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Would you tell the BON about brief relapse?

Recovery   (9,646 Views | 58 Replies)

LilRedRN1973 has 8 years experience and specializes in ICU, psych, corrections.

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This isn't my area of expertise but:

You really consider 2 months of abusing oxycodone a "slip up" and not a "relapse"? Diverting her husband's meds from a lockbox for a number of weeks seems more like a relapse to me.

The OP was also taking several a day and I assume she was also working at the time?

Does that change your impression?

I also disagree that knowingly attesting to a different sobriety date is acceptable. I am willing to wager if the BON discovered this it would be reason to pull a license.

Sent from my iPhone.

It depends on the language used:

Was it two months of abusing? Or was it using the medication as directed with a slip up?

Was she working, or should we assume she was working?

These are some of the reasons I would be fearful of giving the BON a nugget of information, they can pull your license based on assumptions.

That said I am not advocating working while impaired. I am advocating for a person who has a disease to be able to manage said disease with her care team.

If she was taking a medication prescribed to her she is technically in the clear on that aspect. If the workplace monitor did not see any behavior indicating impairment then we should assume she was not impaired.

She did in fact have a relapse/slip up that she learned from- a relapse is part of recovery. I sure learned from mine- I was caught on a drug screen- luckily my BON was understanding.

This is a grey area that would be tough to call, my relapse was a sign to me that something was not right in nursing for me... For OP this might be a sign that she has to get right with her god, her spouse, or self- not necessarily the BON

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324 Posts; 9,786 Profile Views

very well said, 1sttime!! you hit the nail on the head!

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258 Posts; 3,924 Profile Views

I would never encourage lying. after all honesty helps one keep sober. However, answering only what is asked is the smartest thing. Good luck and work your program!!!!

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LilRedRN1973 has 8 years experience and specializes in ICU, psych, corrections.

1,062 Posts; 16,098 Profile Views

For OP this might be a sign that she has to get right with her god, her spouse, or self- not necessarily the BON

This.

I am also back to seeing my LADC regularly, I attended my Aftercare group and made my amends to them and I am going to be checking in with the faciliator for my old nurse support group to see what her opinion is on the matter. She has worked with the BON for years and has about 20 years of experience in working with substance abuse/nurses on contract. I do NOT consider this a slip - it is what it is. A relapse. I was prescribed the oxycodone from the ER but did end up taking my husband's after a couple of weeks. I did not take it at work but that doesn't matter as I know enough to know my thinking is impaired when I stick that crap in my body, even if it's not affecting me physiologically at the time. When I am using, I am not thinking with the head of someone in recovery.

I appreciate everyone's feedback and understand both sides of it. My Aftercare group gave me a lot to think about as did my counselor (he faciliates the group). I am looking forward to hearing what the RN's in my old nurse support group have to contribute as well as my old faciliator. I respect her very much and her guidance has never been wrong so far.

Edited by LilRedRN1973

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81 Posts; 1,735 Profile Views

It sounds like you are using the tools available to help you with your addiction. I think you're doing the right thing and confronting your issues. I'm proud of you! Hopefully this was a good wake-up call, and you won't allow yourself to fall into the trap again--remember, one is too many! If you have acute pain issues, use other people to back-stop you, to help keep you from getting sucked into using beyond your acute phase--do whatever you have to do to keep from getting drawn into the addiction cycle again! It can happen so easily--God bless, you got through this relapse without trouble, but next time...Don't let there be a next time!

As far as the Board is concerned, I know people who haven't gone through the whole monitoring thing don't understand, but if you can handle it without the Board, go ahead and do that--the Board is for work-related problems, for your "nurse-self;" if you're back with your sponsor and home group and working a good program, there is no need to bring the Board into it. Keep us posted.

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june2009 has 13 years experience and specializes in long-term-care, LTAC, PCU.

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One of our basic spiritual principles is honesty. I am shocked by the number of nurses who would not be honest. Two months of abusing oxycodone is not just a little slip. It is a full-blown relapse. Part of working a program of recovery is to accept the consequences of one's actions. I have been through my state BONs monitoring program and I know how aweful it was but OP, you made the decision to use again. Part of recovery is to accept the consequences that come with that. You said it yourself that your thinking is impaired when you "stick that crap in (your) body". It affects how you care for your patients.

Also, having no consequences makes it easier to relapse again. I can't even believe the number of posters who are encouraging this behavior.

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Tenebrae has 8 years experience as a BSN, RN and specializes in Mental Health, Gerontology, Palliative.

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Were you working?

Were patients being put at risk by you in an impaired state?

If your answer to either of those was yes, I think you need to front up and be honest with your BON

Among other things, if it comes back to them via another source, you will doubly get your butt kicked for not being up front with them.

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299 Posts; 5,100 Profile Views

One of our basic spiritual principles is honesty. I am shocked by the number of nurses who would not be honest. Two months of abusing oxycodone is not just a little slip. It is a full-blown relapse. Part of working a program of recovery is to accept the consequences of one's actions. I have been through my state BONs monitoring program and I know how aweful it was but OP, you made the decision to use again. Part of recovery is to accept the consequences that come with that. You said it yourself that your thinking is impaired when you "stick that crap in (your) body". It affects how you care for your patients.

