SNB1014

The TX BON will not accept an assessment from an NP, even a PMHNP. They have a very specific list of evaluators that you can choose from. The only way your own doc would fly is if they have a long, established therapeutic relationship with you and there's no way you can just move to tx, get an appt and a psych eval and then boom! They accept it. If you truly are not bipolar, then a thorough psychiatric exam would prove that.

Ooof this is a big concern for me as well. I’m in austin and am hoping that HRs don’t ruin a perfectly good interview and initial offer.

Which company do you test through? MedTox/Labcorp/ quest/ etc?

I prefer to use the term “dx with Substance Use Disorder” (the actual medical and diagnostic term) or “ am in verifiable recovery from Substance Use Disorder”. the more evidenced based, using evidenced based and up to date terminology allows us to take away the disgust given by others and the shame we put upon ourselves.

I have a neurogenic bladder and hence I need to self catch. Practically by default I have UTI very frequently. My urine CX often comes up + for nitrates. I’ve never had an issue testing. Perhaps the level was outrageous?? See if you can get a lawyer to subpoena those results, see you pcp stat for a UTI workup, and if positive get on abx stat. Then repeat a urine cx. Then it would be wise for the lawyer to help you contest these results or see if another qualified pathologist/ lab can independently verify the program’s test or refute it

Yes, absolutely.

So, some places have HR policies that you must disclose if you’re having a “personal/intimate” relationship with a coworker. If the doc is a actual EMPLOYEE of the hospital, VS contracted/consultation privileges, that could make the difference. Additionally, if neither parties reported, they are both is violation of such a policy exists. The MD should be held for sexual misconduct as well. I mean if you were pulling a greys anatomy situation and screwing in the on call room while both on duty and “abandoning pt care”, that’s different. that is discrimination if one employee is held to the standard (if one such exists) and the other is not. I would suggest that either your “partner in crime” be held to the same standards and reprimanded by either the hospital/hr or reported to their medical board, as well. If not, I would be firm and state that this is discriminatory and therefore that should be dropped entirely. unless you two are in love, just quit seeing each other. And if NOTHING happened on work ground, while on duty, that should hold merit.

It matters specifically related to the state you are licensed in/where you are applying for employment. You must look at what your order states- does it say something in regards to notifying employers while ON probation or does it say notifying to all future employers? if you look up your license on the TX BON website, for example, it will likely state that your license doesn’t have any active disciplinary action, it’s in good standing, etc. BUT you CAN see if they have past disciplinary actions, if you look. If they check through NURSYS, it will essentially be the same. Unless you were in a confidential agreement, this is sadly public. Most hiring managers/ Recruiters don’t do this automatically. If you get a phone call about an interview, take it and sell yourself. Don’t shoot yourself in the foot. That being said, I have found that being said, if you haven’t worked in a little bit as a nurse, it would be wise to be short and sweet but honest that you were “recently” on probation with the BON, but have successfully completed it and advocate for yourself and state “but I have learned personally and professionally from this experience, my license is in good standing. I’m excited to work in this position for XYZ reasons and am thankful for this opportunity. I believe in being forward and honest with potential employers to act in good faith; I hope this doesn’t interfere with continuing on to any future steps in the hiring process.” you run the risk that it will be taken poorly if you aren’t “up front” and if they think it’s a toss up between you and another candidate, they may feel “duped”. The answer is in both what your contract states and how the real world, with real human fallacy truly works. I wish you the best!!

Following. Many of us who will come out the other side of monitoring are interested to know as well. is there anyway you could ask your professors/deans about quality/reputable high risk student malpractice ins? Even if you need to ask “just for a old colleague”?

Following- curious to hear others’ responses.

I’m a bit confused...are you in a monitoring/alternative to discipline program through your state? Bc if so, across the board, there is a zero tolerance for alcohol policy, regardless of your substance of choice. If you are in monitoring (since pre-employment screens wouldn’t invest the money into routine pETh testing and alcohol is not a controlled substance for ppl 21+)....you absolutely MUST re-read the terms of your monitoring agreement. Alcohol is prohibited. If you are a social drinker, it has to stop 100% ASAP. This WILL become a violation of your contract. best of luck to you

It’s been a few months now...I hope you are well, physically, mentally, financially! What was the outcome after speaking with the MRO and your monitoring program?

I’m in Texas and unfamiliar with this new legislation you speak about re: removed/expunged....can you link this info or share where you got this? I know a lot of us would be interested in finding out about this. im not familiar with Michigan rules, sorry. Thank you in advance for sharing the Texas tidbit if you can!!

