Reporting to BON

[perfectbluebuildings, BSN, RN]

I am not sure if I should be posting this in this forum or in the Nurses/Recovery forum.

I know a former colleague who self-reported several years ago for prescription pain pill abuse. She went through the whole state program for health care professionals (not sure what it's called in my state) and eventually was cleared and returned to work and did well for a couple of years, an excellent nurse, and managed to get her nurse practitioner degree during this time as well.

She has since relapsed and is again using pills regularly and much more severely than before, as reported to me by her parents, and she also told me about it several months ago but told me she was going to get help for it. She has not gotten help. She has done things such as break into her parents' house to steal money, she has stolen from friends who allowed her to stay at their houses for a few days "to try to get clean" which never worked. Also her parents have cashed out retirement funds.

Also, for the past year or so, I was stupid enough to believe her fake tears and excuses like "behind on my bills" that she would use to ask me for money and I had given it to her several times. When I saw her a few days ago it was obvious the signs of her abuse... she had called for a small amount of money and within the half-hour it took for me to drive and meet her she called over ten times asking how long until I would be there, very anxious. After this incident I realized that I was just enabling her at this point; that until she makes the decision to seek help, I can't be part of her life anymore. I have blocked her in all forms of contact that she has for me and am 98% sure she does not have my address.

My question is, should I report her to the state BON? She is a nurse practitioner now and has been bouncing from job to job, somehow avoiding urine drug tests. She has a daughter who is witnessing this whole situation as well, and has no real consistent, healthy caretakers; biological dad (divorced from my friend) is also a drug user.

I hate to turn in a former friend of mine and possibly have her lose her license, but I'm scared for her, I'm scared for her patients, I'm scared for her daughter and the rest of her family. I really don't know what to do, because I can't prove objectively without a shadow of a doubt that she is abusing drugs, I just know about it from things she's told me and things other colleagues of mine have told me; I've never seen her use the drugs. I don't want to ruin her life but at this point I think she is going to end up in jail or dead unless she makes the choice to enter a rehab and get serious about recovering. I also thought of reporting to DCS but I don't have any actual proof of neglect in the child's case, just knowledge that the mother is seriously addicted to pain pills.

Sorry for the long post. If you have any thoughts or advice I would really appreciate it. I care a lot about this person, I've known her over ten years, and love her; but she's become a different person and I can't stand behind her anymore. Please give me advice, thoughts, any feedback negative or positive. Thank you so much.

(I want to clarify that although I have been much more of a lurker on here the past couple of years than a poster, I have been a member for a long time and am not just making this post up to get attention, as I know has happened in similar threads.)

[FolksBtrippin, BSN, RN]

Do you have information to give the BON? It doesn't sound to me like you do, since you have cut off contact with her. It sounds like her parents are telling you all of this. Have you advised them to report her to the BON?

You are well within your rights to end your friendship with her, and have no contact. But you must understand that this means you are no longer in a position to know anything about her firsthand. Thus, you are not in a position to report her to the BON. People who have actual contact with her know better than you what the situation is, if she is as bad as you think, it will come to light.

Removing contact is not for the addict. That is a misconception. Addicts do not have better success rates when their friends and family pull away and have nothing to do with them. No contact is for the friends and family who feel they need to protect themselves from the tornado that addicts create in life. You may need to pull away from her parents as well.

[caliotter3]

If it bothers you as much as you say in your post, then turn her in. It is only a matter of time before she implodes anyway, but you might be helping someone to avoid a tragedy.

[~Mi Vida Loca~RN, ASN, RN]

This is a really really tough situation to be in. I wonder if it should go into the recovery forum because I would like to hear what some of our recovering addicts have to say. I know some feel that getting reported felt like it saved their life even though they didn't feel that way at the time. I also know that there are a lot of grey areas to these situations. I don't feel you should get DCS involved, not if you have seen no signs of neglect or abuse. If she is reported and has to go through the whole process again, that will be enough hoops to jump through on it's own. But I don't think having the threat of her child taken away will be of any help. Again I am only saying that if you have no knowledge of any abuse or neglect going on.

I know in my state NP's seem to have a much easier time if they get in trouble for diverting or using. Because here the Medical Board also still has authority over NP's and so it's more complicated when it comes to disciplinary actions. The BON is in the process of changing it so the BON is the only body over them. I guess we are one of the few left. Maybe 10 states?? I think is what I read.

