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

No, but still it just would make me feel so paranoid I guess. I'd feel really ashamed for putting them through that. Once I found a woman I worked with. Not intentionally but I googled her name and it popped up. Honestly, when they told me that I couldn't work as a nurse I felt ... relieved. I loved my time as a nurse, but it was something that I chose at a time when I was too scared to go for what I really wanted. It's still early at my new job, and it has it's downsides as any job does. But it brings me much closer to what I want. If I didn't have to go through this program, then I wouldn't have gotten honest with myself about my life of quiet desperation.

Your sponsor doesn't mind that you don't have an SUD? What do you talk about? I'm just curious because I imagine if I say I'm not an alcoholic that people will be hesitant to even be a sponsor. At the same time, I can totally relate to the underlying issues (ie shame, depression, anxiety, insecurities, etc) so I feel like it can be beneficial either way. And no, I mean I tried to commit suicide at work using medication. That's diversion, so it's automatic 5 year contract. They have a criteria and there are some offenses that just go straight into a contract. I didn't mind not getting evaluated because it's almost a grand, but being in this situation makes me think maybe that'd be a better choice. And I have to go to AA for 3 days a week after my initial 90 meetings in 90 days. I got into therapy on my own, it's not in my contract that I have to go to therapy but they do expect I am in therapy The other issue is that if I choose to get evaluated, they won't let me go on a family trip. It is abroad, so if the evaluator says I need treatment then I'd have to cancel. I'm willing to take that gamble just because I know they take forever to submit a report. But if they say I have to go to treatment, I'm not flying back early just to go. If I don't get the evaluation, then I can wait until I return to go to treatment. It doesn't make much sense, but from what I learned in group it sounds like the evaluator will likely label me as having an SUD.

Is there anything that says they CANNOT report you? I think if there isn't some stipulation that exempts nurses who are seeking help, then op should keep it to themselves.

You should ask your board of nursing. Then ask the board of the state you want to relocate to. Some states will honor the time served, but others will make you start over. My state also makes sure that if you relocate, the new state gives you the same contract length. It's 5 years here, and I'm moving to a state where I'd have 3 years. However, they will honor the time I've already spent in the program.

I don't want to humiliate my family with a discipline order. I have another job at a tech company and the requirements (support group, drug testing) aren't an issue for me. I would be in therapy even if I wasn't in this program. Rehab doesn't sound bad honestly because it's basically just therapy. I'm willing to lie and play along, except the AA part. I've attended AA for a clinical assignment in nursing school, and it was really touching experience. But as an observer. Having to navigate the 12 steps and find a sponsor feels dishonest. Then again, maybe it is a good thing like if I'm not an alcoholic, the fact that I would resort to drinking to cope with an emotionally abusive environment (in light of the high cost of being kicked out of this program) suggests I am susceptible. It's hard when someone says you have a substance use disorder to dispute it because denial is a part of the problem. I don't want to be labeled as a problem, but also feel like maybe I should ask to be evaluated first?

Yeah they want me to go to treatment facility but I don't have a substance use issue. I mean granted I've never struggled with depression like this but it seems so odd to now make me go to AA for 5 years. I don't mind though, it's all free and I have a lot of time on my hands.

I noticed a lot of people do view these threads even if they don't reply, so I thought it'd be nice to share the things that helped everyone in their recovery For me 1. Buddhism - I'm not a true believer or anything but I did start taking classes in universal compassion at a meditation center in my area. I loved it so much because it is so warm and kind. It was more like a study group than simply meditation. However, meditation really helped me with emotional regulation 2. Self-compassion - I took a course in self compassion at the center (run by Chris Germer) that was my introduction to meditation. I'm still not at the point where I can meditate on my own, but it was so insightful to learn about shame, self compassion, and how developing this practice is proven to work 3. High intensity cardio - I did my research on cardio for depression. I followed a running plan for beginner's from runner's world. It is hard to get up and do it daily, but I learned that consistency begins with setting a time/day for any new habit. So, even if I only run for 5 minutes, what matters most is that I get into the habit of doing it at that time/day. It also helps me to build confidence in myself because I keep my word. 4. Moving - this is a little hard depending on your finances/job prospects. I had a serious setback over the last two weeks because of how depressing my household was. Yet, I am moving which fills me with excitement/dread. I worry because it's half way across the country, and not a very diverse area. Yet, I am excited to be on my own again and able to set boundaries with my parents. 5. Volunteer - I volunteer with a woman's center as an ESL teacher. I love it. The women are so very grateful because it is a free program run by the Catholic church. I've met the most amazing, resilient women, and it really helps with feelings of shame to spend my time helping others. I also volunteer at the local food bank, either giving out clothes to children or sorting food for distribution 6. Family - I have had issues with my parents, but my extended family & siblings have been so helpful. I went to Egypt to visit my friends and family, and they really lifted my spirits. It was nice too as a break from remembering about monitoring. There's a lot of sunlight, and so much to see that it has lifted my mood to be able to escape if only for a little while. It also helped to talk with my family back home because they really put my problems into perspective. What has helped you?

I am not looking for advice so much as I would like some kind words (feel so weird asking for this). So, I had dilute urine. It wasn't intentional, just that I drink a lot of water and don't eat very much (I take adderall for ADHD). I had to take a blood test, which I am sure is a peth test. Now, I did binge drink for maybe two weeks. I know I'm not an alcoholic, and I know every alcoholic says this at some point or another. I lived in an emotionally abusive household, which I didn't realize it until a couple of weeks ago, when my father told me that I was worthless. He was so angry that I attempted suicide, and said I ruined his life. He and I patched things up, and I know he regrets his words. He just has trouble expressing his emotions (Not making an excuse but my dad did tolerate my depression for years before this). One of my problems is that I have a really hard time opening up to strangers. So, in situations like this one, I feel really ashamed to disclose after the fact. I don't want people to think I'm making excuses or failing to take responsibility. I am always too proud beforehand, and after I *** up, I feel really pitiful, and it all sounds like excuses. One of the things I do like about this program is that I feel nobody cares, in the sense that I don't have to worry about letting anyone down. To my case manager, I'm as anonymous as I am to all of you (considering we only communicate via text). At the same time, I think my case manager may report me for noncompliance once the results come back positive (and they will be positive). So, I feel really down. I hope I do not get kicked out of this program. Hopefully I will be sent to AA or rehab. I don't mind saying I'm an alcoholic if it means I don't get kicked out of this program. I just found out that I got my dream job, which is not in nursing, and am moving across the country to start my third career LOL. I haven't taken any steps to reactivate my license, as I have no intention to return to nursing. However, I can't bear the idea of my family having to suffer the public humiliation of a discipline order. Anyway, I don't know why I am sharing other than not having any other place to share. Ironically, I can't share with my therapist, because IDK what she shares with the board of nursing. So, I have you lot here to confess to

Oh yeah, I have a great support system and I'm doing this IOP program. I have a therapist as well. I don't feel good when I talk to them. I just wanted to say something in peer support because of the program stipulation that you have to participate positively (as one of the conditions for re-activating my license and going back to work).

Thanks for mentioning this. I requested 3 weeks vacation but it is abroad. I didn't even think to ask if that meant my time would be longer as a result.