CryssieD

Sorry for your loss. About the drug charges, etc--I don't know how it works in NY specifically, but from my reading of Nurses/Recovery forum on this site, as well as from personal experience (DUI for Rx muscle relaxant--my Rx, and possession of narcotic--not my Rx, in 2009 [possession charge was dropped after 2 years' probation]), Boards take drug-related convictions/guilty pleas very seriously; it's common to wind up in a monitoring program, with years of random drug screens, treatment/therapy, NA/AA, practice restrictions, etc. Wish I had better news--maybe you'll be the exception that proves the rule?...One can hope, I suppose. You can try getting a lawyer and pursuing the matter before the Board, but it probably won't work. The Boards always seem to err on the side of caution--public safety trumps everything else, and one of the Golden Rules of addiction medicine/theory is, addiction is a chronic disease that waxes and wanes but never goes away; once an addict, always an addict. The good news is, no matter what they decide, you can handle it. I realize I don't know you, but I'm assuming you're clean now (right?), and it sounds like you have lots of people and years of exemplary behavior and performance on your side. I wish you the best of luck--keep us posted on how it goes!

Congratulations! Welcome to nursing--it's an awesome career full of awesome people! About the anxiety: Is it specifically nursing-job-related, or do you have it in other situations? If it's an on-going problem, you might want to consider some behavioral therapy, meditation, and stress-reduction measures--anxiety can really affect your quality of life; I don't suffer from it too much but my sister does, and it really does impact her life in some negative ways. As for anxiety about being a new nurse: Relax--that's normal! It's the newbies who aren't nervous who worry me. I think any area of nursing may cause some anxiety for you--the main thing here is, whatever field you choose, make sure they give you a good, solid orientation: getting thrown in at the deep end is a new-nurse nightmare. Find out right up front how much orientation they will give you and whether you'll be working with one preceptor or get bounced around--I found having my own preceptor extremely helpful because we got to know and trust each other, which made us both much more comfortable asking questions and giving/receiving criticism. I don't know enough about you to suggest a particular field--look back at nursing school and remember what areas you found most interesting and comfortable for you. In general, my personal opinion is that new grads should avoid ICU and ER, just because they haven't got the experience that brings the nursing judgment and keen assessment skills so vital to practice in these areas--but that's just me. I know others disagree. Good luck!

Gastric distention can cause subjective feeling of SOB without objective evidence--it doesn't have to be extreme distention, either. Other than that, can't think of anything other than simple anxiety. You did the right thing though--we take patients at their word, but we don't give medications without appropriate indications for them; Proventil and other neb meds have side effects and contraindications like any other drugs, and we don't use them as placebos. That said, I would always be alert to SOB as a potential harbinger of bad things to come--doesn't mean you have to jump on it right away, just keep eyes and ears open and remember to reassess a couple of times. Better safe than sorry!

Not sure what to do, but I assure you it is not unusual at all for actions against your license in one state to cause similar actions to be taken by Boards in other states--it's not persecution, it's quite normal. Sorry you got into this mess. In hindsight, I'm sure you realize that your biggest mistake was your denial that you "had any knowledge of the forged form." Had you 'fessed up immediately to your misplaced trust in the dishonest person who forged the reference, you might have had a prayer. I don't think there's much you can do at this point, except to be utterly truthful with Illinois, as well as any other states in which you hold licenses, and hope they merely discipline you; I think the good news here is, one, states seem (I have noted) to base their actions on the actions of other states (which might let you keep your Illinois license the way you'll be able to keep the Wisconsin one), and, two, you have learned a valuable lesson: honesty, however bad it looks in the light of day, is always the best policy! Again, sorry it worked out bad, but it could have been worse! Live and learn! Good luck :)

My first job was on a general peds floor; I got a full 12-week orientation with a preceptor. Overall, a good, thorough orientation and wonderful learning experience. My second job, a little over a year later, was on a pedi sub-acute unit: 10 kids, most with trachs, and most of those on vents. I had only ever seen a ventilator about 3 times while on my ICU rotation in nursing school, and I was hardly allowed in the room--I never got anywhere near the vents. The facility allowed me to shadow the day nurse for one shift--the next day, I was on my own with a CNA and we had an RRT stop by a couple of times. I cannot believe I actually put up with that. I mean, I'm a quick study and all, but that was insanely dangerous.