What are you referring to when you say “contracts of this kind”? How do you anticipate this dx changing how contracts are stipulated? TPAPN has recently *tried* pretty hard to move in the direction of the medical model of SUD treatment and adjusting testing frequency/ contract stipulations based upon the severity of your SUD. Compared to the previous cookie cutter, sanctimonious contracts given out only a couple years ago- this is a great improvement. Ironically, my saga started in 2015. I had an admin violation that restarted my contract- not a relapse. I am now pregnant. I am as sober as sober can be. For years. I now have to go get a SUD assessment by a psychiatrist/psychologist/LCDC where I would not meet a single criteria for SUD...for a few years now. No cravings for substances, no medications required etc. however, I STILL will be placed into some SUD track and be required to attend AA/NA (which are very triggering to my mental health due to the black and white thinking), drug and booze testing...and for what?!?! You can get a DUI and not be an alcoholic. You can be an alcoholic and drink at home until you black out and pass out. What about occupations that aren’t traditionally considered “safety sensitive”??? I don’t want an actively altered accountant advising me on retirement or electrician on day 3 of an uppers binge working in my newborns nursery. sorry, it was a rant. It’s just all BS. I understand the rationale behind keeping close eyes on HCP with known SUD, but HIPAA shouldn’t be thrown out the window bc of my license. That is just a great way for me to lie straight to an assessors face, not feel guilty and give the “right” answers out of fear and shame.

WOW! I’m in Texas and as far as I know, this is not the case down here. What state are you speaking of?

I never knew SSDI was an option! Thank you so much for clearing this up. I’m in Texas and will be looking into this

Hmm, my biggest question I think is we’re you caught/ witnessed by an employee or person in charge? If not, I would consider yourself very lucky (the house always wins, remember that....if you aren’t caught this time, just give it a bit and it will happen). If your employer isn’t requiring you to self report to your state’s monitoring program/fire you/ report you to the BON, then I suggest you NEVER even have the option to drink alcohol at work. On break, whatever . Zero. No. Keep up with your recovery program and God Bless

That depends- what is the lab you use?

I wish anyone worth recent (2017-current) experiences would respond. I live in the Austin area and don’t want to be railroaded, financially

I think that since some addict use Benadryl for synergistic effects with other narcotics and because it can be used to alleviate symptoms of current use( itchiness, water eyes, sniffling, insomnia) that it has been looped in. Or someone claiming when confronted that they "aren't high, they just took their allergy rx" etc

For what it's worth, I took topamax During recovery from my eating disorder and coincidentally had no headaches. I actually was placed back on it for a couple months because I was getting migraines super bad. They were also related to stress. It helped immensely. Topamax can make your brain foggy for some. (Mine did the second time around)...and will often reduce your appetite/ pleasure in eating. ( I was on a highly monitored dose bc I was anorexic with VERY frequent binge and purge episodes that essentially fed into each other. This is a daily Med and is not a controlled substance. Best of luck!

Why did they ask you to give a UDS? Was it for cause (suspicion of being altered, abnormal narc pulling or narcs don't add up, etc)? Or does your facility perform totally random checks? It was a poor choice to refuse. Period. Your next best bet is to get a hair screen (yes, it will be a bit pricey). However, paying $60 a pop for 2-4 (or more) UDS/ month for 3-5 years will cost much more. If you drink, don't worry about it. If you've been smoking weed or more, it will show up. This is your very bet bet to show you haven't been using on the side on your own time or diverting from your facility.

Hmm.... well I speak from personal experience. I was reported to the BON for suspicion of misappropriating RXs (they were right) but shockingly did not have a + UDS. ( I think I hadn't fully metabolized it. Had they of done a blood test, I would've been screwed). I was told they would report me, and they did. I got a letter shortly thereafter from my BON indeed stating there would be an investigation. Well, I was in denial and thought that a new place, fresh start, etc would kick my booty into acting right and scare me to do t again. i got a job at our competitor's hospital nearly immediately. Naturally I did not say anything. I worked there and immediately after orientation I fell back into my behavior and got busted. they reported me. I finally had enough sense to get help, go to meetings bc I knew they would be required and began documenting them. ( For me, attendance at meetings didn't help much at all, with the exception of a single womens' meeting that I still attend. Therapy has helped me 100x more than meetings ever had. Some people feel the opposite, but you'll have to go anyways). imy investigation was still on going. I waited about 6months and then got a job, which I've been at for approx a year and am doing very well. No diversion. After LITERALLY 2yrs since my investigation began, I have finally gotten my letter for our state confidential recovery program. My my point is, NO you do not have to disclose. In fact, I firmly advise you don't say anything until it is finalized. Innocent until proven guilty and hopefully by then, you will have proven yourself as a worthwhile employee and your work will cooperate with you. THAT SAID- learn from me!!!! Do NOT begin working until you have had treatment. It will backfire beyond belief if you are not in a healthy place with support from your family, friends, treatment team and /or sponsor. you could hurt someone and hurt your ability to ever work as a nurse for a very, very long time. edit- I should mention hat I am not in your state and had not yet had any action by BON. If you have stipulations that require you to tell, you basically freaking have to.

I am a klutz. The 10% of he time I wear something white, there is a 50% chance I will spill something obvious. I feel you. However, just as if a cop pulled you over- a refusal to blow= automatic DUI + loss of driving privileges for 1 yr. The sole fact remains that if you didn't have anything in your system ( that was there without a valid Rx for your self in an appropriate amt) you should have tested. I'm sorry, it it's the truth. You get no kudos from management or co workers for being self righteous . I would get. Hair test done , at your own expense, asap. I would assume you can't come back to work there until this thing is sorted out as clean. And that's the best case. Otherwise, count your blessings that you have the second job and be prepared for that one to be your primary and act accordingly . Nonetheless, best of luck.

At YOUR cost..... which in the end equals how much money exactly???