Texas BON mental health question. To disclose or not disclose?

Davey Do · Jun 10, 2019

1 hour ago, Mortaaaay said:
I want to check no because it never affected me and I’ve never been hospitalized for psych stuff at all.

I truly appreciate your candor and approach to dealing with your situation Mortaaaay, facing your pain, seeking assistance, and gathering more information.

I cannot give you a definitive answer but can impart some information which may help you make a decision.

First, as you probably know, if anyone seeks services from a health provider, they must have a diagnosis on which to bill for those services. Perhaps at the time of your assessment, you manifested symptoms relative to a diagnosis of bipolar. Lamictal is, among other things, a mood stabilizer.

Next, a rule of thumb is that if a condition does not affect your health, relationships, or your job, it isn't a problem. It sounds as though you're appropriately reacting to stress. It's okay (in a sense of right and wrong) to feel depressed, experience insomnia and anhedonia after a major life event.

Your coping mechanisms are impressively healthy- e.g. deep breathing and exercise- and you are a highly functioning, contributing member of society. I truly doff my proverbial hat to you.

My vote is that you make this decision with whatever gives you comfort.

Good luck and the very best to you Mortaaaay!

Mortaaaay · Jun 10, 2019

6 minutes ago, Davey Do said:
I truly appreciate your candor and approach to dealing with your situation Mortaaaay, facing your pain, seeking assistance, and gathering more information.
I cannot give you a definitive answer but can impart some information which may help you make a decision.
First, as you probably know, if anyone seeks services from a health provider, they must have a diagnosis on which to bill for those services. Perhaps at the time of your assessment, you manifested symptoms relative to a diagnosis of bipolar. Lamictal is, among other things, a mood stabilizer.
Next, a rule of thumb is that if a condition does not affect your health, relationships, or your job, it isn't a problem. It sounds as though you're appropriately reacting to stress. It's okay (in a sense of right and wrong) to feel depressed, experience insomnia and anhedonia after a major life event.
Your coping mechanisms are impressively healthy- e.g. deep breathing and exercise- and you are a highly functioning, contributing member of society. I truly doff my proverbial hat to you.
My vote is that you make this decision with whatever gives you comfort.
Good luck and the very best to you Mortaaaay!

Additionally, I did not use insurance to pay for my visits at this facility. They did not accept my insurance so I paid out of pocket

Davey Do · Jun 10, 2019

If you don't want to report your diagnosis, Motaaaay, it'e perfectly understandable, as a mental illness diagnosis carries with it a stigma.

After rereading your initial post, I believe I would feel comfortable answering "no" since your diagnosis has not “impaired or does impair your behavior, judgement, or ability to function in school or work.”

I sense that's the way you're leading, eh?

Jory, MSN, APRN, CNM · Jun 10, 2019

Normally, I would never advocate not disclosing the truth on an application, but a big middle finger to any BON that has that question on their forms.

Answer no and move on. They don't have access to your medical records.

Mental illness is like any other illness and people have a right to be treated. They also have a right to privacy.

guest974915 · Jun 10, 2019

Wow, just wow! I have been licensed in numerous states (never Texas) and am just appalled that this question is asked of applicants. What a slippery slope! Why not inquire as to nurses' BMI, COPD, or arthritis? All of these conditions might impair their abilities to effectively respond in a code situation. Divorces? Bankruptcies or financial problems? Those could be grounds for moral turpitude and irresponsibility. The list could go on an on....Very intrusive to say the least!

Closed Account 12345 · Jun 10, 2019

https://www.bon.texas.gov/licensure_eligibility.asp

I think I would have your provider issue a written statement indicating that your condition has never impaired your behavior, judgment, and ability to practice as an RN and does not currently pose any threat of doing so. In that case, I think you could honestly answer "no" because of TBON's wording.

Without that, I'd encourage truth telling in all BON matters.

Your NP can't disclose your diagnosis. Nurse-patients are entitled to HIPAA protections, too.

Mortaaaay · Jun 10, 2019

38 minutes ago, FacultyRN said:
https://www.bon.texas.gov/licensure_eligibility.asp
I think I would have your provider issue a written statement indicating that your condition has never impaired your behavior, judgment, and ability to practice as an RN and does not currently pose any threat of doing so. In that case, I think you could honestly answer "no" because of TBON's wording.
Without that, I'd encourage truth telling in all BON matters.
Your NP can't disclose your diagnosis. Nurse-patients are entitled to HIPAA protections, too.

