Best/worse experience in monitoring. Please advise

[HoldenC]

Hey everyone, I want to be honest here. I work for one of the monitoring programs. I would love to hear your input. I am always researching and found this forum a long long time ago and it has truly impacted how I feel about the toll/burden/stress and onward these programs put on people. I am not here to hurt/catch anyone and never have been -just want to make that clear. I respect this as an anonymous forum like I respect my participants confidentially without question.

My my question is what can we do to help? What can we do differently? I have read many posts here about people feeling they did not need monitoring - or at least not 5 years. Tell me I care and want to hear.

Finally, as an employee of one of these programs I often struggle with feeling intrusive relating to simple things in a participants life that I need documentation for. How can we become more of a partner and less of a weight/burden? How can programs be more supportive?

[Leigh37]

Hey!! I just enrolled into the program and I got to tell you... it has set my anxiety into overdrive!!! Feeling almost the same as when I was in and after rehab.

I ended up addicted to prescribed pain medication after multiple kidney stones and 4 root canals in a small amount of time. I was totally honest with my employer as to why I took off work when I went to rehab... never did my addiction have ANYTHINGto do with work. I recognized my problem and chose to be truthful abdgo to rehab. I was told by my employer it was law that I had to self report with my issue and now here I am enrolled in what feels like a life long sentence of being under the KBN's thumb. The checking in daily and wondering how it will affect my day (seeing as I have 3 kiddos) and am run ragged as it is. Ex: were going to Disney soon and was basically told, too bad you still would have to find SOMEWHERE IN ORLANDO... to pee in a cup! I think that's just crazy! I also live in a small town and am still confused as to where I am supposed to find somewhere on a Saturday or Sunday to do a drug screen!! I am not paying 600.00 or more to go to the ER! Also 3 meetings a week seems a little much.. especially when you live in a town as small as I do. I shouldn't have to put myself in a place where other people I would never tell what has went on will now know. As I mentioned before I also think that the 5 year span of this agreement is nuts. Especially since as I said before this had nothing to do with my job therefore nothing to do directly with my license. I don't know, I am just so happy I found this forum. I also was denied a job at a Peds office (they knew everything) but was denied a job bc the KARE program and those in it are PUBLIC KNOWLEDGE!! It's one thing for your employer to know but the fact that any person could google and find my name associated to this program is just wrong. I feel like you are taking a "Health Issue" and splashing it everywhere! That is NOT necessary. The only people that need to know is myself, KBN and my employer. How is this not considered a HIPPA violation or similar. We're going through beyond enough as is without y'all making it PUBLIC KNOWLEDGE. I have also been told by many people in my IOP group that this is worse than drug court... and it's definitely a lot longer. I know I am rambling and hope this made some sense. It's hard to see what I am typing on my phone. :)

[Leigh37]

I feel you,girl!! Mine had NOTHING to do with my job but I was honest when I took time off to go to rehab... never been in any kind of trouble at all. But I was told by my employer that I HAD to self report to the KBN. So now here I am under the thumb of the KBN for FIVE YEARS!!! Yes, 5!!! This was a total innocent thing (kidney stones and 4 root canals) got addicted to prescribed medication and fixed it myself. Only to now have to deal with this. I am beyond overwhelmed and my anxiety is through the roof!!! I also think the calling in every single day no matter where you are or what you ar doing is crap!! To say I am not happy with this would be an understatement... I have 2 therapists I see and they both absolutely cannot believe all this! And the fact that they make this PUBLIC KNOWLEDGE is CRAP!! I was turned down a job at a privately owned Peds office ( they knew everything) but They at the end of the day said if this was private knowledge between you, me and KBN that's one thing. But they make it PUBLIC!!!! That is BS!!! Do they not think we are going through enough without them letting any and everyone know that looks me up?? I was DENIED a job bc the KBN feels the needs to let every freaking person know that wants to look it up!!

[hppygr8ful, ASN, RN, EMT-I]

I went through monitoring from 2002-2006. For me it was a mostly positive experience but they didn't seem to be as punitive then as they are now. Also in my case I really needed the structure that the program provided for several reasons I won't go into here. I do believe that the programs should be more individualized and less cookie cutter. My heart bleeds when I see what nurse currently in monitoring go through.

Hppy

[Leigh37]

It's mega overkill I feel... I also believe there should be some sort of incentive program... it shouldn't 5 years under their thumb if you have been completely successful within the first 2-3 years. I also don't feel this should be PUBLIC KNOWLEDGE. It's hard enough to go through this without any Person able to look it up!!! I was denied a job at a Privately owned Peds practice bc this is PUBLIC KNOWLEDGE!!!! No one should know expect myself, the KBN and my employer!

[Neats, BSN]

If I can say a few words.

I have never been in trouble with my license and I am grateful.

