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saillady

saillady

Consultant, educator
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  1. I'm so sorry. I feel like I badgered you. I'll send you my contact info separately and if the need ever arises, I can connect you with my sister. Hopefully, not, however! I've been a registered nurse for my entire adult life. One thing that astounds me is how we in our profession are so unmerciful with one another. There are about 3 million registered nurses in the U.S. and the only advocacy for nurses seems to come in the form of labor unions. We are an aging profession. In my estimation, few occupations are as productive. Is it realistic to expect a nurse in her late 40s, 50s, and even 60s to produce as she did in her 20s and 30s? With respect to this chronic pain issue - there is no voice or advocacy that I have been able to locate. Hence, the reason for my posts - some other unlucky soul may be able to use it. At any rate. I hope you are also able to get some pain relief. Perhaps you are already considering another job that is less physically demanding? One really great thing about nursing is the diversity of opportunity. Take care.
  2. Glad to hear that you have a supportive healthcare provider. Just a cautionary note because you say that there are "threatening" noises being made. In this type of situation, there are two entities that are somewhat intertwined and also are not not. First is your employer. You should have some rights under the Americans With Disabilities Act. If you find yourself discriminately terminated, the time limit to do anything about that is 2 years. The Americans With Disabilities Act does not protect your license. The Board only cares about public safety -- not whether you have a license. They can initiate an action based on a complaint made by a private individual, such as a coworker. It does not have to come from the employer. In my sister's case, two nurses told their supervisor that they could not work with a nurse knowing that she used pain medications. There was a pre-termination hearing where the Chief Nursing Officer tried to force my sister to voluntarily enter an inpatient drug detoxification - with no regard to pain control. The Chief Nursing Officer tried to coerce my sister into revealing the names of other hospital employees using pain medications. She said that they would do a retrospective chart audit and that they would find discrepancies - because every nurse makes them. (They found 3 discrepancies, 2 of which my sister was able to clarify with charting elsewhere in the medical record.). The CNO also insinuated an improper relationship between my sister and her pain doctor. My sister's pain doctor was the head of pain medicine in the hospital and he subsequently dropped her as a patient. During the trial, the prosecution tried to imply the same improper relationship; the the judge did stop that. (Interestingly, my sister's pain doctor encouraged her to educate herself by attending local pain society meetings - because she initially had concerns about using opioid medications and working. The Chief Nursing Officer also attended the pain society meetings. Because she attended the meetings one would think her somewhat educated, on the subject of chronic pain management, so her actions with respect to my sister seemed really strange. Did she attend the meetings simply for the free food?) Early in the Board investigation, long before the trial, my sister spoke to an Assistant Attorney General (AAG) who's husband had chronic pain - and she seemed very understanding. Based on those conversations, my sister thought she had nothing to worry about. Later, abruptly, that investigator was replaced by another, and there seemed to be no transfer of information. Time went on and on. More people came and went. Things would start and stop and throughout the process, my sister was provided very little information. Then, suddenly, years later, everything seemed to take on a life of it's own. Those of us who are not legal eagles assume the presumption is that one is innocent until proven guilty. Not so in Administrative Law Court where these cases are tried. My sister's attorney did not even understand that and he saw no need to produce an expert witness for pain management - the judge had very little good medical information, because the expert nurse witness provided by the Board was disqualified as a pain management expert. Additionally, many of the statements that the hospital provided to the Board in their initial written complaint turned out to be obvious untruths, based on the witness testimonies. The judge acknowledged this discrepencies, but did not believe my sister when she said her supervisor knew about the pain medications. During her testimony, the supervisor said she did not know about the pain meds, but, to her credit, she also said she was not concerned about patient safety, impairment, or drug diversion when the nurses made their complaint to her. (The prosecuting AAG was speechless for a few seconds after that statement was made.) At the end of the hearing, my sister's attorney was convinced they won the case. Six weeks later, the judge issued a written ruling and stated that he was holding my sister to a "higher standard" because she was a nurse. As such, he said, she practiced sub-standard nursing care because she did not tell her supervisor that she was taking mood and mind-altering drugs. He left it to the Board to evaluate my sister for fitness for duty. The Board deferred everything to Peer Assistance Services. Peer Assistance Services recommended the 3-year monitoring program. (I found this very interesting, because Peer Assistance Services is a private organization and they just landed the CO Board of Nursing contract at the end of 2008. Peer Assistance Services focuses on addiction and most of those people have no medical background. There was an Associate Degree RN supervisor who freely admitted she knew nothing about pain management. Hope this is not information overload. I've left out many details, but you get the picture. Watch your back. Good luck.
  3. I don't know this site very well. Is there a way for us to communicate privately? Don't do anything rash. First do your homework. What does your state Nurse Practice Act say about the matter? What is the policy of your employer? Are you a member of your state nurse's association? ANA? Are you unionized? Lawyers are a completely separate matter. Does your attorney specialize in licensing issues? This is such a sensitive topic. Few people have much knowledge. We wished we could go to the media with this issue, but can you imagine how that would turn out? Think very carefully before you take action.
  4. For almost 5 years now, my sister has been undergoing an ordeal with her state Board of Nursing because of a complaint lodged by her employer. Long story made short, she had chronic pain, underwent many, many conservative medical therapies, had a 3-level cervical spine fusion, and eventually required use of opioid medications. She was under close supervision of a pain specialist and there were no issues of impairment, drug diversion, or patient safety. She has now spent thousands of dollars on attorney fees (3 attorneys, so far), experienced an unsuccessful mediation, went through a trial that was prosecuted by an Assistant Attorney General (representing the Board), had her license suspended for 9 months (the suspension didn't actually occur until after her pain resolved to a point that she no longer required the pain medication), and is now in a 3-year Peer Assistance Services program for people who have substance abuse and mental issues. In this program she must submit to weekly random urine screens, attend two group therapy sessions per month, and two private counseling sessions per month. Her employer must monitor her and send lengthy reports to Peer Assistance Services. She has received a letter from the federal government stating that because her license was suspended for drug reasons, she is not permitted to work in a facility that receives federal funding (i.e., Medicare or Medicaid) for five years. She is fortunate to have employment, but makes about half the salary she would in other positions for which she is qualified. That said, it has been very difficult to find information that pertains to the issue of healthcare professionals, management of the healthcare professional's chronic pain, and fitness for work. I just came across the following statement issued by the AANA (American Association of Nurse Anesthetists). I post it below in the event that it can help another "non addicted" nurse who appropriately utilizes prescribed pain medications in her employer/Board dealings. The statement does make a recommendation for a neuropsychological evaluation and written clearance for return to work by the physician. This would mean disclosure to to nurse's employer. It is my opinion that employers (yes, healthcare providers) and staff/members of the various Board's of Nursing are largely uneducated about this subject. In the interest of protecting the public (an important consideration) they (employers and regulatory agencies) would rather err on the side of conservative, rather than potentially face public outcry in the event that a patient safety situation arise - and then have to explain for their apparent lack of due diligence. Position statements, such as the one cited below, may help to inform and inspire productive conversations and lead to actions that will benefit patients and be fair and supportive to nurses. AANA Advisory Opinion 5.4 Patient Safety and CRNAs on Drug Therapy Regimens for Pain Management http://www.aana.com/resources.aspx?ucNavMenu_TSMenuTargetID=51&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=2185
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