"Recovery" and public shaming

NurseDiane · Jun 23, 2018

This is a perfect example of the abuses perpetrated by nursing boards across the country. Prosecuting a nurse for a DUI (which, incidentally, does not mean that you had a drinking problem---it means you made a stupid decision) that occurred BEFORE you were even licensed & mandating you to a 5 year "program" which is nothing more than a way to drain your wallet & make the addiction medicine industry RICH, RICH, RICH is nothing short of abusive. If another state that a nurse is trying to get a license in wants to make discipline from another state "reciprocal" for licensing purposes, that is one thing---but forcing them into a 5 year monitoring program without any evidence of current substance abuse/addiction or actual conviction is criminal. The nursing boards operate independently, but enjoy protection from litigation as an "arm" of the state government that is protected by sovereign immunity. You should be able to file a lawsuit against the PA BON in state court for forcing you into a monitoring program when there is, and was, no complaint or proof of current alcohol/drug problems---forcing nurses into unnecessary monitoring programs is legally considered arbitrary & capricious, and should be litigated as such. Actions such as this taken by nursing boards across the country MUST BE STOPPED! And the only way to stop them is for nurses to start suing the boards for negligence, harassment & abuse. You don't say whether you entered into a consent agreement to be in the program for 5 years or if you went the whole route with an administrative hearing. Had I been in your situation, I would have gone the long way--if you were not using/abusing/addicted to drugs or alcohol at the time of your evaluation, what would the BON's rationale be for forcing you into a monitoring program? What would they "monitor"? And then, if the BON took action against your nursing license, you could have filed an appeal in court to challenge the justification for being thrown into a 5 year monitoring program for a DUI prior to being licensed as a nurse, IN ANOTHER STATE. Arbitrary & capricious is an accurate definition for what the BON's are doing to nurses. And the topic of publishing the "dirty details" of a nurse's past, including things that not only affect their livelihood but are patently derogatory and designed to do nothing more than shame & embarrass them to the public, needs to be taken up with lawmakers. Why should a neighbor or mother of one of a nurse's kid's friends or a potential romantic interest be privy to details of issues that are extremely personal & confidential, convictions/pleas that wouldn't even show up on a criminal background check because it is so old, mental health problems, drug abuse issues, etc.? How does that "protect the public"? What would happen to a nurse if, while working a shift, every single patient assigned to that nurse looked that nurse up online & found out that they had a substance abuse or mental health problem & refused to let that nurse take care of them? Would the patients be assigned to other nurses & would the nurse who nobody wanted taking care of them be able to kick back & play Angry Birds for 12 hours on company time? I mean, if patients tell the unit manager that they do not want a specific nurse taking care of them, the unit manager must comply, right? And, what would happen if this happened every time that nurse was working? Certainly, the hospital wouldn't be able to fire that nurse, as what was happening was no fault of their own--it was the BON's fault by publishing extremely shameful information for public consumption. What BON's are doing has nothing to do with "protecting the public"---it has everything to do with protecting their own jobs, working in collusion with certain "approved providers" that may or may not include kickbacks of some sort, taking punitive action against nurses with specific legitimate diseases/illnesses of an extremely personal nature & blatant abuse of process. The BON's and "professional assistance programs" offered by licensing boards brag about the high recovery rate of licensed professionals that participate in the programs--however, those numbers are totally false, considering the number of licensed professionals that do not have substance abuse/addiction problems of any kind to begin with that are forced into these programs. Getting a DUI doesn't mean someone is an alcoholic--it means that they drank too much & made a really, really stupid decision to get behind the wheel of an automobile, but not that they have a problem with alcohol. Taking an opioid pain pill prescribed to your mother/husband/wife/friend for a severe migraine headache on a Sunday afternoon does not mean you are abusing drugs. But, BON's can't prosecute a nurse for being stupid. Plus, neither of those things occurred while taking care of patients, and therefore it did not affect the ability to care for patients safely. Nurses must begin to contact their state legislators about the abuses being perpetrated by the BON's against nurses for things that do not qualify for prosecution and/or disciplinary action, and pushing legislators to mandate stricter rules that govern how & why BON's can take action against a nurse's license, and what ways nurses have to appeal those decisions. As it is right now, nurses do not have any due process rights when it comes to defending themselves against a BON charge(s)--the BON does not provide any discovery, like a copy of the actual complaint submitted to the board (the BON's justify not producing the complaints to protect the identity of the complainant, which is total B.S.), what the BON found in their "investigation" (there have been accounts of complaints & charges against nurses where the BON never even conducted an investigation) or the evaluation report from a "board approved" provider (that BON's rely on to support their allegations), so when a nurse goes into an administrative hearing, they have no idea how to mount a defense since they are not aware of what the BON has to support the charges/allegations. And BON's actually depend on the lack of due process to be victorious in an administrative hearing--during the road to a hearing, BON's are purposely evasive in an effort to get the nurse to agree to a consent order. BON's are famous for utilizing threats, trying to make deals that sound better than going forward with the formal disciplinary process, ordering that the nurse do something by a certain deadline which usually doesn't even allow them enough time to consult with an attorney, refusing to answer questions asked by the nurse about the allegations, etc. They will also try to get the nurse to admit to something that could support their allegations in any way, even if the nurse didn't do anything.

