restricted or required to do a new monitoring program.

The answer to your question is a very clear cut...No

What if state A is 3 years and state B where one would move is 5 years? I really don't understand the logic or lack of logic. If a state feels the need to put one through torture for 5 years so they can say you are fit why would they think 3 years from another state is appropriate?

Steven Thompson · Jul 11

Healer555 said:

What if state A is 3 years and state B where one would move is 5 years? I really don't understand the logic or lack of logic. If a state feels the need to put one through torture for 5 years so they can say you are fit why would they think 3 years from another state is appropriate?

Logic is not mine. The logic is the state boards. And the answer to your question is YES, state boards of Nursing historically do NOT add another 2 years if a nurse completed a 3 year program and moves to a state that has a 5 year program. Has there ever been a nurse out there who has finished a 3 year program and then moved and received 2 years extra (2 new years) for the new state they just arrived to? I'm sure it's happened of course, but it's very very very rare. Why? Legally, the Board can have issues here. It is Possible, but very difficult if the nurse puts up any fight with an attorney because the nurse is coming to the new state with an unrestricted/no probation/presently clean license that is now made multi-compact. The new state now has to not just add their 2 years, but generally would require the license be single state again and legally by doing this, you even get into issues with the National Practitioner Data Bank. A civil defense type attorney would have a field day with this. Imagine a nurse does her or his time, license is now restored, unrestricted, and now multi compact, and the NPDB is now updated by the state showing the nurse is now in good standing, no probation and within 1 month, the new state where the nurse moves starts the process again an adds 2 years. This means no longer multi state compact license restricted, probationary type, and a Possible NEW entry into the NPDB. A lawyer could chew a Board up for this and imagine what it does to APRNs who carry malpractice and their malpractice that they just paid for now skyrockets again or is even possibly revoked. These are reasons why State Board rarely, very rarely try it.

Here's what is happening at present for all states. Every state will be a 5 year program within 2 years AT Most for those who have diverted or drug related other than marijuana. Alcohol infractions, even the most minor ones will be 3 years of monitoring. This was discussed at the ANA IN 2023 and the DNP conference in 2023 in conjunction with presentations from 3 leading recovery centers/researchers 1 year ago and the Data supports 5 years for diversion/drug related other than marijuana and 3 years for an alcohol infraction and anything in between for individual issues. Are there still states where the monitoring programs 3 years even for diversion cases? Yep, there are butbtheu are fading fast.

The same applies for a minor alcohol infraction or smoking marijuana one time and got caught while applying for a job as these types were often less than 3 years of monitoring and sometimes, just 12 months of monitoring. It's rapidly changing across the country to a 3 year minimum.

Your question regarding what to do with programs in transition in which a nurse that completed less than 5 years in a program (for example 3 years in state A) and then moves to a 5 year program state came up regarding what to do with them. The general consensus was...no more time added by the new state but that was NOT a hard and fast absolute rule. But, the legal issues surrounding this and the legal issues that have surrounded it are the reasons the new state is, and has always been reluctant to add more time.

Healer555 · Jul 11

Steven Thompson said:

Logic is not mine. The logic is the state boards. And the answer to your question is YES, state boards of Nursing historically do NOT add another 2 years if a nurse completed a 3 year program and moves to a state that has a 5 year program. Has there ever been a nurse out there who has finished a 3 year program and then moved and received 2 years extra (2 new years) for the new state they just arrived to? I'm sure it's happened of course, but it's very very very rare. Why? Legally, the Board can have issues here. It is Possible, but very difficult if the nurse puts up any fight with an attorney because the nurse is coming to the new state with an unrestricted/no probation/presently clean license that is now made multi-compact. The new state now has to not just add their 2 years, but generally would require the license be single state again and legally by doing this, you even get into issues with the National Practitioner Data Bank. A civil defense type attorney would have a field day with this. Imagine a nurse does her or his time, license is now restored, unrestricted, and now multi compact, and the NPDB is now updated by the state showing the nurse is now in good standing, no probation and within 1 month, the new state where the nurse moves starts the process again an adds 2 years. This means no longer multi state compact license restricted, probationary type, and a Possible NEW entry into the NPDB. A lawyer could chew a Board up for this and imagine what it does to APRNs who carry malpractice and their malpractice that they just paid for now skyrockets again or is even possibly revoked. These are reasons why State Board rarely, very rarely try it.