True. I only went twice to this psychiatrist and just went today and he didn’t rediagnose me but we were leaning in the direction of me having anxiety from my personality and how stressful the job can be at times. I dunno how confidently they can say I can safely perform my job because they don’t know me that well. I’ve neevr been hospitalized or taken off work because of mental health issues. No one at work hasn’t mentioned me acting erratic of anything. They mainly tell me to stop stressing because I overthink things because I absolutely do not want my patient to die

FolksBtrippin, BSN, RN · Jun 10, 2019

No one is going to find out unless you tell them.

KCMnurse, BSN, MSN, RN · Jun 12, 2019

It is so sad that as nurses we are concerned that our healthcare provider will not protect our privacy. You are entitled to the same privacy protections as your patient and your provider cannot share your information without a subpoena or other legal request.

Based on your post I think you can safely say 'no' to this question as you are managing your anxiety and stress well. It is not interfering with your ability to perform your job safely. It is perfectly normal not to want your patient to die.

In my humble opinion, the BON is overstepping in asking this question, and just as another poster stated its a slippery slope to further intrusion into our private lives.

Orion81RN · Jun 12, 2019

On 6/10/2019 at 3:39 AM, Mortaaaay said:
So, last hear I went through a horrible breakup and was very stressed about my new job. I have terrible PMS and got very anxious and restless around the time of my period and then would be content and happy during the times I don’t have my period. I have always had trouble sleeping but it got worse when I broke up with my ex and I had a tendency to obsess about my ex and wasn’t able to sleep as well as I normally do (we dated for seven years and almost got married and he left me for another woman) and I needed sleeping meds. I also would have racing thoughts and I would get so exhausted I would sleep for 16 hours.
So, I went to the psychiatrist and she said I had bipolar disorder and put me on lamictal. I really disliked the medication as I just was tired and after working on myself and ridding myself of my partner and building a better life for myself I have learned that I was anxious in general (which I deal with by exercising and breathing exercises) and probably get depressed at times because of life and my job (I work nights and sleep tons on my days off).
I didn’t go back to the doctor after the first three times and literally I have never done anything reckless with my life or missed work or made mistakes because of this.
So I’m renewing my license and it asks about being diagnosed with various psych disorders (bipolar disorder being one of them) “which impaired or does impair your behavior, judgement, or ability to function in school or work.”
I want to check no because it never affected me and I’ve never been hospitalized for psych stuff at all.
Could the board find out or could I face legal repercussions from this?
Also, what happens if I put yes on this question?
should I go back to her and get re-diagnosed?
My NP asked me what I did and I told her I was a nurse and she asked where I worked and I told her just thinking she was making small talk. I am nervous she has told people about what we discussed and if we know anyone who works with me and that she may tell the board. I should have never received treatment or told her anything truthful about me. If only I had remembered this question on the renewal.

I know I'm treading on territory that isn't exactly per TOS, but I don't care. I have to say it. Those with PMDD (IF you have that) have been known to be misdiagnosed with bipolar disorder. I'm not saying you WERE misdiagnosed. But I'd see someone intimately familiar with PMS and PMDD and go from there. This topic is too aggravating of a topic for me to ignore as I have personal experience with PMDD.

Xoeie · Jun 13, 2019

This situation is very similar to mine, At the time I lost my child, mother, and closest uncle, in a auto accident. I lost myself, eventually I got help for my depression. About 8 months passed, it was time to renew my license,I answered yes to the question. Texas BON made me do 2.5 years of TPAPN. If you're not familiar with with the program, it's hell. Got re-evaled with their providers, twice as a matter of fact, they didn't believe the first provider reporting I did not have a substance abuse issue, but in light of what had happened they world be more afraid if I was not depressed. Bit was managing myself very well.As a result of being referred to the program I lost my job of 8 years,since it was not"approved" since I handled narcotics. Even though my employment did a statement, that they were not concerned with putting patients at risk, or my job performance. I could no longer take my anti depression medication, (or hands sanitizer) while on the program.My advice answer no.