Sam_0896

I noticed the collection site fees increased last year. I was curious if anyone knew whether the drug testing costs increase too? Just figured it is likely to get more expensive as time goes on and curious if anyone has any experience with how much the test costs can increase

In our program, it's an automatic 1 year extension if you have any positive drug screens after your first year. It's just not worth it at all. It's not worth the stress to have just a couple of drinks. It's also not worth having to undergo unnecessary treatment, loss of work, and having to be in AA.

I have been on ritalin for 20+ years for adhd. My program does not allow nurses to take any controlled substances, with or without a prescription, except for adhd. You need a letter from the doctor stating that this is the only medication you can take. I feel uncomfortable asking for the letter because I frankly do not want to share being in monitoring with anyone. I did not tell my psychiatrist but I have to, and guess my worry is that he will think I'm suspect now. I failed a urine drug screen for alcohol while in monitoring so I was put in AA, and had to undergo treatment for alcoholism. Normally, I do drink alcohol in moderation and never on days that I've taken ritalin. A big part of how I cope with monitoring is to keep it in a box that I don't talk about unless it's absolutely necessary.

I don't know if every state is the same, but I believe option 2 is egt. I take controlled medication and that is the only one that is never positive for me.

I wish I could hug you through the screen!! I am right there with you!! I felt the same way and my only saving grace was finding a career outside of nursing. The only advice I can give is to actively seek connection with others who are in your shoes and keeping in touch with your dreams. It would be great if these alternative to discipline programs had an alumni network, or something similiar, which could instill a lot of hope in the beginning. I think you can start off in something like dialysis or case management for a while, then switch to med-surg and work your way back into critical care. The way I see it, the time will pass anyway. If you spend the next 5 years positioning yourself so you can be in critical care (or already working in critical care) then it won't be a waste. Something that has helped me is to try to picture the proverbial finish line. I mean, really try to imagine what it is like to have accomplished your goal, because I think it will still be worthwhile even if it is deferred by a few years.

I would definitely look at job boards in your community for elder care or babysitter. My boyfriend did uber while he was a resident, which is also a good option. I worked in an Amazon warehouse for 2.5 weeks when I was first referred to this program, definitely not for the faint of heart. It's fast paced and I honestly would forget about my life when I was there. I would have definitely stuck with it until my license was reactivated/got a nursing job. Super easy to get hired if you're interested. For longer term, I would have taken tutoring more seriously. You can get $50+/hr depending on demand and skill

Wait, TX allows you to have a compact license while you're in monitoring?

You may find this useful. It is a study of different state programs and their components https://www.NCSBN.org/public-files/ComponentsofNurseSubstanceUseDisorderMonitoringProgramJNR.pdf

I agree that the board cares about safety but I don't think this contradicts what I wrote. I just meant in this specific case, taking Adderall that has been prescribed is not an issue that will affect any nurses' career. The prescription matters because all my drug screens are positive, and I need to show proof to the MRO. That was kind of where I was going in my post. Based on the op, which isn't very detailed, it's possible they may be suffering from addiction (based on the need to take more and more). That can be a safety issue because Adderall is neurotoxic and can cause psychosis. They mention using it for 4 years and how it helps them at work. Admittedly, I'm assuming here that if there was a safety issue/problem at work it would have been included in op. --- If op or anyone does want to get off Adderall, find a doctor who is competent and will taper down your script. I went from 60mg to 20mg because my doctor took a gradual approach (combined with diet, exercise, behavioral changes, therapy) over 14 weeks. I did experience withdrawal symptoms, but it was less intense than any drug holiday I've taken.

Wait so they had to go to rehab over a positive screen? I agree about how the board looks at it, which makes sense bc they aren't invested in whether nurses can successfully complete the program. I just want a neutral third party to evaluate me according to same tools/standards used by the board to determine tx. LOL I feel so conflicted because I naturally want to advocate for myself but worry it may but me in the *** somehow. I was originally on mental health contract after diverting and attempting suicide. But I didn't have to go to any inpatient treatment probably because it was 2 months later that the board reached out. This positive drug screen was two months ago too so fingers crossed no rehab for me!

It depends on the state you live in. I've read posts on here saying it took months for BON to reach out. My advice is to get another job and keep working. If they do refer, it's good to have some money saved up. in my state, resigning in the midst of an investigation is an automatic board referral (think it's called cullen's law). It's to cover the hospital because they'd be fined if they didn't. Refusing a drug screen wouldn't lead to a referral in my state. I know a nurse who did the same and was not reported by our hospital. I would reach out to a nurse attorney for a consult to get a sense of what the hospital may do in this case.

I'm already in a 5 year contract. The way I see it is I'm only in this position because there was something wrong. If I wasn't 100% guilty, then yeah I'd feel indignant about being compelled to participate. However, I definitely had depression that was not being addressed properly beforehand. The only real difference now is that I have to go to AA. However, I wrote the op because I don't think I arise to the level of needing an IOP (after reviewing the ASAM criteria). I do think I was at risk for alcoholism because I have depression, was unemployed and living in a toxic environment. Yet, I made the decision to move to a place that was healthier for me until I got a new position and could afford to live on my own. I am also in therapy again (I had a gap of two weeks when I was binge drinking) and that helped me to correct course. I did this of my own volition before I notified the board of my binge drinking. That's partly why I'd like to get a diagnosis first. These nuances don't get taken into consideration with AtD programs, which I get makes it easier to administer but also makes it sort of emotionally taxing for me. As much as I loved the trauma-based IOP I did before, it was....a lot for me to get through it. So, I'd like to at least get some idea of what I'd need for my own well being and present that to my case manager. He may very well say that I still have to do another IOP but it doesn't make a difference for me time wise (4 weeks, virtual, evenings) to at least present that for him.

Should I get an evaluation for alcoholism or just go straight into an IOP? For reference, this is my backstory: https://allnurses.com/I-dilute-urine-t755646/ I've been given a new contract that includes dual diagnosis and told by my case manager to go into treatment. I asked to see one of the BON approved evaluators, but my case manager said if they recommend treatment I'd have to go immediately (I will be abroad until mid-December). If I do not get an evaluation, then I can wait until I return. I was looking at the ASAM criteria because he was vague about what treatment meant. I don't think I arise to the level of needing IOP. Granted I'll do whatever the board wants, but I was just wondering if I should first go to a counselor and determine the level of treatment required in my case.

I actually looked this up, and I think you are right (albeit I don't know if it is etg or ethanol that cannot be diluted). Dilute is interpreted as positive in my program, because the possibility that it is intentional. Additionally, I have no idea what the different options test for and am not sure if it even included etg before.

I'm a nurse who takes adderall for adhd. You'll be fine. As long as you have current prescription for inevitable positive drug screen, it will never be an issue for yiu