dancinginthedark

Dialysis. All you give is vitamins. They accept a lot of nurses in monitoring. The hours allow you to test without stressing about making it on time. You can also try for corrections nursing. I mean, it's a pretty awful place to work imo, but they do accept nurses in monitoring. In my program, you can't work for a staffing agency but a lot of corrections positions are through staffing agencies (case manager said it was acceptable in this case), but you should double check if that is a stipulation of your program. If you don't have a narcotic restriction, you can apply for med surg positions. If you do, then your best bet is to avoid bedside at the hospital. I've seen nurses waste lots of time trying to get jobs in a field where they will not hire you with a narcotic restriction. As long as you remain flexible and open to doing diff kinds of nursing, then you should be able to find employment.

It's funny I never thought about why they ask those questions. I always put no but even if the answer was yes, it didn't make much sense to divulge that info. Because you're right, what does it matter? I never thought it could be used to inform whether I get tested more or less

That's crazy, we don't have to test when we are on vacation (but we do have to go to this peer group meeting). But you have to put in for a monitoring interruption. They have some arbitrary rules about how many you can take and how long you can go before they decide to extend your contract. I went to Spain for 3 weeks, and had to extend my contract to go. I only did it because I had some family things that I couldn't miss. Part of me is glad I went, but another part feels it wasn't worth it. Now, I still plan to go on vacation but only if I don't have to extend my contract.

For our program, there is one in the beginning and one near the end.

One case manager told us that monitoring is punitive. It really meant a lot to have someone simply acknowledge that, like a weight off my shoulders. That said, if you can afford not to work, or can get a job that makes equal to/greater than what you made as a nurse then monitoring may not be worth it. I think everyone goes through a phase when they want to chuck nursing altogether. Eventually, when you get back to working, your feelings will change. It will still be a burden, but mostly background noise after a while.

I would ask your case manager. In my program, it's roughly every 3 months. Everyone gets PETH tests, not just those who are in monitoring for alcohol related issues. If you get a dilute urine, then you have to automatically do a Peth test. However, that peth test does not count towards your every 3 months peth.

Yeah, it's not the same as being on probation. That would show on your license. Technically, when you're in monitoring, you have an unencumbered license. I think because it's voluntary vs when they put actual restrictions that are involuntary and public record

No, they don't check for alcohol. It's not reliable test for that. Just fyi, if you're a heavy drinker, the peth test can show up positive after a month. I went through binge drinking episode and took peth 30 days later, and it was positive

Usually some point in the 90 day period. I'm not sure when, but it's typically in first month. It can show up to 90 days if I'm not mistaken, so it makes sense to have it done sooner rather than later.

How expensive is it? RAMP costs ~ $360/month ($4,400/yr). Evaluation is one time out-of-pocket cost ($500-$1000). If you have to do treatment of any kind, you can go to provider in your insurance network. The costs are primarily drug screens & peer group. Peer group meetings are $120/m (you can save $90-$120/yr by signing up for quarterly or yearly subscription). There are two urine screens (should never be more than 3/month) and a Peth test roughly every 3 months that is $130 ($180 if you do it at home). Hair and nail tests are not routine, and only used at the very end of monitoring and during the evaluation period. Can you afford it on a nursing salary? Yes, you can afford it. The real cost is the lost wages from no overtime pay, and not being able to do night shift/float positions (if that's your thing). That is roughly 30k/yr (depending on your base salary). Unless you are fortunate enough, you will have to take a low paying job to start in a field where people don't usually want to work (so your base pay will be low low - I took 30% pay cut for 2 years and just went back up to my pre-RAMP base pay which is still 15% less than what I would be making otherwise). So you will be on a bit of a budget to say the least. Will you find a job? You will be able to find a job, probably not one you like for the first 2 years. After 2 years, you can work in any field (except travel/home nursing/floating/night shift). Is it worth it? If you can work in another field and make a comparable salary, then the program may not be worth it. If you cannot work in another field and make a comparable salary, then yes the program is worth it. If you were referred to RAMP, then yes it is worth it. It doesn't matter if you want to do something aside from nursing, you do not want your license suspended. That will be something that any employer can bring up down the line and is not worth having to explain. Word of advice, for the first year they do not extend your contract. If you have any positive drug screens or miss tests after the first year, they will extend your contract. You will never be kicked out for a positive drug screen, but it can go on indefinitely. What medications can you take? You cannot take any controlled medication. You may get a pass to take stimulants if you have to take them. Otherwise, no controlled meds at any point unless you are hospitalized. There is a medication guide that they use to approve your prescription medications. If it has a potential for abuse, but not a controlled medication, you can take it with a prescription. Some of the stuff I've taken without a script and it didn't show up on a drug screen. It was honestly frustration at the stringent rules and kind of a f--k it attitude, but I wouldn't do it again. It was a flash of teenage rebellion but these are the rules and it's just not worth extending my contract for a single day.

