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self reporting, questions/concerns


Hello everyone,

I'm new to posting to allnurses, but have been browsing this site since the beginning of nursing school. That was when passing the nclex and getting through clinicals was my main concern. Well now that that's out of the way, I'm a new grad and have been an RN for 8 months now, working on a med-surg floor. The reason I am posting here is because I've been battling with addiction problems since highschool. I drink socially and would smoke marijuana socially as well. But my main problem has been with opiates. It has gotten to the point where it was no longer on the weekends or here and there, but I began to use everyday and became physically dependent on them. Recognizing I had a problem, I decided to seek help with a treatment program. Like I said I decided to get help before my addiction caused me to divert meds or fail any random drug screens at my place of employment. BUT, when I went to be evaluated by the doctor he told me "we are going to detox you and get you better..then I want you to self report to a monitoring program. If you don't self report then I will have to." Immediately I broke down. all I could think about was all the hard work I put in to become an RN and hoe I don't want to lose my license. Long story short..I do realize I need the tx but I feel like once I'm sober and in recovery being monitored by an MD why wouldI have to self report? I feel like it is self incriminating. From the posts that I have read, these monitoring programs seem to take over your life, no vacations, checking in everyday to take a drug. screen and not to mention $thousands of dollars. I'm just overwhelemed by all this information. Any advice would greatly help. Thank you

wish_me_luck, BSN, RN

Has 6 years experience.

sweet, they have a duty to report any healthcare provider that is receiving mental health treatment, addiction/dependency treatment, etc. This is why I went ahead and disclosed on my application for my license. You back yourself into a corner of not being able to get help if you don't disclose. If you don't disclose and then seek treatment (I guess that's your situation; did you have a drug addiction when you filled out your application for licensure/did they ask about drug issues?), then you not only get put into the monitoring program; but, you run the risk of penalties from the Board for lying.

I am not sure where you are and what Board you are dealing with, but the monitoring program that I am in is not too bad *knock on wood--now that I have said that, it might be*. I do not spend every waking moment dealing with my monitoring program. The cost for drug screens is about $1700-$1800 a year. You can go on vacation--you just have to find a testing place where you go or they test you by other means if they agree not to while you are on vacation. I check in first thing in the morning, if selected, I go right then and there. So, I get it over with--check in takes a minute; the UDS and driving there actually only takes me about 30 minutes or less.

Are you a good employee? Is your manager understanding? Some monitoring programs let you continue working, others make you wait a period of time before looking for work. Your employer will have to know you are in a monitoring program though.

Good luck.

Thanks for responding wish_me_luck. I live in nj by the way. I have been a good employee *thus far* :\ with no disciplinary actions against me. And my manager is understanding from what I've gathered. It's hard working nights cause you don't get a chance to really form a bond with management, bosses, etc. I just thought looking into tx options would be confidential, but I guess all that goes out the window once you're a health care provider. I just WISHED I looked into this more before I sought out help. Now I'm more depressed than I ever was :(

wish_me_luck, BSN, RN

Has 6 years experience.

See if you can move to days because if you do have to do a monitoring program, most, if not all programs will not let you work nights. The reason being that there's less people and it would be easier to divert (I know you didn't divert, but that's just what these monitoring programs require for that reason); usually, you can't carry the narcotic keys; some, if not all, states you have to have x period of time before being able to give a narcotic (usually, if you are in a hospital setting and there's an LPN; then, get them to give your PO narcotic and you do something IV wise for them. For the PCA pumps and such, get your charge nurse or upper person--some places have a med surg advocate, which would be an alternative option to give them). You can't do home health, usually, for a certain period of time--typically, I think it is as long as you have a narcotic restriction. Same reason you can't do nights--because no one is there to supervise you.

Do a search for threads about NJ's monitoring program; people in NJ or who have lived in NJ would better be able to advise you as to specifics for that state.


Specializes in ER, Psych. Has 3 years experience.

I'm in the monitoring program in PA (PNAP) and I can work nights. I'm also the charge nurse so I have the narcotic keys my whole shift. I only had a six month narcotic restriction. Every state's monitoring system is different. As is every licensing board. The best way to get your questions answered is by talking to someone in the RAMP program. That is NJ monitoring program. Best of luck. I have a year in already and I have nothing bad to say about PNAP. So grateful for the second chance.

Thank you guys so much for the information and sharing with me your stories. I know every state is different but it's nice to get a sense of what i'll be dealing with. I didn't find many threads on here about RAMP but I have already looked into NJ's professional monitoring program (PAP) and found some good information. First amd foremost I'm just working on my sobriety and just hoping that everything will fall into place.


Specializes in ER, Psych. Has 3 years experience.

It will all fall into place. Last year at this time I lost my job, was reported to the BON and self reported to PNAP then signed myself into rehab.

I was terrified, alone and so scared. I had no idea what was going to happen to me or my license. It was all out of my control. The only thing that was in my control was my sobriety. So I dove head first into recovery. 90/90, sponsor, home group, got involved with service and didn't pick up a drink or a drug no matter what.

A year later, my license remains active, I was offered a full time charge nurse position as soon as I was released to go back to work, and my life has greatly improved since being in recovery.

Everything works itself out as long as we stay sober and keep doing the next right thing. :)

lmccrn62, MSN, RN

Specializes in Pain, critical care, administration, med.

I just want to say god bless you and your desire to get clean. I have a son that is not a nurse who has been dealing with opiated addiction. I am proud to say he has been clean for 3 years. It's best to seek help then to be caught. Do what you need to do for yourself. Nursing takes a lot out of you and a clean stronger you will make for a better nurse. I wish you the best in your journey.


Has 10 years experience.

I had always wished I had just tried to "get clean" on my own, without telling my employer or reporting to the BON, but in honesty I don't think I'd have been able to do it...and my problem was not "that bad." It's the mandatory UAs that really keep me clean in all this, though I can say with confidence that enough time has gone by (3+ years) that I FINALLY feel capable of staving off urges on my own.

I just had no willpower. It is REBT that has really saved me in all this. I now know that urges will not drive me crazy, that I don't have to give in to an urge to make it stop, that the bandaid solution of giving in to a craving in order to stop the twinge of boredom, stress, or whatever it is that's driving me to use is nothing but self-destructive in the long term. I could not have done it without my peer assistance program. If you can get through it without getting fired, and keep your status in the program between yourself and your nurse manager, you are only trading the costs of the program for a new lease on life and ideally won't have to go through losing your job history, your good name in your medical community, your professional integrity, etc. Worth every penny.

The UA's really are a solid road block for me as well. I think that if hospitals had random daily/weekly/monthly UA's it would help a great deal with things. I too wished I could've went a more career preserving route, but in the end I am a much more humbled person! No matter which way it happens, at least it's happening and we are clean and sober. Wishing you the best!