I have hired a lot of medical staff in my career some with issues while they have been employed. I try to get my staff who had issues into programs that will help them and try to keep them hired throughout their program, sadly I cannot do this every time. In the prison system it was the Warden who decided who to keep and who to let go. I had one nurse who was on a probation at work due to ETOH use. They came into work and you could smell the choice of drink on them. I had to get them to quit or the warden would have called the police (no ETOH on prison property it is a felon), hated doing this but it was the best thing for this nurse.

I had a nurse in a SNF who diverted scheduled II from some of the residents. The state would not allow this nurse back into the facility...a family member complained and that is all it takes.

I had a SNF nurse who was being monitored and this nurse was the best MDS coordinator I could ever find.

Saying you can only get jobs only other nurses do not want, or the job environment is bad well I think emergency room environments are the worst. To me a job is a job.

Owning what you did and spending the time to make it right seems like a small price to pay for such public trust nurses have. I think we are held to a higher standard...rightly so, but I do think the programs you all speak of seem to be extreme.

[catsmeow1972, BSN, RN]

Owning what you did and spending the time to make it right seems like a small price to pay for such public trust nurses have. I think we are held to a higher standard...rightly so, but I do think the programs you all speak of seem to be extreme.

This says so very much. Yeah, people have 'messed up' if you will. Yes, we are in a position of trust. Yes, there are situations where such a nurse should not be be working at that time or not at all. There are settings where a nurse should not be working in at that time or not at all. Ascertaining who those people are, what those places are and so forth, to me is the role of the monitoring program.

Unfortunately now "monitoring" is synonymous with punishment, control, abuse, financial ruin and near certain professional ruination for some.

Public trust? Higher standard? Some days, I'm not sure I'm so proud to call myself a nurse anymore. Especially if this is how we treat each other....

[Wizard 1]

It has been two years since I successfully completed monitoring.

Much of what I could add has already been said but I can add one thing.

The last month of my monitoring, I test positive for alcohol (I did not consume). I went from getting ready to complete to limbo, quickly. My caseworker's attitude towards me changed. I kept hearing "we have to discuss this" and "continue monitoring for now" for weeks, during which they decide to do an ETG on the original positive result. This allegedly was positive. I kept pressing for resolution. During these extra weeks I was tested again, which was negative. They continued to string me along, until one day I contacted the program director to inquire into my finishing the program. He contacted me back, stating that the ETG was NEGATIVE and I would be successfully discharged within a few hours. I was, but before the final papers were sent I also requested a copy of that ETG, and downloaded all my other test results.

All those weeks of worry. Those that are on the other end have no idea how much worry. The second guessing one's self, the sheer panic (how did this happen? I have not used or drank, but THESE PEOPLE THINK I'M LYING, etc), and the evasion on the part of my case worker. The case worker that probably didn't even know how to read the test! The test in question, on the results, was VERY OBVIOUSLY negative.

I know that for some, these programs are lifesaving. But there are many, many problems that really need to be addressed...but who's going to do it? Nurses are likely not going to, because that would make them "troublemakers" and put a target on their back.

There needs to be real accountability and oversight in state governments for these programs. I'm not just talking about the Board of Nursing. There needs to be an advocate for nurses (and other professionals) that are caught in the no win situations these programs create, within the state government, that is not connected to either the program or the Boards, that can intervene in these situations on their behalf. I do not mean a lawyer. I mean an office within the government that can help the nurse and is accountable to the citizens of that state.

These programs are out of control. The casualties are plenty on this forum.

[rn1965, ADN]

It has been two years since I successfully completed monitoring.

Congratulations!

Much of what I could add has already been said but I can add one thing.

The last month of my monitoring, I test positive for alcohol (I did not consume). I went from getting ready to complete to limbo, quickly. My caseworker's attitude towards me changed. I kept hearing "we have to discuss this" and "continue monitoring for now" for weeks, during which they decide to do an ETG on the original positive result. This allegedly was positive. I kept pressing for resolution. During these extra weeks I was tested again, which was negative. They continued to string me along, until one day I contacted the program director to inquire into my finishing the program. He contacted me back, stating that the ETG was NEGATIVE and I would be successfully discharged within a few hours. I was, but before the final papers were sent I also requested a copy of that ETG, and downloaded all my other test results.

Wow, that is so frustrating. I would have been livid. That seems almost like a power trip with the CM. Good on you for going above their head!

All those weeks of worry. Those that are on the other end have no idea how much worry. The second guessing one's self, the sheer panic (how did this happen? I have not used or drank, but THESE PEOPLE THINK I'M LYING, etc), and the evasion on the part of my case worker. The case worker that probably didn't even know how to read the test! The test in question, on the results, was VERY OBVIOUSLY negative.

I know that for some, these programs are lifesaving. But there are many, many problems that really need to be addressed...but who's going to do it? Nurses are likely not going to, because that would make them "troublemakers" and put a target on their back.