One of my very first actual patients in nursing school was a young man with late-stage brain CMV (demented, blind, and mostly incoherent at 20 years of age--incredibly sad), secondary to AIDS, who projectile-vomited all over me quite unexpectedly. I was, needless to say, slightly freaked out, especially since it got on in my eyes (nope, not wearing a mask with a shield--live and learn, right?) Thankfully, gastric juices aren't particularly hospitable to HIV, so no worries--but it did give me lots to think about! Since that time, after working Peds, PICU, pedi and adult sub-acute, and psych, I've been sprinkled or splashed with every possible bodily fluid (except amniotic--I can't stand L&D, so I never got near the stuff)--I guess you just get used to the concept. No more freak-outs for me, I just roll my eyes and make a bee-line for the nearest sink.

I must be really old...I have no idea what PVT is. All I can say is, I had no choice but to wait the...what was it?...7 or 8 weeks to get my results. You youngsters get no sympathy from me! Oh no, you have to wait 2 whole days?! However do you stand it?!!!

RecoveringRN--I think you're confused by the label of "addict" because you have an image in your head of some strung-out junkie living on the street; because you don't fit the "classic" description of an addict, you must not have a problem, right? Wrong. There is nothing normal or OK about "experimenting" with morphine and Dilaudid just to see what they feel like. These are hardcore drugs, and you, as a nurse, know that perfectly well. None of this sounds like "experimentation" at all--I think you know exactly what you're doing. Your drug abuse--and yes, taking powerful opiates just for funsies is definitely drug abuse--tells me you have a serious need to escape your own life. I know it's normal to want to get away from harsh reality once in a while--that's why many people have a social drink now and then--but morphine and Dilaudid are not drugs someone does socially, unless that someone is hanging out with heroin addicts. Actions speak louder than words, and your actions bespeak a serious problem brewing. Believe me, I've been where you are--minimizing, excusing, denying; we all try jumping on the denial train, only to find out that it doesn't go anywhere. Ever. Take a deep breath and jump off. Forget about fighting the label, it's wasted breath. If you want to keep your nursing license intact and your hind parts out of jail, you're going to have to go through the whole recovery thing, whether you think it's appropriate or not. Incidentally, the doctor who did my addiction evaluation told me that even if I wasn't an addict--and I am--I would still find many useful things in recovery. She was so right. I sincerely hope that you embrace this opportunity, because that's what it is. Your post could have been written by me--I didn't fit the label either, if you asked me; the problem is, I didn't know what I was talking about. I know better now. I hope you learn all I have and more. Mostly, I hope you let this episode be the beginning of a whole new chapter in your life--and the best one, too. Good luck. Much love. :) Keep us posted, OK?

OP: There is a time for everything--and right now it's time for you to take care of yourself. I hear in your voice all the desire to be the heroic healer--but first let yourself be healed. You can only carry others when you are strong enough to carry your own weight first. Your story tells me you are anxious and overwhelmed, and the stress of your work is only adding to your problems. Please allow yourself some space to get the help that you need and deserve. Your workplace probably has an EAP (Employee Assistance Program, or something similar), or you can seek help privately; perhaps you can ask around for "someone to talk to." Lots of people have had episodes like yours and are absolutely OK, but they couldn't do it alone--nor can you. Anxiety and depression are like any other illnesses--they can be greatly exacerbated by stress, and you have chosen one of the most stressful (and exhilarating, too!) specialties in an already high-stress profession. I know it was your "dream" job, but it's becoming a nightmare and it's time to wake up. Let go of the job--there are jobs everywhere; there is only one you. Your health and happiness are far too important to wait any longer. Please talk to somebody and let them help you heal the way I know you have helped others to heal. I wish you all the best--please keep us posted on how it goes, OK? :)

Unfortunately, it's all about the money, honey--it's the American way! I find it disheartening, too, but I just keep trudging along, trying to deliver quality health care with some remnant of the TLC nurses are so famous for. When healthcare is run as a business, the name of the game is efficiency, not wellness or compassion; nurses are providers of a commodity, and the idea is to make money from that commodity, which is not just the technical skill of your dressing application or IV piggy-backing but the whole of your person--your compassion, your smile, your steadying hand, your experienced eye, everything you have learned and everything that you are. Suffice it to say that nurses are the best buy in the American healthcare system. We are awesome! Keep reminding yourself that!

I interviewed for a medical receptionist position. As for the monitoring--maybe just being in a medical environment, dealing with medical issues, using medical knowledge and terminology, is enough to require oversight; or maybe they were afraid I'd get friendly with the doctors and get them to write prescriptions for narcotics? Honestly, I don't know why they (the monitoring program) felt it was any of their business, since I wouldn't be working as a nurse, but I just looked at it as an opportunity to get someone in my corner, submitting good reports every month, giving them positive feedback. I told the HR person interviewing me for the receptionist position about my problems and the monitoring agreement, because I was obviously overqualified for the job and she wanted to know why I was applying for it. She didn't have a problem with it--she was actually very understanding and wanted to help. So maybe letting your employer know about your situation will work out better than you think. Good luck, and hang in there--you will get through this!

