RAMP in NJ...Does RAMP violate the ADA if medications are for disabilities?

U.S.A. New Jersey


I am a licensed registered nurse in the state of NJ for more than twenty years. Earlier this year I was terminated from my previous place of employment due to failure to follow procedure. Upon my termination my previous employer reported my error to the State Board of Nursing who required I enter their Recovery and Monitoring Program (RAMP) since the error I made involved data entry of medications. It was a clerical error but standard procedure, since it could technically be labeled suspicion of diversion, is to have me join RAMP, which I did. I was told my license would be taken if I didn't. I was told it was a 90 day monitoring program in which I have to go to weekly meetings, submit journal entries, and have my hair, urine or blood tested at any time at my expense. I do take prescription medication and I provided letters from my doctors, both neurologist and psychiatrist, stating I am disabled and need the medication to function normally and that I pose no risk as a nurse under their care taking these medications. I have reached the last days of the 90 day eval period in this program, I have been compliant. Except for one or two people in admin for RAMP they have been at best rude, I will be kind and not say what the worst has been like. They just contacted me and are requiring that I remain in the program and disregard my doctor's prescribed treatment, work to stop taking the medication my doctor has prescribed even tho my doctor who has been treating me for over five years made it clear it was to treat a disability, or they will pull me from work. They have also required I pay a ridiculous amount of money to be evaluated by their doctor. It seems that having to indefinitely be forced to undergo constant random testing of my hair, blood, and urine at my expense is at least an invasion of privacy and threatening to take my license unless I disregard my doctor's orders is a breach of the ADA. Has anyone else experienced anything like this? Is this not a violation of the ADA? My attorney did indicate that if I pose no risk and can complete my tasks being removed from work could be argued as a violation of the ADA but then I would have to leave RAMP and take my chances with the board. It's a difficult situation. Being in RAMP has been a miserable experience, I was doing very well working with my physicians in dealing with my disabilities but this has been awful. I love being a nurse, I am good at it, my patients appreciate the care I give them. This is sucking all the joy out of it. Anyone have advice or experience dealing with this kind of situation? Please respond only if you have factual knowledge, I appreciate opinion but I need hard facts at this point and it is difficult to come by.

MunoRN, RN

8,058 Posts

Specializes in Critical Care.

I sympathize with the hassle you've had to go through, but unfortunately as far I know the BON is within it's rights to apply these measures. In general in these types of situations where there is a question of ADA protection it makes no difference whether or not your doctor thinks the medications will affect your work, it's purely up to your employer or your licensing body to determine their view on that. Whether or not you meet the ADA definition of disabled doesn't really matter either, since most nursing jobs are "safety senstive" jobs, which drastically limits the accommodations employers must make in terms of allowing prescription drug use on the job.


3 Posts

Thank you for the quick response, Muno! I should note for the thread that I do not take the medication at work. It is purely before bed. But, that's part of the grey area in dealing with this.


11,525 Posts

Specializes in NICU, PICU, Transport, L&D, Hospice.

I have a couple of observations.

First, it seems that the BON has applied some sort of cookie cutter plan of action to your case, rather than a personalized plan. That is pretty unacceptable from the highest department of professional nursing in your state. YOU would get in trouble for that in your lowly position.

Second, the BON seems to think that they know what is best for you as a patient and are now trying to interfere in your personal health maintenance program designed by your health professional as a portion of your overall plan of care. You didn't say what procedure you did not properly follow, but I can only imagine that the consequences were substantial enough that the BON is concerned about patient safety in your care. Apparently the BON feels that your medication puts your patients at risk (can they prove that? do they have to prove anything?).

I am sorry for you. This situation sucks like a hoover.


3 Posts

Thanks so much for the post TMB! The thing is it's not even the BON, it's a separate program that was set up by the BON to monitor nurses who might be under suspicion of diversion or actually have committed diversion or other drug related offenses. My procedural error was purely clerical, there was no patient in danger at any time but because it was a clerical error for a narcotic, and I had been written up for other minor infractions, they terminated my employment. In a way I am happy to be out of there, it was becoming, and is, a very dangerous workplace and I was vocal about it. New owners came in recently in and they were writing up the existing staff left and right for minor infractions to clear out the nurses that had been with the former company for years and bring in either their own people or recent graduates while reducing the number of RN's to bare bones with huge patient load. But, because my procedural error involved a narcotic they report it to the board and then the board requires you join their program, RAMP. RAMP is the group that is dictating the situation at this point and they do basically hold your license in their hands. The situation has improved somewhat since my post as my physicians have become more involved but it is still a harrowing situation. I don't understand how they can insist against my doctor's orders when I am disabled, neither does my doctor but if I don't comply they can remove from work. It does certainly suck like hoover and it does seem to straddle the grey area of the ADA, that's what I am trying to get more clarity about.


67 Posts

Specializes in Sub acute transitional care.

I honest can say that my expirence with Ramp was the complete opposite.


6 Posts

I am in ramp as well, because I called them asking questions and basically told on myself, not knowing that they would report me to BON they required I get an eval immediately or they would put an action against my license... I am going through the steps and will have a minimum of 5 yrs in the program if i choose to continue. they said that was standard for anyone in the program... I have had the rudest people and they treat you like a number, and using a cookie cutter program is all they are required to do. we are "suppose" to be above error and flows, so I think they think that this is doing us a favor by letting us keep our license... I have had such a hard time with them that I am currently looking to leave nursing and follow another path in the medical field and surrender my license. I am only an LPN though and have no where near as much schooling as you do so I am not sure how you feel about that. But I do feel for you and your troubles...


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