But I know a NP right now that I am about 99.99% positive she is using narcotics and alcohol. She was recently convicted of 2 DUI's and allegedly the BON told her to just make sure she reports those on her Lic. Renewal. She was arrested 8 years ago for stealing narcotics from work as a NP When shipments came in she paid for some of the deliveries with her own credit card and they raided her home and found them. Large quantities. She was charged with trafficking. Took a 2 year deal for first time offenders and did probation and eventually dismissed. Her only punishment from the BON was 1 year of suspension of prescribing controlled substances and she had to see one of the approved addictionologist. She bragged that the $550 she paid to see him was worth it. That it was 15 mins and he stated she wasn't an addict.

That was it. No years of drug screenings, no treatment, no meetings. Nothing and the BON in my state is known as one of the hardest on it's nurses. Had she been only an RN her punishment would have been a lot more severe and now she is in trouble again, but not with the BON. It's crazy to me because I have talked with another nurse that was caught with an unprescribed benzos in her system, she recently lost a child and her mom had been given her xanax (wrong yes) and she has spent over 10 thousand dollars so far on all the requirements and she will be jumping through hoops and doing all this for 3-5 years.

[Anonymous865]

Of course you need to report this NP to the BON.

Evidence of relapse:

1. The NP admitted to the OP that they were using again.

2. The NP's parents told the OP that the NP was using again at a much higher rate than before.

3. The NPT told OP that s/he would get help but has not.

4. The NP has committed multiple crimes to support her habit (breaking into the NP's parent's home, stealing from the NP's parents, stealing from the NP's friends)

5. S/he has signs of addiction (unable to hold a steady job, stealing, calling 10 times in a 30 minute period trying to get money from OP)

If this were an airline pilot, you would report them without a second thought.

If this were a school bus driver, you would report them without a second thought.

Why do you hesitate because this is a NP? Doesn't an impaired NP put people's lives in danger?

Do the right thing. Don't wait for someone else to do it. Don't wait for the NP to kill a patient or themselves.

Get the NP to self report (make sure the do), or you report them.

[~Mi Vida Loca~RN, ASN, RN]

Of course you need to report this NP to the BON.

Evidence of relapse:

1. The NP admitted to the OP that they were using again.

2. The NP's parents told the OP that the NP was using again at a much higher rate than before.

3. The NPT told OP that s/he would get help but has not.

4. The NP has committed multiple crimes to support her habit (breaking into the NP's parent's home, stealing from the NP's parents, stealing from the NP's friends)

5. S/he has signs of addiction (unable to hold a steady job, stealing, calling 10 times in a 30 minute period trying to get money from OP)

If this were an airline pilot, you would report them without a second thought.

If this were a school bus driver, you would report them without a second thought.

Why do you hesitate because this is a NP? Doesn't an impaired NP put people's lives in danger?

Do the right thing. Don't wait for someone else to do it. Don't wait for the NP to kill a patient or themselves.

Get the NP to self report (make sure the do), or you report them.

I took them as being hesitant more because of their history and friendship (which would make it a hard situation for most), not so much because they were an NP.

I would be more on the lines of confronting them and giving them the option of self reporting first.

[Orca, ADN, ASN, RN]

You have more than enough evidence to report this to the board, and IMO you would be doing the people she is in contact with a great disservice if you don't. In reporting, I always refer to Joe Friday's old line from Dragnet, "Just the facts, ma'am." Tell them exactly what you said in your opening post: Your personal observations indicate evidence of substance abuse (you can describe what they have been), she has admitted renewed substance abuse to you, she has told you that she will not seek treatment on her own, her parents have shared their observations, and you know of her past history of the same behavior. The board has investigators to sort fact from hearsay.

[perfectbluebuildings, BSN, RN]

Thank you all for your objective perspectives and understanding. I'm going to speak with another friend of mine who also knows the situation and hasn't completely cut off contact with this person. Just to discuss thoughts/options; maybe ask this mutual friend to tell her that there's a possibility someone will report her to the BON because of her behavior, and then if she's not willing to self-report at that point, take as much information I have and make the report myself. Once again thank you all. Sorry it took me so long to reply.