Here's what is happening at present for all states. Every state will be a 5 year program within 2 years AT Most for those who have diverted or drug related other than marijuana. Alcohol infractions, even the most minor ones will be 3 years of monitoring. This was discussed at the ANA IN 2023 and the DNP conference in 2023 in conjunction with presentations from 3 leading recovery centers/researchers 1 year ago and the Data supports 5 years for diversion/drug related other than marijuana and 3 years for an alcohol infraction and anything in between for individual issues. Are there still states where the monitoring programs 3 years even for diversion cases? Yep, there are butbtheu are fading fast.

The same applies for a minor alcohol infraction or smoking marijuana one time and got caught while applying for a job as these types were often less than 3 years of monitoring and sometimes, just 12 months of monitoring. It's rapidly changing across the country to a 3 year minimum.

Your question regarding what to do with programs in transition in which a nurse that completed less than 5 years in a program (for example 3 years in state A) and then moves to a 5 year program state came up regarding what to do with them. The general consensus was...no more time added by the new state but that was NOT a hard and fast absolute rule. But, the legal issues surrounding this and the legal issues that have surrounded it are the reasons the new state is, and has always been reluctant to add more time.

So for me, I am half way through a 3 year monitoring agreement. Are they going to increase current monitoring agreements to 5 years?

I contacted a lawyer too late and was told that they can do little except try to get a person a good evaluator. Are you still on the board?

Steven Thompson · Jul 11

Healer555 said:

So for me, I am half way through a 3 year monitoring agreement. Are they going to increase current monitoring agreements to 5 years?

As it relates to your state that you are in its overwhelmingly likely 2 things will happen by the time you finish the remaining 18 months.

1. You will be done at the 3 year mark (approximate 18 months left) and it's over and you can move on.

2. You will likely see increased years (4 or 5 years) for NEW people coming into the program in your state which had a similar infraction as yours. Could they try and lengthen your time? Possible, but absolutely overwhelmingly unlikely and unheard of, and they will not fool with you UNLESS......

Do NOT mess up. Let me tell you what is happening across the country. Many nurses are in programs where they are in a 3 yr program and the state has made the transition for NEW nurses coming into the program to do 4 or 5 years. California is an example. A nurse gets a positive test or missed a bunch of check ins or whatever the nurses requirements are, the nurse messes up, and the nurse doesn't get 6 months added, they get the full 5 years. It's happening all of the time as states are transitioning to more lengthy times. With that said above, and again, I'm an Instructor and work with about 100 nurses per week across the country on Zoom in my meetings I have NEVER met a nurse who had their time extended out of the blue in transitioning states when they were compliant in their program. Not one.

So, you being done in 18 months at the 3 year mark and no time extension is a given. You will be done, but if you or a nurse in your situation were to mess up, an added "2 year sentence' would be far more likely than a 6 month extension.

Healer555 · Jul 11

Steven Thompson said:

As it relates to your state that you are in its overwhelmingly likely 2 things will happen by the time you finish the remaining 18 months.

1. You will be done at the 3 year mark (approximate 18 months left) and it's over and you can move on.

2. You will likely see increased years (4 or 5 years) for NEW people coming into the program in your state which had a similar infraction as yours. Could they try and lengthen your time? Possible, but absolutely overwhelmingly unlikely and unheard of, and they will not fool with you UNLESS......

Do NOT mess up. Let me tell you what is happening across the country. Many nurses are in programs where they are in a 3 yr program and the state has made the transition for NEW nurses coming into the program to do 4 or 5 years. California is an example. A nurse gets a positive test or missed a bunch of check ins or whatever the nurses requirements are, the nurse messes up, and the nurse doesn't get 6 months added, they get the full 5 years. It's happening all of the time as states are transitioning to more lengthy times. With that said above, and again, I'm an Instructor and work with about 100 nurses per week across the country on Zoom in my meetings I have NEVER met a nurse who had their time extended out of the blue in transitioning states when they were compliant in their program. Not one.

So, you being done in 18 months at the 3 year mark and no time extension is a given. You will be done, but if you or a nurse in your situation were to mess up, an added "2 year sentence' would be far more likely than a 6 month extension.

I have been the model prisoner so far. I wake up so irritated about this so I remember to check in. I used to post notes but I don't need them. I almost said eff this monitoring agreement but when I decided to do it. I'm in 100% for the 3 years. I know I would walk away if more time was added.

