Drug diversion and tnpap

[blue4nurses]

HELP!

So recently, about 3 months ago, I was terminated from my job for drug diversion. I was diverting pain medication in which I was taking myself. I quit the next day and detoxed myself and have been clean since. I was told that I needed to call and self report to the BON in 2 days and if not then they would.

I didn't know what to do. I wanted about 5 days and then I called and "Self-reported". to the BON and then they referred me to tnpap.

I have signed up for tnpap requesting their services. I have met with the evaluator in which he determined I have an "opioid used d/o". I have NO drug use background whatsoever and this was the first time "using". He says I will most likely "need inpatient treatment, because I will most likely use again." It sounds a little insane.

I have no job, no family, alone with both of my kids.

How am I going to go to inpatient? Where will my kids go?

and also, what happens AFTER inpatient?

should I just try and hire a lawyer and fight against the BON?

I don't know what to do....

[SpankedInPittsburgh, DNP, RN]

Oh boy!!!I don't know what its like in your state but just about everyone up here is required to attend inpatient then outpatient, I was in both of these treatment facilities for about four months. This sounds problematic in your case. First, without a job or insurance I have no clue how you would finance all this so you may not even be able to go if you want to. Second, what do you do with your kids? I honestly have no idea. Luckily I kept my job (government job / union contract) and I had plenty of leave accrued to finance this boon-doogle. After that you have to get permission to return to work and even then you have restrictions placed on your license. Here's the bottom line. You are going to be expected to do all of this garbage and it gets expensive. The monitoring program folks don't care if you can make this work. They have thrown out plenty of good nurses in my state despite certified clean time just because they couldn't afford to pay for continued treatment and drug testing (yeah you pay for that too). You really need to decide how much being a nurse is worth to you because these monitoring cannibals are going to get their pound of flesh and could care less about you as a person. I do wish you luck!!!

[blue4nurses]

This is bad bad news for me ..... I'm left with no option at all ...

[blue4nurses]

My only option is to try and hire a lawyer

[SpankedInPittsburgh, DNP, RN]

I'd do that for sure

[hppygr8ful, ASN, RN, EMT-I]

If it's not too much to ask Why were you diverting and taking meds. That in itself indicates you have some sort of substance use disorder. If you were in pain for some reason why not just go to the doctor and get a legit prescription. No one can predict weather or not you will use again. A good lawyer experienced in professional practice issues might help you get the best deal you can - but like spanked said you need to decide how much being a nurse means to you. If you are mandated for inpatient and don't have insurance or money to pay for it you will have to look around for a pro-bono bed. Do you have friends or relatives your kids could stay with while you are in-patient?

Hppy

[blue4nurses]

One mistake led to too many mistakes and then I️ just kept going.

I've recently lost both parents. I've got no family at all. They're either passed or were never in my life.

There has got to be another way.

This mistake was huge and now it's going to ruin my life so what's the point in even trying ?

[SpankedInPittsburgh, DNP, RN]

The only point is how much you want to keep being a nurse. Maybe there is a way but you would have to find it. Perhaps there are pro bono beds in rehab but I've never heard of any. Maybe there is a way for you to get insured with the affordable care act or other resources. If you get in a monitoring program its a tough road with many requirements of time and money & from my experience there is no getting around it. If all this is impossible now you can revisit the idea down the road. I've been in nurse support groups with people who gave up the licenses for years because they couldn't do the program when offered and are trying to get back into nursing after working in other careers. Good luck and the very best of wishes for you and yours.

[Lisacar130]

I hope the following doesn't come across as harsh, I have done the same thing you did and probably worse:

You were caught diverting and also self reported. A lawyer CANNOT get you out of this. What will your defense be? You lied when you self reported to the BON? I just don't want you to waste $$$ on a lawyer when the outcome will be the same. I'm sure any lawyer you call will tell you the same thing.

You said you were caught diverting and "detoxed" yourself at home, but then you said that it was your first time using? And that you have no drug use background whatsoever? You do realize that taking opiates from work for your own use constitutes a drug use background? And the fact you chose the word "detox" indicates maybe you did this more than once?

