To Anyone Who Will Listen

[MJAJKJ]

I tell this story to as many people as possible.  I'm in Arizona but I would bet nursing boards in other states have the same unchecked authority.  A lot happened but I will keep this as short as possible.  From 2015 to 2018 I did complete a Alternative to Discipline program with no missteps.

April 2019 I was working in the ER and was called into managers office because I had not documented a Fentanyl.  I asked the doc for the order which they gave verbally, but did not write the order.  The manager questioned me about this and I told them I did speak to the doctor.  My manager said they spoke with the the doctor too, but had to discuss with me as well.  He said in no way did he think I was diverting, but if I had any other issues I would have to drug test.  I said no problem.  Fast forward 6 months and I show up for work at 6am and Im back with manager for fentanyl vials that had been opened and returned to med machine.  My name was on the machines print out and I did nothing so I said send me for my drug screen right now.  My test was negative, I was fired a little over a week later.  I took a travel job and continued on.  

One day I get a detectives business card on my front door from the area where I was working.  I found this strange so I said screw it, Ill get an attourney.  I told him everything above and he already had the negative random drug test so suggested a polygraph test.  I was happy he brought that up and I said where and when.  The polygraph determine I was honest so the attourney said he would talk to detective and handle that.  Last I spoke to him he said the detective wasnt giving him much and he said that was a little unusual, but my drug test was negative and I had passed polygraph, so from that perspective, nothing to really worry about.  Almost two months from when I was let go, the nursing board wanted to send me for a hair follicle test. I was sent an email with instructions to call a third party administrator, recoverytrek, to set up my drug screen.  At my expense of course.  I was starting the travel job (important fact for later) the next week, so I reached out to my attourney and said let the board know I will take it after the first paycheck, which was one week later.  Certainly within the 90 day test range of hair follicle tests.  A different lawyer responded to me, a lady, and said she would let them know.  Well, this new lady decided to tell the board I hadnt been working and would need 2-3 weeks before I would take the test.  Sounds a lot more suspicious.  I was (still am) furious.  So the board then sends an official order for me to get the hair test, and also stated on the order I had already missed the date for my hair test.  Wait....WOW!?  The email they sent me had no dates on it....and it was an email.  The board NEVER sent an official order for me to test.  Never. It was just the email.  So I checked the boards website and the order requiring me to test that also stated I missed my test date is on there, but no original order with the date they said I had missed.  If I had an order with a specific deadline, where was it?  The order saying I missed the date was there, but where was the order with the date?  Jerks just made that up.  Literally made it up.  I never got a deadline.  I reached out to them through my lawyer.  Oh, the new deadline they gave me was within my one week I said I would take the test.  It was deliberately deceitful and, in my opinion, was an attempt to make me look dishonest.  So I take my hait test and wait for the result, I waited over 3 weeks for it to result.  Strange for two reasons.  First, they do not take anywhere near that long.  Second, I take adderall so I should have been contacted by a Medical Review Officer (MRO) so I could provide my prescriptions for the stimulants.  During the wait, I reached out to the testing company to find out what was up and why I had not heared from the MRO.  The rep at the company said I had to get my results from the third party agency.  More suspiciously, the rep also told me they do not use an MRO to verify drug testing results.  That's right nurses, my hair test was sent to a company that would not use a MRO to verify the validity of positive hair tests.  So a hair test that would result in 5 days or less I wait over 3 weeks to result, and it was sent to a lab with no MRO.  And can you believe, I was at an airport in LA when I get a voicemail from the attourney who had sent the email requesting a 2-3 weeks for my hair test.  She said the test came back positive for fentanyl.  Imagine that.  The test that took over 3 weeks to result and was not reviewed by a MRO was positive.  So now I'm extremely anxious and even more pissed off.  But there is an important little nugget about that hair test.  It was positive for fentanyl, and nothing else. Where are the metabolites for my prescribed stimulants.  100% of the drug screens I have taken while on adderal I have spoken to an MRO, except this one.  Why was I sent to a lab without an MRO, and why did it take to long for my test to come back.  When I saw the positive fentanyl report, it showed it took 4 days for the test to result.  4 days!!!  I wasnt informed for over 3 weeks.  Could it be they suspected the test was false because my prescribed medications were not present?  Because if I had that information within 4 days I would have taken a second hair test right away.  Which I did, but now its 3 weeks later. The test came back positive for my prescribed meds but no fentanyl.  An argument could be made that if I had done anything wrong, the 3 weeks between hair tests would be enough for any substances to no longer be in my hair.    But, there is this....remember the important fact from earlier?  The travel job I had started?  Well, you take drug screens for those.  The screen was fine, talked to MRO, totally routine.  Those test don't detect specifically for fentanyl, but it picked up my stimulants just fine.  While the boards hair test is questionable, this without any doubt proves their test is garbage.  I took the urine drug screen before the boards hair test and the hair test I took on my own after the boards 3 week delay in reporting the first hair test.  Both hair test fall within 90 days of when I took the urine drug screen for the travel job.  The UDS has my stimulants, verified by MRO.  All three tests should match.  All of them should have metabolites from stimulants.  The first hair test was 3 weeks closer the to UDS so that one should absolutely, without question, have stimulants detected.  But it did not. And it was unreviewed by an MRO. And the board received the results within 4 days but did not tell me for over 3 weeks.  I admit, this was starting to feel very personal, but truthfully I doubt it is.  I think the board operates on autopilot.  I had already completed a Alternative to Discipline program and my name came up again, so it felt automatic that they would go to revoke my liscence regardless of disproven drug screens and passed polygraphs.  