Just curious--did you get a preceptor and decent orientation at either of these jobs? The hospital I started at had a minimum of 12-weeks' orientation, longer for critical care areas(ICU, CCU, ER, OR/PACU). That orientation time is critically important when you're just starting out--it sounds like you got thrown in the deep end. And are you really interested in med-surg, or is that all that's available? Ask yourself what you liked most and least about your nursing experiences; look into other areas of nursing, find out what they entail, and see if any of them sound like your cup of tea. I've worked in many different areas, and necessary skills vary from specialty to specialty, and one setting to another. I don't know what kind of area you live in, so I don't know what's available. But it sounds like the nursing home (LTC) was poorly-run--honestly, there are never enough CNA's for the work in a LTC facility, but if staffing was that bad, believe me, the problem wasn't you. And it sounds like the hospital just threw you in, sink or swim--which isn't all that uncommon; med-surg can be a rough unit to work, so, again, it isn't necessarily you--lots of people find med-surg overwhelming. I don't know for sure, of course, but I think you've just had really bad luck. If you don't think a real orientation on med-surg would be enough, look into other areas. Nursing offers so many opportunities--I bet the right one is out there waiting for you! Keep us posted, and don't give up yet--you're so new at this, and, like I said, I don't think you're the problem; you've just had bad luck. Keep your eyes open and keep the faith--the right job will come along!

One of the many problems in this society is ignorance about mental illness; having a mental health issue, even a formal diagnosis, is not a matter of incompetence or moral failure. No one with half a brain would consider a diabetic incapable of being a nurse or caring for others--bipolar disorder is no different from a physical disorder like diabetes; if you take care of yourself, do what you should, don't do what you shouldn't, use medications properly if you need them, and see your doctor when you're supposed to, mental illness is usually no more disabling than diabetes, hypertension, asthma, or any other chronic disease that requires management. Unfortunately, the stigma of mental illness and public hysteria over a couple of unbalanced nurses who went on killing sprees causes Boards to adopt legislation requiring nurses with mental health problems to submit to monitoring(tpapn is Texas' program for that, I think) if the Board decides it is necessary; this usually requires evaluation by a psychiatrist or psychologist, some review of your medical/mental health history (specifically diagnosis, medications, and whether you've ever been hospitalized--these should be private and none of the Board's business, but nothing is sacred if the Board thinks patient safety might possibly be an issue), and maybe an interview. If they decide you need monitoring, it can be for a few years, or it can be for much longer--it depends. Sadly, being in such a program can make it difficult to get work--not impossible, just difficult. Now, since you're just starting school, if you do wind up in monitoring and do well, you will have that much good news to give prospective employers. However, my advice is, read the Order they send you very carefully, and, if you can possibly afford it, get legal advice before you sign anything. I mean it--this is your career, and you don't want to be handicapped by a monitoring agreement if you can avoid it. And, for the record--it's not the people with the diagnosed mental illness who keep me up worrying at night; it's the ones without a diagnosis...yet! Best of luck to you, and don't let the Board scare you--they have a lot of power, but they're just people.

A fellow HPMP member! Awesome! I've never had much trouble getting hold of my case manager--we occasionally play a short game of phone tag, but usually she gets right back to me. Maybe the people there have been going on vacation--you know, before school starts up again? Anyway, sorry you're having a hard time--hope it gets better!

I'm glad you are excited about your new life in recovery--it really is a does give you a different perspective on life; I have grown so much and learned so much in recovery--it's really been an awesome journey. Welcome! About the job--it's great you found a medical-type job that doesn't actually require a nursing license. However, if you wind up in a monitoring program, they may still want reports on how you're doing there. When I was looking for work, I was offered a receptionist position in a medical office--not a nursing job, didn't require a license or anything under the Nurse Practice Act. However, my case manager told me that if I took the job, they would still require that my employer be made aware of my situation and submit monthly reports on my performance. I'm not an expert, but I think the job you've described sounds perfect--you need some medical knowledge but not an actual license, so you shouldn't be in any hot water with the Board--but just be aware that a monitoring program may still consider it to be in the general medical field and therefore something they need to be involved in. Good luck to you in all you do.:)

Glad to see you fighting back--these people really do have too much power. It's a shame that something so important (help for genuinely sick nurses) has been turned into a witch hunt; the holier-than-though attitudes and assessments that identify normal people as raging alcoholics/addicts are really disheartening--but it is true that when all you have is a hammer, everything looks like a nail. Sorry for your problems--hope it works out. Keep us posted.

