Suboxone treatment

Horseshoe, BSN, RN · Feb 28, 2017

I have been an LPN for about 6 or 7 years. On my very first job, a co-worker accused me me stealing medications (I had just gotten the position she wanted, and she had also smoked marijuana with me the previous weekend). I did not take a drug test, immediately resigned. They did an internal investigation, found nothing, and dropped it.
I found another job, no problems and continued my nursing career. A few years later I did develope an opiate addiction. I didn't ever divert pain medications, never was accused of being high, but maintained my addiction.
Fast forward to last Easter Sunday. I had worked a 12 hours shift on my normal unit, and floated to another hall to do a medpass. The nurse taking over for me made me do the charting on 4 patients. I was tired and wanted to go home. Against my better judgment, I wrote down vital signs that I did not take. That nurse found out, told my DON and administrator. I admitted to it, got fired, and reported to the board of nursing. I never contacted the board, in my nativity I thought it would just blow over.

I think you mean naivete, which is entirely different. You knew you were reported to the board, but thought it "would just blow over." Yes, that is naive. Falsification of the medical record is serious to the BONs. The chart is essentially a legal document. You admitted to falsifying medical records, which in most states is a criminal offense. Most nurses completely freak out when they are reported to their BON and many of them immediately hire legal counsel. I have to wonder if your addiction clouded your judgment.

I entered suboxone treatment on my own free will in December of 2016. In January of this year I got a call from the Ohio BON regarding the vital signs. I met with the investigator, he asked if I was in treatment, I denied it. We went through with the meeting, and at the very end when I thought I was going to get away with a smack on the hand, he told me he had run an ORSA report on me, and knew about the suboxone treatment. I was shocked. I told him the truth about it, and he said I could revoke my license willingly, and enter an alternative program to get my license back with few repercussions. So I de-activated my license.
Now I am sitting here jobless, wondering if I made the right decision. I feel black balled. Besides my 1st job, where they found nothing amiss, I have never been accused of taking medications or being high on the job. The complaint had nothing to do with narcotics.
What should I have done? Did I do the right thing? I will admit it right now, I am terrible about sigoing narcotics out on the MAR. I always sign them out in the narc book of course, but I overlook the importance of the MAR, just like every other nurse. I am scared to death and I just would like some insight. I had no yet been accepted by the board into an alternative program, and truly cannot afford a lawyer

What do you mean "like every other nurse"? I can't speak for every other nurse, but narcotics or not (but ESPECIALLY with narcotics), I understand the MAR is a critical part of the chart. I feel like you've left something out here. You speak of making up vital signs and being reported to the board for it. What does that have to do with signing out narcs but neglecting your MAR?

Once you admitted to falsifying the medical record, and then to lying to the BON investigator, and subsequently admitting it after being called on your dishonesty, I'm not sure what else you could have done. You apparently didn't have malpractice insurance, so that's no help to you. It seems to me you are lucky you have any chance at all to get your license back.

You need to put your recovery as your first priority. Secondly, don't make excuses for your other behavior. Lying on this scale is usually not an isolated event. I'm thinking you probably have a history of making up vital signs or other documentation when you get "tired." I suspect maintaining your addiction has necessitated other dishonest behaviors.

I don't see anything good happening for you until you conquer your addiction. This is influencing your thinking and behavior to negative results. Once you are clean, you can begin to tackle your professional quandary. You will probably need to get another non nursing job in the meantime.

Good luck. I understand that addiction is a tough disease to fight. You will need a good support system to help you through this.

NanaPoo · Feb 28, 2017

I will admit it right now, I am terrible about sigoing narcotics out on the MAR. I always sign them out in the narc book of course, but I overlook the importance of the MAR, just like every other nurse. I am scared to death and I just would like some insight. I had no yet been accepted by the board into an alternative program, and truly cannot afford a lawyer

I'm not sure what nurses you're working with but I don't know any nurses that overlook the importance of the MAR. That's an incredibly important aspect of documenting medication administration if not THE MOST important aspect.

Your story is concerning.

ponymom · Feb 28, 2017

I personally have never worked with a nurse who ever overlooked the importance of the MAR.

As for the rest of the undertones of the story hoo boy...

Carry on...

klone, MSN, RN · Feb 28, 2017

I see a lot of concerning things in your OP, and I see very little taking of responsibility for being in the situation you are in. Hopefully substance treatment and the recovery process will give you insight into your behavior and your responsibility towards your current situation.

Been there,done that, ASN, RN · Feb 28, 2017

The big issue is not your treatment for opiate addiction, the issue is you lied to the BON. This is not being blackballed. Big brother knows everything, now you know.

You took the offer, I see no other choice. Now go through the required hoops.

You could see an attorney pro bono for a consultation. However, even the best attorney will not change the BON's decision. You must take responsibility for your actions.