I later found out the gal from the attorneys office took over the case because my the attorney I first hired had passed away. I don't know the circustances and that is awful for the firm and the family.  I hiried im as after I received the business card from the detective, but I was still upset about the email the lady sent requesting a 3 week wait for my hair test, so I hired another attorney who works with nursing.  The travel job paid very well so this seemed smarter.  She called the drug screen "nonsensical."  My investigative file at the state board cannot be removed, but my attorney went there to review it and take notes.  There was not much in there not already known, but one interesting note was in there.  The investigator at the board had reviewed my pharmacy profile and saw the stimulants.  They noted in the investigative report the hair test reporting fentanyl did not detect my prescribed medicines.  So...they knew the whole time.  They KNEW the whole time.  They knew it.  Maybe thats why they waited so long to tell me about my results.  However, they did not know about the UDS I took prior to both hair tests.  This implodes everything on them, and they knew it.  My random drug screen from the job was negative, my UDS was negative, the hair test I took on my own was negative.  The ONLY thing they had was their hair test, which is unquestionably false, and they had the results for over 3 weeks and didn't tell me.  Just let me keep working.  Makes one think.  

In Arizona, if a nurse can go to a hearing with an adminstrative law judge with the board of nursing.  Its not a trial, but operates in a similar fashion.  After both sides present all their information, the Judge will make a recommendation to the board.  Yes, a recommendation.  The board can accept the recommendation, or refuse it and do whatever they want anyway.  That's too much power.  They operate 100% unchecked by anything at all.  As the date of the hearing approached, I talked a lot with my lawyer, my family, my friends, nurses I knew I met in the alternative to discipline program.  The consensus was in no way was the board not going to discipline my license in some fashion.  My attorney told me that has never happened in her experience.  So I was going to be disciplined for something I did not do and nothing happens to the board for delaying my results, not reporting my stimulants werent detected, nothing.  So everytime I apply for a job I would have to say yes to past discipline when asked while applying.  For something I did not do.  That would be a very tough pill to swallow.  And the investigation from the detective was not closed, so my attorney was worried something could be said that would harm me in that case, and she said she would never recommend risking my freedom as something like that could land me with jail time.  I asked her to send me a agreement from the board for a voluntary surrender.  There is a section called "Finding of Facts."  It will say my name, I hold license number 123, this happened on this date, and so on.  Fact for the board must be relative because my polygraph was not in there, my UDS was not in there, the FACT in the boards investigative report that my stimulants were not detected was not in there.  They pick and choose facts, omit others, and call it all the same.  I rewrote the portion about the "positive" fentanyl test to include my hair test and the UDS. My attorneys words are better than mine, this is a direct quote she sent me regarding my changes:

"They are not going to make those changes. That was the language they were willing to give me. There is no way they are going to add language that essentially admits their test should have picked up the prescribed meds."

And how can they get away with this?  Because a judge can only make a recommendation.  The board can do whatever they want, however they want, in every case, all the time.  I could not renew my travel contract because of all this, and for my lawyer to represent me it was going to cost another $4000-4500 bucks and I was already two attorneys deep in this at the end of which the board can do whatever they want.  Knowing this and my family fearing the risk of jail, perhaps wrongly, I surrendered.  I found they best job I ever had as a medical device clinical specialist.  I traveled around teaching staff to use the device and I thought my life was amazing.  I saw that job as my forever spot, I never felt that way in nursing, though I thoroughly enjoyed nursing.  You have to have vendor credentials as a med device rep, and one of the credentialing companies screens you against the OIG sanction list.  The board considers voluntary surrender discipline so my name is now on that list.  There are several credentialing companies, and of the ones I needed, only one checked that list, although initially they granted my credentials.  I was supposed to fly to San Diego to train staff there when I was informed I wasnt credentialed anymore because of the OIG list.  It was a shock with my managers and coworkers, even more so for me.  If I cant get in to all the hospitals, I cant do my job.  Despite my short time with the med device company, I was still granted a severance and have stayed in touch with the people there.  I miss them.  I miss that job.  I had the time of my life, however short it was.  But, for something I didn't do, and I did everything I could to prove that, because of the boards disregard for facts and unchecked authority, it has been hell since.  I cant find work.  I most recently applied to stock overnite at Lowe's for minimum wage and didn't even get that job.  The least desirable hours for the least amount of pay and I couldnt even land that one.  I feel like I am at some sort of breaking point.  I'm angry all the time.  I don't yell or flip out, but its always there, just below the surface, and the frustration just mounts and mounts.  I have 5 kids, no job, cant find one, on food stamps....Im just angry. So very angry.  

