Reporting to BON

solarex · Aug 5, 2022

No, if someone has had No issues at work in which your workplace, boss, human resources has not reported this person to the Board, but the person has a substance abuse issue in which their work or board isn't aware of, but that person is seeing a mental health professional, then that mental health professional by law can NOT contact the board about the person's condition. That'a a HIPPA violation. Now......once the board gets involved and is aware, everything changes.

solarex · Aug 5, 2022

Here is where things get sticky. If a person has not been reported to the Board and there are no known workplace issues, and the person is seeking a mental health professional on the side for substance abuse issues, then again, that mental health professional can not and will not tell the Board about a private citizen getting help, for this would be a HIPPA violation if it occured.

But, lets say a person has been seeing that mental health professional for 6 months or 1 year, and then an issue comes up at work in which the Board opens an investigation due to some kind of complaint from work, eventually....in order for that nurse to work as a nurse, the Board will have that person agree to see all mental health professionals that the person is seeing or has seen, and if the person doesn't agree to it, then he or she will not practice. The Board will then be able to look back and see that the nurse has had a substance abuse issue from the records for 6 months or a year, etc.

Yes, an attorney can initially block the board from getting the records and will tell the nurse to not agree to the Board seeing the records, but the Board will simply not let the nurse practice until that nurse agrees to do so. The bottom line is......if a nurse has a known substance abuse issue that the workplace and board is not aware of and the nurse is seeing a mental health professional on the side, this is a good thing, but the nurse better make sure they get it right. They better be dang sure they get the substance abuse issue resolved and never had a workplace/board investigation come up; otherwise, sooner or later, whether 2 months or 2 years, the Board will be able to access those mental health records if the nurse wants to practice nursing again. So, put 100% effort into getting the substance abuse issue fixed while the chance is there without the Board involved.

allnurses Guide · Aug 8, 2022

There are also exclusions written into HIPAA that allow a medical/mental health provider to report a p[atient if they feel that the person's substance abuse poses a danger to others.

Hppy

solarex · Aug 8, 2022

1 hour ago, hppygr8ful said:

There are also exclusions written into HIPAA that allow a medical/mental health provider to report a p[atient if they feel that the person's substance abuse poses a danger to others.

Hppy

Very true. Historically by Court precedent and case law, if a nurse is voluntarily seeking help from a mental health professional and going on his or her volition without being mandated by the Board or a monitoring program, that is seen as a major positive and progression and will not be reported. Additionally, if going to a therapist, be open in stating you use and what you use, but you do not have to disclose your source of use. The therapist needs to know you have a substance abuse problem and that guides the treatment and therapy. If you have diverted from work, there is no point is saying that.

allnurses Guide · Aug 8, 2022

9 hours ago, solarex said:

Very true. Historically by Court precedent and case law, if a nurse is voluntarily seeking help from a mental health professional and going on his or her volition without being mandated by the Board or a monitoring program, that is seen as a major positive and progression and will not be reported. Additionally, if going to a therapist, be open in stating you use and what you use, but you do not have to disclose your source of use. The therapist needs to know you have a substance abuse problem and that guides the treatment and therapy. If you have diverted from work, there is no point is saying that.

I was more thinking abou a scenario where a nurse presents for out patient treatment and tells therapist that they take breaks in their car so they can have a quick drink or they frequently drive under the influence the therapist can legally report to the police or the BON without fear of a HIPAA violation

solarex · Aug 9, 2022

3 hours ago, hppygr8ful said:

I was more thinking abou a scenario where a nurse presents for out patient treatment and tells therapist that they take breaks in their car so they can have a quick drink or they frequently drive under the influence the therapist can legally report to the police or the BON without fear of a HIPAA violation

And you are correct 100%. Here is the thing though, one wouldn't need to worry about police. Because you tell a therapist you frequently drive drunk will not get a police call because police need you to be drunk driving the car to convict you, otherwise, every AA member of every meeting in the USA would have law enforcement at their homes. The concern is the obvious elephant in the room and that is....patient care. If you tell a therapist you are providing patient care drunk or high, then that can get a report to the Board without fear of HIPPA violation by the therapist.