Also, having no consequences makes it easier to relapse again. I can't even believe the number of posters who are encouraging this behavior.

I can't believe that this one issue should be dealt with by the board: Unless you have been in a monitoring program you have no idea how invasive the BON can be.

There are so many actions by nurses that should be reported to the board, but are not. Why pick this specific rule out of all the rules?

I can go down the list: Have you ever been drunk? "Using intoxicants injurious to self", Have you ever been unprofessional to other nurses? Used the internet for personal reasons while on duty? Made a mistake in medication administration?

According to the BON all of these things (and more) are breaking the code of ethics- it is taking ones mind away from work- it is creating an environment that is not conducive to patient centered care- it is making a potentially harmful mistake that the BON is not aware of...

Had I to do it all over again, I would have quit nursing on my own, gotten myself clean and moved on. The BON puts itself in-between my relationships with my MD and counselor on a "voluntarily" basis (Which is illegal). The agreement that I have is also being used in a way to keep me in an employment situation to the benefit of an employer. I am also forced to participate in a recovery program which I don't agree with, even though the BON does not by law diagnose or treat (Though they dictate what their evaluators will recommend).

Throughout history there have been casualties of unjust laws- I will stand up and say that yes- if the BON is not following the rules I do think that there should be encouragement to maintain ones dignity and privacy when it comes to a health matter.

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catmom1 is a BSN, RN and specializes in LTC, Psych, Med/Surg.

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I can't believe that this one issue should be dealt with by the board: Unless you have been in a monitoring program you have no idea how invasive the BON can be.

There are so many actions by nurses that should be reported to the board, but are not. Why pick this specific rule out of all the rules?

I can go down the list: Have you ever been drunk? "Using intoxicants injurious to self", Have you ever been unprofessional to other nurses? Used the internet for personal reasons while on duty? Made a mistake in medication administration?

According to the BON all of these things (and more) are breaking the code of ethics- it is taking ones mind away from work- it is creating an environment that is not conducive to patient centered care- it is making a potentially harmful mistake that the BON is not aware of...

Had I to do it all over again, I would have quit nursing on my own, gotten myself clean and moved on. The BON puts itself in-between my relationships with my MD and counselor on a "voluntarily" basis (Which is illegal). The agreement that I have is also being used in a way to keep me in an employment situation to the benefit of an employer. I am also forced to participate in a recovery program which I don't agree with, even though the BON does not by law diagnose or treat (Though they dictate what their evaluators will recommend).

Throughout history there have been casualties of unjust laws- I will stand up and say that yes- if the BON is not following the rules I do think that there should be encouragement to maintain ones dignity and privacy when it comes to a health matter.

1sttime, you said it all!! I have said it before and I will say it again: I am 10 plus years clean and sober very much in spite of not because of my very punitive BON that crucified me when I asked for help with my addiction.

Thank heaven I didn't allow what they did to me to completely destroy me. I am scum to them and always will be even though I toed the line and then some. The permanent black mark on my license for a first, very brief, offense is evidence of what they think of "my kind." :mad:

Catmom :paw:

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475 Posts; 7,386 Profile Views

Would I tell the BON that I had a relapse? Absolutely not!!! You had a relapse, you are not using now. Does having a relapse mean that you shouldn't be able to practice nursing? In your situation, I do not think that it constitutes that punishment! If you are stealing meds from patients, then this may be a different conversation. Being honest does not mean that you should have to bury yourself and your career if you have the situation under control.

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Mavrick has 30 years experience as a BSN, RN and specializes in 15 years in ICU, 22 years in PACU.

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What were the terms of your agreement with the BoN? If you required a certain prescription medication and took it according to the directions under medical supervision would that have been approved?

You crossed the line when you got sneaky and started taking medication not prescribed for you.

We all know holding a nursing license is a privilege that requires certain conditions be met. You took on a few additional conditions with your admitted addiction. Without facing the consequences you are a sure set-up for another relapse. The BoN is not your adversary. The close monitoring is intended to keep you honest with the threat of a removal of a privilege. A previous poster was caught with a failed drug screen not an admission of relapse.

The "falling on your sword" excuse has worked for many an addict to keep their fantasy of sobriety alive.

The full-on fear I have of what a relapse would do to me and my career has kept me clean and sober for over 25 years. I've got a few more years before I retire from nursing so I can't let my guard down now and give a disease that is always lying in wait a chance to destroy me.

Work an honest program and you will never be looking over your shoulder waiting for "the Board to find out". What happens is your house of cards and retirement plan and everything you thought you deserved is yanked away because of the mean ole BoN that gave you a second chance at having a wonderful life and career.

Edited by Mavrick

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june2009 has 13 years experience and specializes in long-term-care, LTAC, PCU.

345 Posts; 7,078 Profile Views

Maverick thank you for your response. I couldn't have said it any better!

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