I was in kind of the same boat--I came from one state before my monitoring had been arranged, then had to apply for a license in another state; a condition I was asked to meet in order to get my license in the second state was monitoring (evaluation, testing, counseling, and 3 meetings a week) by their program for 5 years; the monitoring was essentially transferred from my previous state to my new state of residence. My old state required much less than my new state, kind of like your situation. Unfortunately, a nursing license is a privilege, and in order to keep yours you will have to do pretty much whatever they say; you may be able to appeal the length of time required--you've already completed 2 years in your previous state and maybe they will count that toward your new program's required monitoring period--but requiring meetings is pretty standard and I don't think you'll be able to get out of them. I will tell you that I was not happy about having to go to meetings either--I really didn't believe I had any reason to go; however, I'm now very glad that I was forced to go by the program, because I learned so much about myself and really grew as a person. I often wish everyone was required to work the steps, because it teaches you so much and really does make you a better person. Anyway, good luck to you! I know it's hard, but you can get through this--you really can!

Thank you, Silverdragon102! Much better!

We see so much pain in our daily lives--more than most people realize, I think. It is part of nursing. The thing is, you get emotionally overwhelmed by things you feel you have no control over; as a nurse, you will learn that there are things you can do to help (control, ease, and manage) in all kinds of situations--your knowledge and experience will be used to shepherd people through these rough patches in their lives. You will be the rock and foundation for other people because you have such valuable knowledge and experience, and you will be better able to handle your own emotions because you will not feel as helpless.

Such a shame--the helping professions have always gotten the short end of the stick. Everyone wants top-shelf health care but no one wants to pay for it. Those warm bodies cost money, which is always better spent on some CEO's office furniture, or some Board member's personal hobbyhorse. Until we all agree that nurses are the backbone of American healthcare and that we need more of them present in all healthcare fields, short-staffing will continue to be the norm.

Basically why I got into nursing in the first place--nurses are supposed to use a wholistic/holistic approach in planning and providing care; it's actually one of the things that differentiates what we do from the practise of medicine! Not anti-science at all, just incorporates much more than the mere physical.

ER is definitely the place to see the dregs of humanity in all their glory! Besides, where else can you go at 3 am to get free food, drugs, and TLC?

Gonna throw this computer out the window--what is UP with all that FONT stuff anyway?!? Aaarrrggghhh!!!

Sorry, I'm afraid you're totally busted. It sounds like, unless you're extremely lucky, you're going to wind up doing rehab, lots of counselling, lots of meetings, and lots of drug screens! Fun fun fun! I'm sorry this happened—it's a horrible feeling, I know. But…no point in crying over spilled milk—pick yourself up, shake it off, and move on to whatever comes next. I won't lie—it's a very humbling experience, no one appreciates their dirty laundry hung out on a line for the whole world to see; sometimes self-reporting is the way to go because if you volunteer rather than waiting to get ordered into a program you can keep the black mark of disciplinary action off your official record. Ask an attorney for a more qualified opinion,but my gut feeling is that's your best option; as a nurse you know better than to take someone else's narcotic meds and you definitely can't expect the BON to overlook cocaine use. Just remember in your dealings with the Board that it has priorities: 1) itself, 2) the public, and 3) last and least, you. Its job is not to be compassionate, understanding, and forgiving—no excuses or rationalizations are going to be accepted. That said, however, it's not the end of the world--you're not the only one in this boat, you've got lots of support here and you'll find lots of support in Caduceus and 12-Step meetings; you might even find this to be one of the best things that's ever happened in your life—sounds nuts right now, I know, but I'm actually grateful for my mistakes and their consequences,they forced me to get the help I needed. I'm so much stronger and healthier for thisinitially devastating experience I can hardly believe it—so keep your chin up,it will get better and you'll find it was all worth it in the end. BTW, I'm 47 now, and my career is hardly over—recently started the process of going back for my Master's; this is not the end for your career, just a (slightly rocky) new beginning! You have some dark days ahead but there is always sun after the storm. Always. (Don't mean to sound like a pie-eyed optimist,but after 5 years I've gotten some perspective on the whole thing, and it's really NOT as bad as it seems at first—I totally promise.)

Congrats, hope your vacation was awesome! I've got 7 1/2 months to go on a 5 year contract, and I can't believe it's almost over! I totally agree--this can be done: it's annoying and humiliating and frustrating and expensive, but it isn't impossible and if I can do it I know everyone else can too! To all my fellow monitoring subjects--hang in there, it really will be over someday!