Best of luck with your treatment and getting accepted to the alternative program.

KCMnurse, BSN, MSN, RN · Feb 28, 2017

You have a lot going on.

While I cannot provide you with legal advice, I would highly recommend that you seek legal counsel. The BON is not your friend and by not being honest and forthright you further compromised your situation. Asking what you should have done and if you did the right thing is now futile.

You need to look ahead and find out what your options are. Do you have malpractice insurance? If so, now is the time to use it. You do not want to face the BON on your own - they are there to protect the public not you.

Twoyearnurse · Feb 28, 2017

I had a five star review the week before I was fired for diverting narcotics from my work place. I had excellent social relationships with folks at work , my patients and their family members loved me. I was a good nurse. I did nursing well. I was also a drug addict.

There was more though. I was lazy about the MAR. Even though my coworkers never suspected (even though I never suspected) the underlying addiction impacted my practice. Three years into recovery I can see that. I can see clearly where I didn't pay enough attention, where I could have missed important details about my patients help. The vulnerable people under my care. I couldn't see it then. It took time.

Getting caught was the first step towards recovery for me. I am a better nurse for it now ( I am a great nurse :) ). The contract is a pain, but I can do it (you can too).

Your illness impacted your care whether or not you have come to grips with that. It made you lazy about the MAR. It made you make up important health information regarding a vulnerable individual under your care. It made you lie to an investigator. It has you minimizing your role in all of this even now. By minimization I mean saying that somehow because no one knew, no one has accused you recently, no one has caught you...that is addiction thinking.

I only say these things because wow... You are me back then.

You can do this. You can recover.

jackie_rn · Feb 28, 2017

Reading your ordeal I agree with two year nurse. You use language that I did at the time to attempt to minimize my role and my addiction. It can only get better from here if you get help and be honest. 4 years later I still have the addict brain... and always will. Honesty is best.

MrNurse(x2), ADN · Feb 28, 2017

I believe your "story" will be taken from here and sent to nursing schools across the country. Almost every rule that nurses follow to protect their license you violated. I suggest counseling immediately, as your personality is concerning that not one, but multiple people have had it out for you. This is either the age old blame game or you have some tendency to attract it. Your attitude towards your license is troubling, most of us value it and place it up near our relationships and belief systems in terms of importance in our lives. Smoking weed, even in states where it is legalized, is against your Nurse Practice Act, as well as being prescribed opioids, therefore you were breaking the law way before going into treatment. You can either grow from this or keep blaming, I suggest you own everything and realize that you are given a second chance and run with it. Wean yourself off the suboxone and restart.

brillohead, ADN, RN · Mar 1, 2017

Smoking weed, even in states where it is legalized, is against your Nurse Practice Act, as well as being prescribed opioids, therefore you were breaking the law way before going into treatment.

I agree with what other posters have said regarding the OP's disregard for standard nursing practices, however I have an issue with this particular statement.

Being prescribed opiates is not breaking the law / against the Nurse Practice Act!!!

BEING UNDER THE INFLUENCE while practicing as a nurse is not allowed, but simply having a prescription for pain relief is not illegal just because you have a nursing license!

allnurses Guide · Mar 1, 2017

All I can say is how proud I am of our community here of nurses in recovery. As others have said I so greatly minimized my own role in my addiction which was primarily Alcoholism. I drank for close to 30 years as a functional alcoholic and know only too well the lies we tell ourselves. I was a good nurse - I was never drunk or drank on the job - No one ever accused or suspected until one day when I become so tired of the game that I was playing that I took a near fatal overdose of Ambien, Benadryl and vodka. I should have died that day and yet here I am. Sober since 2004, working as an RN in Acute Psych and Paying it forward to those in need of recovery from addiction, depression, anxiety and other mental illness.

Definitely get a lawyer but be advised that your mal-practice may not cover this. You need a specific lawyer experienced with professional practice issues. This will cost a lot and you will be sorely taxed by the rules and restrictions of a contract with your BON.

Active addiction is like a continual nightmare where you are being chased down a long hallway by some nameless menace. Sooner or later you have to turn and face the demon that is chasing you. "More often than not you will find yourself staring into a mirror with a revolver in your hand." Stephen King wrote that in his novel "Dr Sleep" which is one of the best fictional works on addiction recovery I have ever read. I might add that Stephen K as he would be called in the rooms of AA is also in recovery.

Fear is normal in your situation. Remember that Fear stands for Face Everything And Recover. You cannot do this alone.

Today I get to be the best person I can be every day! The nurse, wife, mother, sister, auntie, and friend to others I always feared being.

You too can experience the joy that comes with living a life in recovery - It will be hard but oh so worth it.

Peace and Namaste

Hppy.