If I woke up a billionaire tomorrow, I would not only walk away, I would work for change. The person who 100% has a SUD should do the 5 years. But common sense needs to enter the picture. Sure, a monitoring agreement is appropriate for those who actually have a SUD, for those who have a mental illness who are impaired and don't have the wherewithal to seek treatment but as you know it's not a benign program. I think it deters people from seeking help because they want to avoid a monitoring agreement.

Steven Thompson · Jul 11

Agree with al

Healer555 said:

I have been the model prisoner so far. I wake up so irritated about this so I remember to check in. I used to post notes but I don't need them. I almost said eff this monitoring agreement but when I decided to do it. I'm in 100% for the 3 years. I know I would walk away if more time was added.

If I woke up a billionaire tomorrow, I would not only walk away, I would work for change. The person who 100% has a SUD should do the 5 years. But common sense needs to enter the picture. Sure, a monitoring agreement is appropriate for those who actually have a SUD, for those who have a mental illness who are impaired and don't have the wherewithal to seek treatment but as you know it's not a benign program. I think it deters people from seeking help because they want to avoid a monitoring agreement.

100% agree

Steven Thompson · Jul 11

My program was 5 years. If I would have got 2 million bucks, I would have left the program at any time and not have done the whole 5 years and I had an SUD. For me (to each is there own) but for me not drinking no weed and no drugs was very easy. It was the continous daily fear of..

Did I remember to check in? Two nurses call out sick on a day I'm selected and we get two traumas later in the day so will I make it to the test, or a situation for me, my therapist on March 30th sends my Quarterly report to the Board BUT mistyped the email address and went to Croatia for 2 weeks on vacation the next day. 5 days later, the Board tells me I'm not in compliance and is threatening me and I tell them the situation and the person I'm speaking with doesn't seem to care. Or, I take a test and the lab tech forgets to write down the temperature on the lab form, so I have to go back two days later and retest and pay another 100 bucks and get off of work again 2 days early. Or....... My Aftercare instructor in Idaho gets cancer and dies 1 year after I'm in the program and Idaho has specific Aftercare programs state approved and now, the only open slot approved by Idaho is a program on Wednesdays at 2PM which are days I work, so now my entire job is at risk. It's these little things that seem trivial and individually maybe not a big deal if only a 1 time event, but when you add them all up over time, these programs absolutely wear on you. It did me. Not doing alcohol or drugs was the easiest part. All the other things above and several others that I didn't write about was what made it very difficult.

Healer555 · Jul 11

Steven Thompson said:

My program was 5 years. If I would have got 2 million bucks, I would have left the program at any time and not have done the whole 5 years and I had an SUD. For me (to each is there own) but for me not drinking no weed and no drugs was very easy. It was the continous daily fear of..

Did I remember to check in? Two nurses call out sick on a day I'm selected and we get two traumas later in the day so will I make it to the test, or a situation for me, my therapist on March 30th sends my Quarterly report to the Board BUT mistyped the email address and went to Croatia for 2 weeks on vacation the next day. 5 days later, the Board tells me I'm not in compliance and is threatening me and I tell them the situation and the person I'm speaking with doesn't seem to care. Or, I take a test and the lab tech forgets to write down the temperature on the lab form, so I have to go back two days later and retest and pay another 100 bucks and get off of work again 2 days early. Or....... My Aftercare instructor in Idaho gets cancer and dies 1 year after I'm in the program and Idaho has specific Aftercare programs state approved and now, the only open slot approved by Idaho is a program on Wednesdays at 2PM which are days I work, so now my entire job is at risk. It's these little things that seem trivial and individually maybe not a big deal if only a 1 time event, but when you add them all up over time, these programs absolutely wear on you. It did me. Not doing alcohol or drugs was the easiest part. All the other things above and several others that I didn't write about was what made it very difficult.

Agree 100% . In usual circumstances when things out of our control happen people understand. There is zero understanding with a monitoring agreement. If your car breaks down and you can't make it to test that day, too bad. If you are puking your guts out and have to test, you have to go to the test site and expose everyone to your virus. They definitely lack common sense and understanding. If I have to choose between my current job and remaining compliant, there are other jobs.

But 3 years for me, no sud and 3 million minimum