Yes, this is true! It also does not matter if you have a subsequent negative test. The positive test stands on its own.

Does your program test on major holidays? Christmas, NYE, Easter, etc

Our program does not do hair tests for alcohol, because it is unreliable. I think this is all great advise, but it isn't true that the case manager doesn't know that hair tests are unreliable. My case manager was the one who told me that

Nope, everyone has to undergo RAMP if you have an arrest. There is a chance you will be allowed to get your license after the 90 day period of evaluation. They will make you see a counselor, who may or may not recommend monitoring. Even if they do not recommend monitoring, the board may still require you to have a contract. Every drug test is out of pocket. You cannot have it covered by insurance because RAMP is not treatment. They do allow you to get treatment from a provider in your insurance network. However, the evaluation is set up by RAMP with one of their approved counselors. I've never heard of anyone paying less than $600, and the average is around $800.

I can believe it. I always think "this is the attorney general's office". I assume that they have access to all government records. Our program allows for per diem jobs, but you cannot have more than one job at a time.

I'm in a bit of a bind where I have a part time non-nursing job that I need to keep, but also looking for per diem work as a nurse. Is it harder or the same to get a per diem job? Also, I've never worked per diem before and is the orientation shorter? I work three days a week and don't want to miss too many days of work for orientation. Just curious because I haven't even gotten invited to interview so I didn't get chance to ask

Yeah, in our program, it still has to be approved by the case manager even if it was prescribed. It depends if it's a PRN. For those, there is a good chance that if it has any potential for abuse they will not approve the medication. But if it's a required drug (I.e. adderall for ADHD) they will approve it.

In my program, they tell you that higher level testing will be completed as you near end of contract. There is at least one hair or nail test

There are nurses in my program who are hired in medical surgical units, dialysis, case management, and corrections.

How expensive is your peth test? In NJ, it's about 140. They also have option to do it remotely that I think is like 180. From my understanding, the nurses who are in it for alcoholism have to do a peth every 3-4 months

There was an investigative article about RAMP. I remember the case manager mentioned that the collection site fees are a new thing that was introduced during covid. I think the subcontractors and evaluators are trying to make money of course, but I don't think the board is intentionally trying to run a racket. The thing is that general trend since 80s to deprive the state of money through tax cuts, so it's not as if there is a pot of gold sitting around to cover the cost of these programs. https://www.medpagetoday.com/special-reports/exclusives/93779 Another aspect is the way that the state tends to take a punitive stance overall, even when it's allegedly designed to help participants. When I explained RAMP to my therapist, he noted that it's very similar to probation. He explained how his patients who are in probation have rather stringent requirements that are designed to make it as frustrating as possible. And if they fail to meet these requirements, it is deemed as some kind of personal failure. I think where it gets frustrating is the conflicting message about this program being designed to help. On the one hand, it does allow you to avoid suspension and public order. On the other hand, it is still punitive. For the board, it is a win-win. If you fail to meet the requirements, then you can't work as a nurse. If you successfully complete program, then it ensures public safety. The main issue I have is that there is no gradual loosening of restrictions. To me, it would make more sense if the restrictions were lifted over time so you can practice as you normally would. And the board can see that you will be safe to practice without monitoring. Because if working overtime or night shift or whatever is a risk factor for relapse or whatever, then let people work overtime while in monitoring. I find it is less upsetting just to think I am doing this to prove I am safe to practice vs this is meant to help me.

I want to add that since this post was made, two year contracts are increasingly rare. It's mainly 5 year contracts. My case manager mentioned that even if you have a decade old DUI, it's like 90% will get a contract. If you have old dui + documented mental health disorder, definitely getting 5 years (one nurse had eval that said she didn't need monitoring but still got 5 years). In which case, it seems like an awful waste of money to spend $$$ on evaluations that are immaterial.

Wow this is amazing. Honestly, I'm not even sure what supervision means because there is still a nurse supervisor on night shift. Do they explain what direct supervision means in your program?

In NJ, there is a law that if a facility reports a nurse to board for impairment, misconduct or incompetence, the same facility has to notify other healthcare facilities about this report. Although monitoring is 5 years, the law requires notification for 7 years. I read that other states have this law, but was curious if anyone knows what the terms are in their state.

My concern is that employers and schools will do background checks, and find the suspension order. So, even if I quit and want to do something else, any school or job that does background check will find that I was in a monitoring program. The board has started issuing less detailed suspension orders. Before, they would include drug tests, psych evals, private correspondence. But it still says they failed to comply with monitoring.