I'm bringing this to your attention because if you say things like this, these contradicting statements, the monitoring people will not look favorably upon you (if you choose to continue with the program).

They don't care if you got second hand contact high from marijuana that someone else was smoking... any illicit drug use or positive drug test or admission of any one time when you took an old norco from an old prescription. It's all the same to them and you have to go through the entire rehab program and years of drug testing. Fair or not, it is a one size fits all program.

I feel bad for your situation with your kids. I don't know how you would go about doing inpt if you have no family. Do you have family in another state that would take them in while you attend inpt? If you don't do what they are wanting, you won't be able to work as a nurse again. So bottom line is either figure out who can take your kids in or find another career. Please consider asking various inpt rehabs for help, there may be programs set up (like temporary foster care) for people in your situation. It's not ideal but they do need a healthy mom. What would happen to you if you had to have emergency surgery? Where would your kids go then?

[Lisacar130]

The only other thing I can think of is seeing if you can get another eval by someone else, and explain your situation about your kids. They might recommend PHP instead of inpt. Different states handle this stuff differently and inpt is more commonly ordered in some verses others, so I don't know how likely a second opinion will change your outcome.

I don't know if this is even possible or not, but find out.

They might have ordered inpt because they didn't believe you when you said you only used once. You could try being more honest the next time. They look for "minimizing" and "denial" statements and those are red flags to them.

I was very honest during my eval, admitted to years of diversion and said I was an addict with a problem and they did not recommend inpt. I had to do PHP and IOP though but not inpt.

[blue4nurses]

Hearing all of this is awful. Now I'm seeing the only option I'll have is to give up my license. Find a job and get insurance for me and the kids. That's the only thing that seams reasonable in my case.

I'm currently looking for insurance at least for my kids right now. But unfortunately family is something I've never really had and there's no way possible I'd see myself putting them in temporary foster care. I'd not be able to live with myself not knowing what's happening to them.

Unfortunately, my outcome is most likely going to be surrendering my license. It sucks but I'll have no other choice.

Thank you everyone

[hppygr8ful, ASN, RN, EMT-I]

One mistake led to too many mistakes and then I️ just kept going.

I've recently lost both parents. I've got no family at all. They're either passed or were never in my life.

There has got to be another way.

This mistake was huge and now it's going to ruin my life so what's the point in even trying ?

I can only speak from personal experience and I was not required to go to in-patient treatment. After my Suicide attempt for which I was not even put on a 72 hour hold as a "Professional Courtesy" I self enrolled in and Intensive Outpatient Program before I called the BON. When I was called for my first meeting with my Diversion enforcement committee I had almost completed the IOP. The decision was made to monitor me for relapse behavior and that in-patient would be required if I failed. I also started attending AA meetings right away and getting an attendance slip signed. As for pro-bono beds they are available through organizations like the Salvation Army. But waiting lists are long. You might also look into Sober living homes that accept mothers with children. None of it is perfect - but I don't see you getting out of some kind of monitoring and treatment. If you absolutely can't afford it and that may be your reality right now then you may have to step back from nursing/healthcare and do something else. If you decide when you are in a better financial position to return to nurses you can deal with it then. One of my co-workers did this and after about 3 years simply applied for license reinstatement - She had been going to AA/NA for those three years so knew how to walk the walk and talk the talk. Her license was reinstated on probation (which is a permanent mark on the license) and she got 3 years mandatory UDS testing, AA/NA attendance, and weekly nurse support group. No treatment recommended. A word to the wise Medicaid does not cover treatment for Alcohol/substance abuse treatment unless the you have a co-morbid psych diagnosis such as Major Depressive Disorder, Anxiety, PTSD etc... This is not medical advice just what worked for me and many of the people I did this journey with. Because I had a genuine psych diagnosis (you should not lie about this) I was able to qualify for disability during the time I was not permitted to work. Also the Tax code allows you to deduct 100% all medical costs relating to medical care. I learned this too late but some of my friends were able to declare deductions for every penny spent on rehab, drug tests, support groups etc.....

Hppy