What I recommend for any nurse seeking outpatient therapy with a substance abuse or alcohol problem that has used or sometimes uses/under the influence while providing patient care is....

1. Stop, go immediately to rehab, and rehab has a definition to it. It is simply Not 1 or 2 weeks in a dry out ward. Think more like....12 weeks and more on that below to truly call it "rehab."

2. If you will not go to rehab and want to pursue the outpatient therapy thing, STOP using at work obviously, but tell the therapist you have a substance use problem and never discuss your use at work. If you are asked directly, you simply say that you do not feel comfortable discussing that, and this statement is more than enough to protect you from a therapist contacting the Board as you have not admitted to using while providing patient care and it takes a full-absolute admitting of your own words saying that in order for a therapist to confirm it and report it. You would have to literally say the words. A therapist can not "reasonably deduce" that you are likely using at work, so they report you. It doesn't work like that and it can't be vague. You would literally need to say the exact words in order for a therapist to be exempt of HIPPA and report it, and trust me, they always error on the side of HIPPA, and most would not report it anyway, even if you admitted to it, but some would, and you wouldn't want to take that chance.

3. The therapist obviously needs to know that you have a substance/alcohol problem of which you are there for, and the amount you use per day, and that is it. The therapy for your treatment can be guided from there. You do not go into details about using at work and if asked, you simply say I do not wish to talk about that, and you will be fine 100% of the time.

4. From a recovery perspective, if you are a nurse who uses at work, then your addiction is way, way, way beyond a successful treatment with only psychotherapy/outpatient therapist. You need to immediately and absolutely ensure you complete a 6 week partial hospitalization program PHP followed by a 6 week intense outpatient program (IOP). Your odds of beating the addiction with only an outpatient therapist and not completing the PHP and IOP part are not zero, but they are less than 1% according to the studies. If you are addicted enough (and I was) to where you divert at work, or you use at work or in the parking lot at lunch, you are LITERALLY pissing in the wind by trying to overcome your addiction with only outpatient therapy once per week. It will not work and the data shows that.

5. How many people that divert from work or use in the parking lot at lunch that do not Yet choose to go to rehab (PHP and IOP-12 weeks) believe that they are that 1% that will beat and "tackle" their addiction with only outpatient therapy? Nearly 100% of them reading is believe it. I know that I did. This is what makes substance abuse/addiction (alcohol and drugs) so deadly. Notice I used the word "Yet" regarding your choice to go to rehab in line 2 of this paragraph. You can make that choice now on your own and avoid the State Board, or 99% of the time as the numbers show, the State Board will make that choice for you because you have a 1% chance of beating addiction without true rehab which is 6 weeks of PHP and 6 weeks of IOP (12 weeks total) and if you keep working in nursing, you will get caught because you can't stop without completing rehab. It's not quite mathematically impossible to stop with only outpatient therapy once per week, but it's very close.

A good outlook....if you do a 6 week PHP where you stay at the facility, then you come home and do IOP which is 6 weeks total by zoom meetings which are 9 total hours per week for 6 weeks, and you then do an Aftercare program which is 1 meeting per week for 1 hour for 52 meetings total (1 year) and during this time, you ALWAYS attend a minimum of 2 recovery meetings weekly be it AA, Celebrate Recovery, NA, or SMART recovery, and you do those 2 meetings weekly for 5 years, your chances of relapse are 9%. 9 out of 100. The chances of any nurse who has never used has a 1 in 10 chance of having a Substance A use problem of 10% in the future, so if you follow the steps above, after 5 years, your chances of reuse are LESS than all other nurse who have never used!

Check this out...if you are 3 years into it and you decide you only need 1 meeting in recovery per week instead of 2, and you regularly only attend 1, then your risk for relapse goes to 75%. If you attend zero meetings per week, your risk goes to 88%. There is a proven, statistically step by step process for recovery that is proven and does work, as long as you comply. If you shortchange on any of these steps, relapse rate skyrocketd.