IPN vs. BON?

  1. I went for my IPN evaluation yesterday. It wasn't nearly as scary or as intimidating as I thought it would be.

    There was a doctor there, a psychiatrist, who told me she was a former addict as well. Still takes meds for depression and still attends NA meetings. I was fascinated by this. Here was someone that knew first hand the issues I have encountered being a nurse on bipolar medications.

    What interested me was the fact that she told me that my DON at my former job did NOT need to call the Board of Nursing on me with regard to my being impaired at work. She told me that the DON could have just contacted IPN and left the BON out of the equation. The Board never has to be involved at all and there would be no punitive damage done to my license.

    I wonder...do DON's really know to call IPN for a nurse or is it always straight to the BON? That really confused me.

    Anyway, I have to do 3 months of IOP but the Pdoc in charge of the IPN where I am insured me that I will probably be released for work before the 3 months is up. *shrugs* They also told me that I cannot take xanax any longer although it is prescribed to me for my bpd. This is going to be a tough one for me to give up. I just don't know how they expect me to stop it cold turkey like that! I'm going to try though...

    I just have a feeling I am setting myself up for failure.
  2. Visit Cherybaby profile page

    About Cherybaby

    Joined: Aug '02; Posts: 634; Likes: 979
    LPN
    Specialty: 10 year(s) of experience in Derm/Wound Care/OP Surgery/LTC

    12 Comments

  3. by   Magsulfate
    This is a very good question that you have. I do know that in Texas, apparently there was a new rule passed recently that required the BON to be notified of addiction/psychological issues, but they would automatically refer the cases to TPAPN (of course if they qualify). Then, there would be no mark on the nurses record/license.

    Employers used to have a choice whether to notify the peer assistance program or the BON,, and for the most part the board would refer the case to peer assistance. In either case, if the case qualifies for peer assistance, it will be directed there.

    I hope that other states are like this,, as it works out well. Most nurses get help this way. I can only imagine a nurse being reported to the board and no recovery help is offered. A nurse would already be down and out about losing their license....
  4. by   Cherybaby
    "I can only imagine a nurse being reported to the board and no recovery help is offered. A nurse would already be down and out about losing their license...."

    And Mag, I have to ask you because you seem to know so much about the topic. (I read this board a million times already!) Since the IPN/BON is insisting that I must stop taking xanax for gad...and I have to take drug tests weekly to make sure I have done so...do you think that it would be a good thing to join an NA meeting while trying to stop? The dread that is weighing in my chest about having to stop a medication that I know helps me so much is freaking me out! It is causing me MORE anxiety!

    Like I said...I feel like I am being set up for failure.

    What would you do?
  5. by   catmom1
    Hi Cherybaby-

    It is not a good idea to stop Xanax cold turkey. The psychiatrist should have helped you with a weaning schedule since benzodiazepines (especially Xanax) lower your seizure threshold and you could have a seizure if you stop abruptly.

    Can you get in touch with the doc who assessed you & get help with this? I can't believe she did not discuss this issue with you.

    Catmom

    P.S. Absolutely it would be a great idea for you to go to NA while you are trying to stop. Your fellow members will understand like no one else how hard it is to give up an addictive drug.

    GOOD LUCK & ***HUGS*** :icon_hug:
  6. by   elkpark
    Yes, Xanax (or any other benzo) needs to be tapered slowly under professional supervision to be discontinued, not stopped "cold turkey." Acute benzo withdrawal (which is what you would be risking by stopping abruptly) is v. dangerous.

    I agree it would be a good idea to get back in touch with the physician you talked to from the IPN, or your original prescriber -- someone qualified -- about this.

    Best wishes for your journey and recovery!
  7. by   caliotter3
    Find it hard to believe the psychiatrist advised you to stop the xanax without a tapering schedule. She knows better.
  8. by   Cherybaby
    Quote from caliotter3
    Find it hard to believe the psychiatrist advised you to stop the xanax without a tapering schedule. She knows better.
    She didn't advise me to stop taking it immediately. However, they let me know that they would be drug testing me for it as early as this same week. So, taking that into consideration...if I don't stop...I will come up with a dirty drug screen for my very first one! Not very encouraging...

    Don't know what to do about this. I can taper and wean myself...but my drug screen is going to reflect differently, you know?

    *sighs* Can't win.
  9. by   elkpark
    I don't have any personal experience with this sort of thing (fortunately!), but I don't see how the regulatory board can "order" you to do something that is medically contraindicated and physically dangerous ... Have you discussed this specific issue with them?
  10. by   Cherybaby
    They didn't order me to do that. I really need to stress that. They told me that I could not be on xanax any longer. They told me I would drug screen as soon as this week.

    With that information...I can only gather that they want me off the xanax because I have to drug test for it. It is a "no no" drug by the BON standards.

    It's sort of a contradiction of sorts. I called the IPN today and no one has gotten back to me yet...but I am certain I cannot be the only person in this situation! I imagine I will have to "fail" my first screen because I am not going to drop the meds cold turkey. That would be insane.

    Even if I stopped as of right now...it will still show in a tox screen if it is given this week because it stays in the system 3-4 days.

    It's very confusing. The day of the eval, no one really tells you too much. They have you speak to a psych doc. Then that doc speaks to another doc and they decide how long you should be in IOP for. They have you drug test. Then you take a thousand question (no exaggeration!) assessment test. Much of it had to do with alcoholism. I didn't see where that pertained to my issues *shrugs* but I took it as directed.

    I am willing to jump through all their hoops to get my license off suspension. But stop my meds like that? I don't know. They didn't say it...but it was implied.
  11. by   exnursie
    You will not "fail" a test if you disclose that you are taking xanax when you test and this is something that they won't consider as failed. It can be used also to monitor the levels and if they are inconsistant or increase this may be a problem

    I would think that once you start treatment, they will include the tapering of xanax in your treatment plan
  12. by   caliotter3
    Quote from exnursie
    You will not "fail" a test if you disclose that you are taking xanax when you test and this is something that they won't consider as failed. It can be used also to monitor the levels and if they are inconsistant or increase this may be a problem

    I would think that once you start treatment, they will include the tapering of xanax in your treatment plan
    This makes sense.
  13. by   Cherybaby
    I sure hope so...

    The thought of having to do it on my own, cold turkey? Not good.

    Thank you both.
  14. by   sarasidnic
    I take valium and a blood pressure med for my anxiety and seizure precautions and I just gave them my prescription so they could document the validity and that was it. My drug tests always test positive and that is fine with them because my doctor wants me on it and what he says goes. A psychiartrist is not an internist and has no right to challenge one

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