Pursuant to the PA licensing board's rules, with respect to taking punitive action against a nurse for misconduct, the reasons set forth all begin with "The licensee......". So, when it is specifically stated that "The licensee has been convicted, pleaded guilty or entered a plea of solo contendre, of a felony or crime of moral turpitude....." blah blah blah, that means that a nurse had to have already been licensed to practice when the crime occurred, and not prior to becoming licensed to practice as a nurse. Also, with respect to alcohol/drug issues and the BON taking action against a nurse's license it states: "The licensee is unable to practice professional nursing with reasonable skill and safety to patients by reason of mental or physical illness or condition of physiological or psychological dependence upon alcohol, hallucinogenic or narcotic drugs or other drugs which tend to impair judgment or coordination, so long as such dependence shall continue. In enforcing this clause, the Board shall, upon probable cause, have authority to comply a licensee to submit to a mental or physical examination as designated by it." With respect to discipline from another state, the rules say NOTHING about mandating a nurse into a monitoring program based on action taken against them in another state. In fact, it says "The Board may defer and ultimately dismiss any of the types of corrective action set forth in this act for an impaired professional so long as the licensee is progressing satisfactorily in an approved treatment program....."----the key words in that sentence are "FOR AN IMPAIRED PROFESSIONAL". That means that the nurse must have been evaluated & diagnosed as "impaired" for any of the rules to apply to them, and to be mandated into a monitoring program. BON's try very hard to get nurses to sign consent orders--this way, they don't have to go to the trouble of collecting information for the purposes of a hearing where they would have to question the nurse, any experts that may have been retained and whatever persons the nurse brought in on their behalf and the don't have to do much work except sitting on their butts in front of their computer to copy & paste paragraphs previously utilized in other consent orders into the nurse's consent order. Mandating a nurse into a 5 year monitoring program for a DUI that occurred before the nurse was licensed, and for which the nurse already completed another state's requirements (which I am assuming you have done)serves no purpose whatsoever. (The prior state should not have been permitted to prosecute a DUI that occurred prior to you being licensed--they should not have been allowed to throw you into a monitoring program without proving that you were dependent/abusing/addicted to alcohol/drugs.) Plus, in its own regulations, it states that a "licensee" must have been found guilty of something or that a "licensee" willfully or repeatedly violated any of the provisions of this act or regulations of the Board. If you got a DUI prior to getting your nursing license, you were not a "licensee" and legally cannot be prosecuted as a licensed nurse. I believe attorney must begin using that as a defense for nurses that the BON is unfairly prosecuting.

Licensing boards should not be permitted to publish disciplinary action against licensed professionals---prospective employers can access the National Practitioner Data Bank of they want disciplinary information about a nurse & a criminal background check will alert them of a crime. There is no reason for the licensing board to publicly humiliate a licensed professional with explicit details of the misconduct that does nothing other than turn them into a recluse due to their embarrassment & fear that people read this information about them on the internet. This is one thing legislators must STOP, especially in this day & age of rampant opioid abuse that is a legitimate disease, and one that should not create shame & stigma in our medical professionals since their jobs are extremely stressful & the majority of health care facilities offer no options for stress management for its employees in an effort to curtail self-medicating & other destructive behaviors. Doing the exact opposite of what is recommended as far as alcohol/drug abuse/addiction does not create motivation for a nurse to seek help on their own--it creates an atmosphere of secrecy & keeping things private, which restricts a nurse's ability to get help and enter into recovery. There is so much out there now about not stigmatizing alcohol/drug abuse/addiction, getting people into treatment & recovery, being supportive to those in recovery---yet licensing boards continue to treat licensed professionals like lepers instead of human beings that are susceptible to the same diseases as every other human being on this earth.

allnurses Guide · Jun 23, 2018

What you say is all correct but it takes an extreme amount of time and energy to mount lawsuit of this kind or to get the legislator to consider taking up the cause. I have spent years trying to get any member of the California House to even look at this reform. If I could quit my job and work on this full time I might be able to get something started. Anybody out there with a bucket of cash to support me while I do.

