positive BAC

In my state, she would be given the opportunity to report herself to the Board of Nursing, which would allow her to be put on a monitoring contract. This enables her to have a "clean record" with no disciplinary action taken against her license once she is finished with the contract. If a nurse does not report herself, that option is no longer there and they would be put on probation. Still have to do all the same things in the monitoring program but there would always be a report of disciplinary action. For example, a colleage of mine was put onto a probation contract wherease I reported myself. If you look up my name on the Board of Nursing website, there is no disciplinary action noted. If you look up his, it says "YES" in big red letters for disciplinary action and that will always be there.

That being said, each state is different. In my state, the Board handles all the disclipinary action and the monitoring. Some states utilize a separate entity, such as Texas. I went through treatment, intensive outpatient, then a year of Aftercare. I also did individual counseling, attend a nurse support group once a week, and call in daily for random drug/alcohol testing (and am tested about once a month).

I am surprised she was still over the legal limit (she shouldn't have had ANY alcohol in her system prior to going to work) when she went to work....she must have consumed a fair amount of alcohol. I would ask where her judgement was being a nurse and drinking prior to going to work. I did much worse but then again, I was active in my disease and my brain was not working clearly = ) Now that I'm in recovery, I would never make those same decisions. Being put into the monitoring program has been one of the best things that ever happened to me. I was introduced to AA and the program of recovery, which has enabled me to be free from depression for the first time in my life (without the aid of medication). I sleep better, I lose my temper less, and I'm a better wife, mother, nurse, and all around person. I know not everyone feels that way about their state's monitoring program but I feel blessed that they were there to push me into discovering my issues with alcohol and other substances (pills especially). I hope everything turns out well for your daughter.

We are in Texas. You mentioned that Texas uses other entities. What exactly does that mean?

In my state it doesn't matter if you self report or not. If the employer reports and the BON finds you guilty, you will have adverse licensure actions. I found that they do go easier on you if you self report, meaning probation vs.suspension or revocation. I would contact your BON. Good luck.

In Texas, they utilize TPAPN. When you report to the Board, they refer you to TPAPN, from what I understand. When I called them, inquiring about moving there and stated I was currently in a monitoring program, the lady at the Board didn't even talk to me....she referred me to TPAPN. In my state, when I have a questions or issues with my monitoring program, I call the compliance coordinator at the Board of Nursing. We do have a committee called the Disability Advisory Committee, who decides your fate but they are tied to the Board. In some states, from what I understand, the Board doesn't even get involved.

I am not am not a medical person but I don't understand how she could have had a BAC so high. She was home my midnight and the blood was drawn after noon. We had breakfast together than morning so I am positive she was not drinking prior to going to work. Is it possible for her BAC to be that hight 12 hours later?

My last question is do we report to TPAPN or the board?

THank everyone for their advice.

You can contact TPAPN directly and ask them questions.

Contact TPAPN at 1-800-288-5528

As far as how could she have tested so high? It depends on numerous factors including type of alcohol ingested (meaning the "proof" or % of alcohol). It's easier to attain high levels of alcohol when drinking whiskey than beer or wine. Women have a higher body fat content which means they have less dilution of alcohol and therefore have a higher blood level than men for the same amount ingested. Also, everyone metabolizes alcohol at differing rates, but the general rule of thumb is approximately 0.05% per hour.

Do you know what they tested for? They may have been testing for metabolites of alcohol (ethylglucuronide abbreviated EtG, or ethylsulfate abbreviated EtS). The metabolites can be detected for up to 80 hours after consumption. As the blood alcohol level drops the blood levels of EtG rise which could explain a high level.

Keep us posted.

Jack

I am not am not a medical person but I don't understand how she could have had a BAC so high. She was home my midnight and the blood was drawn after noon. We had breakfast together than morning so I am positive she was not drinking prior to going to work. Is it possible for her BAC to be that hight 12 hours later?

My last question is do we report to TPAPN or the board?

THank everyone for their advice.

Women in general have less of the enzyme needed to break down alcohol (Alcohol dehydrogenase). Aside from that one must wonder the high BAC after 12 hours. I would have to ask if your daughter drinks on a frequent basis as a high BAC may indicate a sick liver. Have your daughter go to a doctor for a liver test (Simple blood draw).

I have made an MD appointment for her. She lives at home so I am aware of her drinking habits. She may have one or two glasses of wine twice a week. I don't think it's a sick liver but we are going to do everything possible to keep her from losing her license. She is going to call the board tomorrow and see what she should from here.

I keep telling her to hurry and get another job but she is afraid it will only hurt her situation more. Is it best to wait until after speaking with the board. I am so afraid for her and only want to give her the best advice possible. She worked really hard get her license. I don't want her to lose it.

I have made an MD appointment for her. She lives at home so I am aware of her drinking habits. She may have one or two glasses of wine twice a week. I don't think it's a sick liver but we are going to do everything possible to keep her from losing her license. She is going to call the board tomorrow and see what she should from here.

I keep telling her to hurry and get another job but she is afraid it will only hurt her situation more. Is it best to wait until after speaking with the board. I am so afraid for her and only want to give her the best advice possible. She worked really hard get her license. I don't want her to lose it.

She should also consider a consulting with a license defense attorney familiar with this type of case. She might want to speak to the attorney before speaking with the board of nursing or any other officials.

Contact The American Association of Nurse Attorneys (The American Association of Nurse Attorneys) to get a referral. This is not something she wants to try to figure out on the fly.

Jack

Thank you for your advice. We live in Austin, where the BON is located. I was really considering having her go in to talk to them; however, I never considered the legal aspect behind it all. This situation is too large for us to handle on our own. I pray we make the best decisions. It's so hard to see her feel so lost and afraid.

To clarify, I knew there would be legal action taken against her, but I never thought about finding an attorney. I have let my belief in her cloud m judgement. She is my daughter but the to the board she is just a number.

She should also consider a consulting with a license defense attorney familiar with this type of case. She might want to speak to the attorney before speaking with the board of nursing or any other officials.

Contact The American Association of Nurse Attorneys (The American Association of Nurse Attorneys) to get a referral. This is not something she wants to try to figure out on the fly.

Jack

Yes!! I wish I would have contacted an attorney before the board. Very wise advise. Good luck to you and your daughter. So glad you reached out for advice.

Thank you for your advice. We live in Austin, where the BON is located. I was really considering having her go in to talk to them; however, I never considered the legal aspect behind it all. This situation is too large for us to handle on our own. I pray we make the best decisions. It's so hard to see her feel so lost and afraid.

To clarify, I knew there would be legal action taken against her, but I never thought about finding an attorney. I have let my belief in her cloud m judgement. She is my daughter but the to the board she is just a number.

I wouldn't speak to the board without at least consulting with a license defense attorney first. The board of nursing's job is to protect the public, not advocate for your daughter.

As far as your judgment being "clouded", yes it is. But that's OK, she's your child. Now, what I'm about to say my not be pleasant, but it needs to be said. If your daughter's physician doesn't recommend a chemical dependency evaluation (and don't be surprised if s/he doesn't) I would strongly recommend that she have one done. The board will likely recommend one anyway. Many physicians have no idea what to do when a patient has substance abuse or dependence issues. They receive little, if any, training. A study I read a few years ago said over half of the doctors presented with signs and symptoms of dependence missed (or avoided) the diagnosis!

Keep us posted as to the progress of everything that's going on. Even though things seem pretty bleak, there is hope!

Jack