I think you are right. So many nurses who complete this are probably so thankful, they never want to look back and relive that stress, and in some cases, horror. I do agree that for some nurses, this is lifesaving, but, they need to be specific to each nurse/case. The cookie cutter approach does not work. We wouldn't dare treat all patients with pneumonia the SAME EXACT way. We would monitor them and their progress individually, and adjust as needed.

There needs to be real accountability and oversight in state governments for these programs. I'm not just talking about the Board of Nursing. There needs to be an advocate for nurses (and other professionals) that are caught in the no win situations these programs create, within the state government, that is not connected to either the program or the Boards, that can intervene in these situations on their behalf. I do not mean a lawyer. I mean an office within the government that can help the nurse and is accountable to the citizens of that state.

These programs are out of control. The casualties are plenty on this forum.

[SpankedInPittsburgh, DNP, RN]

Neats,

You seem like a good and compassionate Nurse. I love that you told the Nurse in question to quit before getting charged with a felony thus actually helping that person.

However, we disagree on a couple points. First, in my opinion a job is not simply a job in nursing. When I got my DUI on an off-night with no history of any impairment at work I was an ER Nurse making a little less than $120K per year with reasonable OT and shift differential. After entering this program I was placed in a homecare health management position making my base salary of about $80K per year. Coupled with the vast expenses of this program I narrowly escaped bankruptcy, have wrecked credit and am still digging myself outta financial hell from 2 1/2 years ago. Further ER Nursing wasn't a job for me but a career. I had quite a bit of experience, education, aptitude and investment in my career. My DUI had nothing to do with my job performance. I got excellent reviews during my tenure in the ER and was even selected for a scholarship to attend school to become an NP.

Second, our interpretation of what constitutes a violation of the public trust. If a nurse was never impaired at work how was the public trust violated? Most nurses in these programs have no record of impairment at work in anyway. Some sought treatment on their own for mental health or substance abuse issues and were reported by the providers they trusted. Many (like me) used bad judgement and got a DUI on an off-night and were subsequently and rightfully punished for their crimes by the legal justice system. Some had mental health issues and were placed in a substance abuse program because that's the only treatment that the BON really offers. Some failed random drug tests for weed or non-prescribed drugs (once again) with no history of use or impairment at work. Some are there simply based upon allegations and innuendo of former spouses, rumormongers and other people in their life's with an ax to grind. Nurses are human and have the same problems as everybody else they shouldn't be punished for them unless those issues affected the patient's in their care. Heck we have had a President (Bush) with a DUI and a couple more that admitted using illegal drugs (Obama, Clinton). Their careers and lives weren't derailed by this fact. Are nurses held to a higher standard than the most powerful man in the world? If so that fact is asinine and evidence of Nurse self-loathing and the overwhelming desire that some nurses have to over-punish and judge other nurses at every possible opportunity.

Having been through all of this, I would never under any circumstances advise a nurse to trust anybody in seeking help for their issues lest they be punished for treatment of a disease. From what I've seen and researched the treatment "professionals" have dismal results and are much more interested in grabbing as much loot as possible then getting anybody off booze or drugs. If medical intervention is necessary I would advise them to never admit to being a nurse. Most of all I would tell them to never trust the helping hands at the BON or their appointed surrogates as they will simply be placed into a one-size-fits-all meatgrinder much more interested in punishing then helping.

[Emergent, RN]

I'm not a participant in a program, but have lurked here for some time.

The one size fits all aspect of the programs is ridiculous. Someone takes her sister's Vicodin for a headache is treated the same as someone stealing Dilaudid at work and shooting up on the job. The latter should be dealt with harshly, IMO. The former is barely an offense.

The DUIs should be dealt with by the court system exclusively. I feel that impairment on the job should be the only time the BON gets involved, otherwise leave it to the legal system.

I believe that some of these policies are resulting from the leftover attitudes from a bygone era towards women in the workforce, and a patriarchal mindset.

[dr. eatbox]

"Benefits" : saving money on the occasional night out or bottle of wine, and Uber / lifts, THATS IT

Bad experiences: completely outweighs the above

My social life took a huge hit because I am not going to risk placing myself in any situation where there is alcohol plus being sober at a bar is awful anyway, monitoring costs $200-300 per month, getting hired is IMPOSSIBLE, can't travel much without providing a ticket to Mexico to get time off testing (then get your ticket refunded), and the board even called and said I tested positive for some random benzo I've never heard of, left me waiting all day thinking I was going to lose my license, then called and said they misread the results

I'm not an addict. I got one dui 4 years before nursing school. No crash, no dead bodies. Quitting drinking and "getting sober" was not hard for me. I do t even call it getting sober. 1.5 more years and I'll graduate a stronger person, graduate as an NP the Same year, move back to CA and say goodbye to the ass backwards Nevada board of nursing

[Leigh37]

You are SO VERY CORRECT!!!!