Hppy

NurseDiane · Jul 3, 2018

Agreed. However, simply contacting your state legislators with a letter that outlines how nurses are humiliated & shamed by BON's publishing very personal, humiliating & downright hateful statements about license discipline serves no purpose whatsoever could be the catalyst for change. If a layperson wants to find out if a nurse is licensed or not, they can search the state's website which will tell them when the nurse was licensed, when the license was renewed & when it expires. Gritty details about the discipline made public for neighbors, parents of our kids' friends, our families, our own friends & acquaintances does nothing but humiliate us. This will remain publicly accessible in perpetuity, which is also of no purpose. Why should a deceased nurse's substance abuse problem matter after they are dead? There is no reason for my neighbors or friends or extended family or the PTO to know that my license was disciplined. Do I still have a nursing license? Yes. Is it unrestricted? Yes. Was it ever revoked? No. That's all that should matter, not what the complaint was about & what the BON decided to charge me with & what I consented to. The truth is that the general public has NO IDEA that nurses are being unfairly charged & prosecuted for complaints/reports made in bad faith, and the general public also doesn't know that nurses are being forced into multi-year monitoring programs which include drug/alcohol testing that they pay for out of their own pockets, inpatient and/or outpatient rehab which the nurse often has to pay for because they can only go to "approved" providers, even when they have no history of drug/alcohol abuse and their evaluation (also by an "approved" provider) states that they are not abusing drugs/alcohol and their issue has to do with a mental health problem that requires far different treatment & management. Plus if the BON is not happy with the results of the evaluation that goes against what the BON wants to prosecute the nurse for, they can--and do--mandate that the nurse pay AGAIN for another evaluation, and that can keep on going until the BON finds an evaluator to give them what they want. That should not be permitted. If the BON wants subsequent evaluations, it should be paid for by the BON. The general public loves to stigmatize those who have faced discipline against their license without knowing what the truth is, or what the nurse's story is. The general public has no idea how unreasonable, powerful, controlling & manipulative BON's are so they can get their way & "prove" themselves so they can keep their jobs.