Living all this, I cant help but think how different it would all be if Arizona had a nurses union.  Even when I got my first job over 12 years ago, I didn't understand why a profession like nursing wouldnt have one.  But in Arizona there isn't one.  You just have the nursing board, and the nursing board is not a friend of nurses.

[Healer555]

Your story is horrible.  I'm so sorry.  I understand why you didn't continue pursuing it. However, being that you can't get a job,can you change your mind and do a monitoring agreement in one of the more benign states so you can work as a nurse? Alternatively, maybe take your story to the news media? Again, I'm so sorry. 

[MJAJKJ]

I've seriously considered media.  If nothing else, just to be a headache for the board.  I forgot the mention this my original post.  I the job I was let go from was on an Indian Reservation just south of chandler.  The detective was from their police force.  I found out later but two weeks after I was let go, there was a large drug bust on the reservation.  Which drug....fentanyl of course.  I never heard for sure, but I assume the reservation detective was looking for a possible link.  That would explain why a detective was showing up, because that felt out of place.  Thanks for the reply.  This has been a rough ride.

[Healer555]

I was wondering how the detective came into the situation. That's really messed  up. I thought I got a raw deal for getting a monitoring agreement for a SUD I don't have but your story is really tragic. Did they think you were the fentanyl dealer? Life is absolutely unfair sometimes as we know. I hope really great things start happening for you. 

[ThatLady]

I am so sorry that you have gone through this.  What a nightmare.  Wishing you all the best.

[TIMFY]

I'm a little confused about the MRO thing-monitoring (at least my program) doesn't use an MRO but they still do all of the confirmatory tests. Your case manager is the "MRO". I was taking a few different controlled substances in monitoring and the lab would do all of the confirmatory tests to find out what exactly the substance was and then report it to my case manager as "positive for fentanyl" or whatever and then my case manager would confirm my fentanyl prescription and change the status of the drug screen to "prescription positive". So I would make sure they did all of the confirmatory tests but it sounds like they did. 

[No Stars In My Eyes]

MJAJKJ-

 YIKES! This whole episode dragging on this way, with the Board obviously messing up but trying to pass it off as a fault of yours, is just unbelievable. Was somebody there doing a CYA for themselves? Sounds like it to me!  I sure would feel insane for having to 'prove' the truth to an agency that can't admit their errors. They need to change the name from Board of Nursing to something more apt. I have a suggestion, but it wouldn't pass TOS here, so let your imagination run wild as to what it might be. None of this even happened to ME, but I feel like slapping someone up-side-the-head in your behalf. I am NOT suggesting violence, but I am so appalled, that's the way I feel.

Wishing you all the best, and a spectacularly good ending to all this crap.

[MJAJKJ]

Regarding the detective, it was a shock to have that business card on my front door.   I never directly spoke to the detective.  That was when I first hired an attourney because it freaked me out.  My lawyer told me the detective said the hospital usually would handled these kind of circumstances on their own.   My lawyer told me after my polygraph and already having the negative random drug screen that I would be OK.  OF course he is speaking from a legal standpoint, not issues with my license and the board.   I forgot to include in the original post that 3 weeks after I was fired there was a large seizure of fentanyl pills in the community where I was working.  

https://www.abc15.com/news/state/gila-river-drug-bust-results-in-multiple-arrests-and-seizure-of-50k-fentanyl-pills

That is the link to the story on ABC 15, hope the link works.  You could just Google if the link fails.  Having never spoken to the detective myself, I can only assume there were involved because of this drug bust.  

[MJAJKJ]

Timfy

Regarding the MRO, I feel it was negligent to have my hair sample sent that way.  I was not in a monitoring program and did not have a case manager. This was something the board sent me to do.  As you stated, the case manager is the MRO, but I didn't have a case manager.  My sample/results where never seen by an MRO.  If you recall in the original post, my lawyer went to review the investigative file at the state board.  She took notes and told me the investigator reviewed my pharmacy profile and mentioned my prescribed medicines did not show up in my hair sample.  So the closest thing I ever got to anyone verifying that test was the investigator at the board. The investigator was the closest thing I ever had to a MRO. Hardly a neutral party. Its exceedingly frustrating.  As far as confirmatory tests, I am not familiar with that process.  I don't know how or if that was done on my hair sample.  

[Nursekat22]

Is it possible the board drug test was of the wrong patient? I feel like the lab should be asked about any error 

[MJAJKJ]

Nursekat22 said:

Is it possible the board drug test was of the wrong patient? I feel like the lab should be asked about any error 

Its definitely possible.  I thought maybe they detected my stimulants but accidentally reported it something else.  But I would think the detection values would be different, so I don't know.  What I know is the test was never reviewed by anyone except the freaking state board.  If a MRO would have called me I would have told them I take stimulants and this test did not detect them.  Maybe he invalidates the test, I retake it and all is good but the state board sent me to test where that was not even a possibility.