DistressedRN

You can also try plasma centers or blood banks. They're usually very recovery/monitoring stipulation friendly.

In my state you can ask for a monitoring interruption. I never asked for one when we went to the beach or mountains, but did when we went out of the country, on cruises, or to Disney. I wonder why yours is so draconian. Regardless, if you're going to a nice resort, I guarantee you that they have a FedEx pickup, maybe even daily. Call and ask the concierge..

What state are you in? I have never, ever seen a monitoring program agreement (whether it was for SUD or for a mental health issue) that doesn't beat this horse to death. Sounds like your CM dropped the ball, big time. But beyond the common sense aspect, I guarantee you there is verbiage somewhere in your contract that says something along the lines of 'will abstain from all mind altering substances, including alcohol' or something to that effect. My case manager didn't go over mine line by line, but I know that I was responsible for reading it thoroughly and if there was any question at all about what was/wasn't allowed then it was my responsibility to ask and find out. In TN, saying 'I didn't know' was not a valid excuse and even that phrase is written into our contracts. That being said, the Talbott Medication Guide is a priceless resource. It lists every single drug to avoid, as well as gives alcohol concentrations of common OTC products and cleaners. It's a good place to start if you have any doubts about what meds are safe/not safe in monitoring. It's pretty easy to Google just in case you want it for future reference.

But the thing is, it doesn't matter whether they do or not. If the agreement says no illicit substances or alcohol, then thats exactly what is expected. I see posts here and talk to nurses in my state monitoring program who drink or use THC and then act all shocked when they fail a drug screen & have to be reevaluated. What did they think was going to happen? Someone who doesn't have an SUD should have no problem abstaining from alcohol/drugs for a prescribed amount of time.

In my state you would have to immediately cease practice until they say you can return; most likely get another evaluation and possibly repeat inpatient or IOP; and definitely have increased frequency of testing.

Unfortunately, in TN the way the state guidelines for office based opioid treatment are written, it says observed drug screens.

Before Covid, in TN we had to do three a week, and had to have our location turned on and check in on the Spectrum app and check out at the end. They were big on us sharing location, but I didn't always and my case manager never said a word. I can't tell you how many times I went & checked in and sat in the car listening to music and reading for an hour instead. ?

TNPAP does not require you to serve the time at the end. However, the only time I requested an actual break in testing was when I was on a cruise and once when we were in a remote area hiking. Any time we went to the beach or to Disney or anywhere else within the lower 48, I just told my case manager that we were traveling, but I had identified several testing facilities nearby just in case. In three years I never got tested while on vacation.

I wish that the TN BON and TNPAP would get on board and recognize that recovery with MAT is evidence-based and beneficial to nurses who have had substance use disorders. I do know that they are slowly changing their attitudes toward it, and I have heard that in the near future they may start allowing it, but I will believe it when I see it. So you have to get ANOTHER evaluation? That's crazy. The evaluators that TNPAP uses are board certified in Addiction Medicine. Are they wanting something from the psychiatry angle?

I'm interested to know how that ended as well. A lot of these situations sound like they were so unfairly handled.

Dialysis, blood banks, plasma centers, ‘shot nurse’ jobs, pre-admission testing, non-bedside positions like chart review all are decent jobs for nurses with narcotic restrictions/board orders. You may have to humble yourself a little and take a job that you might not have considered before, but it will be okay, and this too, shall pass. Even though you have some clean time under your belt, my advice is don’t go back to a position where you will have access to narcotics at all. It’s one thing to feel confident right now, but quite another when you’re in the middle of a three day stretch of horrible shifts and the temptation is right in front of you. I posted this on another thread, but when you’re job hunting, frame your monitoring as a positive asset. You’ve shown that you can persevere and overcome terrible circumstances, you’re actively in a program where you HAVE to toe the line…as an employee you won’t risk being tardy or call in a lot, you’ll want to avoid getting caught up in workplace drama, and you’ll be super diligent about your charting and responsibilities because your license is on the line.

So you can frame this as a positive thing. Tell your employer that you worked in a toxic/unsafe/whatever environment and there were allegations that were unproven/untrue. However, you wanted to avoid a long, drawn out expensive legal process where you’d be unable to work while these notoriously slow to act nursing board investigated. To show that you had nothing to hide, you accepted their terms. You’re fine with being drug tested and monitored because you conduct yourself according to your states nurse practice act. As an added bonus, since they have to submit quarterly reports, you aren’t going to be tardy, have excessive absenteeism, or have any disciplinary issues. They’ll wish that they had more nurses in monitoring contracts because you’ll be a model employee. good luck!

My office has a regular urine door that is propped open that we observe through. and while our sink is functional, it isn’t allowed to be turned on before I have the urine in hand. We don’t do DOT or legal chain of custody urine drug screens at my job, just point of care and occasionally send out for confirmation if there is a contested result or there is a suspicion of adulteration or substitution.

Well, if HR and the CNO are coming, they’re going to be prepared with Pyxis or Omnicell reports that have been pulled. Every time you touched the machine is going to be in a neat little printout. Is this something you’ve been expecting? Or a total surprise?

All I had to do was email the BON in my state (TN) after I finished my monitoring program and request they reinstate my compact status. Took less than 48 hours.