I know this from my own experience because I had to admit to something that I didn't even do in order to get a consent agreement & keep my nursing license or the BON was going to revoke it---I was accused of stealing a prescription pad from the Pyxis in a busy ED in a level 1 trauma center. I never "stole" a prescription pad from the Pyxis and don't remember taking a prescription pad out of the Pyxis & not returning it. (This was 15+ years ago before electronic prescriptions were sent directly to the pharmacy.) When I asked the BON for the numbers of the individual prescriptions that were in the pad (because that is how I would be able to track if any of the alleged prescriptions because each individual prescription had a sequential number on it which the state kept track of in a database--when a paper prescription was filled at the pharmacy, it would be scanned into a state database---in case there were any questions about the prescription it could be found & looked at) they refused to give them to me (which I suspect was because the hospital pharmacy did not give that information to the BON since I didn't take it and if it was missing, someone else stole it). When I wanted to know how many actual individual prescriptions were missing, the BON wouldn't tell me that either. I asked whether the prescription pad was a new & full pad or if it had been used & how many individual prescriptions were left on the pad, and they wouldn't tell me. Was it a full pad of 100 individual prescriptions or was there 8 individual prescriptions left on the pad? All they would tell me is that the hospital pharmacist said that a prescription pad was missing & I was the last person to sign the pad out. Mind you, I found all of this out when I returned from a week-long vacation--nothing was said to me prior to going on vacation. (The whole system for how paper prescriptions were managed in that ED was ridiculous---if a doctor wanted to write a prescription for a narc, they had to ask a nurse to get the pad from the Pyxis. And we couldn't just ask them how many individual prescriptions they wanted--we had to take out the entire pad, give it to the doctor, wait for them to finish using it, get it back from the doctor & put it back in the Pyxis. The doctor didn't take off one or two prescriptions & then give the pad back---they'd stick it in their pocket,[because they were too busy to write the prescription right then & there, of course] walk around with it in their pocket, go see a few other patients and the nurses would have to remember to get the pad back so it could be returned to the Pyxis. That procedure should have been turned into the Department of Health---all ED physicians should have had their own prescription pads with their own NPI & DEA numbers on them instead of using one prescription pad that was locked up in the Pyxis, or the physicians should have been given a Pyxis ID so they could get the prescription pad out themselves instead of making the nurses responsible for something that they didn't even use. That was one ridiculous system & a perfect set up for what happened to me.) So, anyway---the BON refused to give me any information that would allow me to contact the state to track those prescriptions so I could mount a defense & show that I didn't take it. Had the BON given me the numbers of the prescriptions that were allegedly missing, I could have shown that either the prescriptions in question had been written to patients & filled or that none of the prescriptions had been filled and therefore there was no basis for "diversion" of the pad. The BON also refused to show me the printout from the Pyxis that the hospital pharmacist (allegedly) submitted with their complaint. So, I had absolutely NOTHING upon which I could mount a defense or prove that I didn't take the prescription pad. (I suspect that the hospital pharmacist was either diverting prescription pads himself or was doing this because he couldn't account for what was in the Pyxis for whatever reason, and he didn't want to face discipline by the pharmacy board himself.) And the whole experience with the BON wasn't about finding out the truth---it was about threatening me to admit to taking the prescription pad so I would enter into a consent agreement instead of proceeding to a hearing, which they said would undoubtedly result in my license being revoked. Of course, those statements were made in threatening ways--"You're better off signing the consent agreement otherwise the board will revoke your license if you go to a hearing". How did they know what the board would do at a hearing? If the BON didn't have evidence to prove their case, they'd lose. So, I did what 99.9% of all the other nurses do out of fear when in this same situation: I conceded to their threats & admitted that I took the pad just so I wouldn't lose my license. So now, guess what? It's public knowledge that I was disciplined for stealing a prescription pad, which I didn't do. The BON never told me prior to the consent agreement that this would be published on the internet. Had I known that, I would have thought twice about conceding to the BON. What's rather ridiculous is that on the BON website, it just says that I stole a prescription pad---not that I filled forged prescriptions, or wrote fraudulent prescriptions to someone else, or sold the prescriptions or that I had substance abuse issues. In retrospect, with many years behind me since that whole experience, I wouldn't have agreed or backed down & would have proceeded to a hearing to force the BON to prove its case against me. They wouldn't have been able to without the prescription numbers, a report from the state about the individual numbered prescriptions & whether they had been filled or not and a corresponding Pyxis report to justify their accusations against me. Furthermore, being disciplined for "stealing" a prescription pad that had no prescriptions filled from it is rather ridiculous. The whole purpose of "stealing" a prescription pad would be to obtain narcotics illegally. How can the BON prove that the pad didn't get accidentally thrown away by the pharmacist filling the Pyxis or some other incident (like stolen by the pharmacist)? The thing is, the BON operates on setting short-term time limits that put pressure on nurses to make a decision about how they want to proceed, which greatly affects a nurse's ability to think rationally & decide how to proceed. The BON doesn't want a nurse to retain an attorney--they want the nurse to feel so threatened & scared that they will do whatever the BON tells them to do. And one of the things that nurses don't stop to take into consideration is that their decision to either concede to a consent agreement or proceed to a hearing will be splattered all over the internet for the world to see, forever. That should be one of the most important things in a nurse's mind when facing the BON--it is worth it to fight the charges & proceed to a hearing? Can the BON prove the charges if they have to? Are there ways for the nurse to defend themselves at a board hearing? And if the BON can't prove that the charges are true, will they drop the case against the nurse if the nurse chooses to pursue their defense?

I got way off topic there, LOL. At any rate, all of the things I said above are true. It also doesn't help that the BON's treats nurses with drug/alcohol problems and mental health issues like moral failings rather than what they are---diseases. Substance abuse/addiction is a legitimate DSM IV diagnosis, just like clinical depression, bi-polar disorder & all of the other mental health disorders that are out there. How can the BON discipline a nurse that has a legitimate disease and then publish it on the internet? The BON doesn't do that to nurses with other diseases like diabetes or HTN or clotting disorders or other chronic diseases, so why should drug/alcohol abuse/addiction and/or mental health disorders be put on public display so that every person on the earth can access this information & judge that nurse based on what the BON decides to print on the internet? In addition, for things like 20 year old DUI's and any other drug/alcohol related issues that occurred long before becoming licensed as a nurse, the BON doesn't put the date of the DUI on the internet posting---it is just a generalized statement that the nurse received a DUI. If the BON is going to publish something like that for the world to see, it should be accurate information with the exact date and not worded as if it happened last week. There is no purpose for BON's to publish anything about license discipline other than to shame & humiliate nurses for being "bad" and not living up to the "standards" that are set that portray nurses as "superior" to others. Nurses are human beings & suffer from the same diseases that the general public does. In this day & age of everybody from politicians to physicians to parents on the PTO advocating for better availability of drug/alcohol rehabilitation & services, for recognition of drug/alcohol abuse as a disease and NOT a moral failing, and strongly advocating for detection & rehabilitation of drug/alcohol abuse/addiction so that people can go on to be productive members of society, nurses should not be treated like outcasts & humiliated for being one of the people that unfortunately fell victim to this epidemic. Instead of humiliating & shaming nurses for the rest of their lives with internet publication of their horrible & reprehensible character flaws & failings, BON should encourage rehabilitation & recovery without causing financial destruction, public humiliation & lifelong stigmatization for something they had no control over. What is happening is that nurses are being bullied by BON's who are using their control & power to justify their paychecks. Policy reform must be initiated & concrete laws/rules set forth with respect to how BON's can conduct disciplinary proceedings, as well as rescinding the "public information" part of discipline when it has to do with drug/alcohol abuse/addiction and/or mental health issues. And BON's should not be able to circumnavigate those laws/rules by manipulating verbiage to avoid those rules/laws just so that they can publish their "handiwork"---for example, instead of finding a nurse guilty of drug/alcohol abuse/addiction or mental health issues after a hearing or when entering into a consent agreement, they should not be allowed to write things like: "Nurse was found disoriented in the staff bathroom" or "Track marks visible on arms" or "Breath smelled of alcohol" or "Used syringe found on person". Those ARE NOT charges that can be disciplined and therefore should not be permitted to publish on the internet. If the BON wants the nurse to go into rehab & enter into a monitoring program due to a legitimate substance abuse issue, that's fine. But there is no reason to let the world know that the nurse suffers from a disease that the general public also suffers from by manipulating words to make them seem like a devious, morally bankrupt individual because they are not. Likewise, things that occurred that did not involve patient care should not be permitted to be disciplined, like DUI or unpaid student loans (if the BON takes away the ability for a nurse to make a living, of course they won't be able to pay their student loans) or shoplifting. It is also unnecessary for the BON to publish any criminal activity that did not involve patients since it will show up in a background check by a prospective employer anyway. There should be concrete rules/laws that govern how BON's investigate complaints/reports, what information BON's are required to produce to the nurse that support the charges, how hearings are conducted, as well as removing the "approved provider" rule that is benefitting BON's because they are working in collusion with one another for mutual financial benefit. Nurses should not have to go broke by paying out of pocket for expensive evaluations & treatments. They should also not have to pay out of pocket for board mandated drug screening. Drug screens can be performed just as well in commercial labs--they have chain of custody procedures just like out-of-pocket places do. The utter abuse being perpetuated by BON's must stop, and the only way it is going to stop is if legislators get involved. This, however, is likely a topic that most legislators want to stay far away from. But, in this age of an opioid epidemic and substance abuse being a legitimate DSM IV disease, bringing how nurses are treated by BON's to the forefront could be a major boon to a legislator's public appeal. Revealing to the public how nurses, who are looked at in a positive way by the general public, are being abused & humiliated by BON's instead of treated like human beings that deserve dignity & respect could potentially cause a major uproar. Of course, the BON would come forward & defend their actions & how their duty is to "protect the public" and they are just doing their jobs and talk about how many nurses have been "helped" to relieve themselves of any liability in ruining nurses' lives. The fine details would have to be revealed. The thing is, legislators are probably not even aware of what's going on because nurses are too afraid to take a proactive stance. They are afraid that the BON will go after them & revoke their licenses. The only ones that should be privy to a nurse's history is an employer/prospective employer. And once a nurse completes the monitoring program, there should be no record of it at all.

When questioned about why the BON publishes disciplinary action against a nurse, their response is always "To protect them public." However, no further explanation is given. I would like to ask that question of the BON, and then ask HOW, exactly, does publishing extremely personal & controversial things about a licensed professional on the internet "protect the public"? How does publishing that a nurse diverted narcotics on the internet "protect the public"? How does publishing a nurse's mental health history on the internet "protect the public" when the entire PTO knows about it? How does publishing a 20 year old DUI on the internet "protect the public"? What BON's are doing is a definite abuse of powers and should not be allowed by state government. "Self regulation" needs to be taken away & governing entities put in place to monitor the BON's actions.