With their close proximity to narcotics, drugs, and other controlled substances, nurses are often monitored closely under the eyes of professional licensing boards so that healthcare facilities can account for every measure of medication. Colorado has a state-maintained program to protect both patients and professionals from the risk of diversion and substance abuse. Moreover, Colorado nurses—like those in other states—are under the authority of the licensing board with their own standards for the handling of drugs and narcotics. While nurses risk losing their license to practice if they struggle with substance abuse, it remains a problem for many, often originating from a single incident.
For example, nurses may be accused of diverting medication, being inebriated on the job while caring for patients, or they may be the subject of an anonymous complaint. Yet, accusations of substance abuse may have no corroborating evidence at all. However, with the pressure healthcare facilities and licensing boards are under in a time when substance abuse is prevalent in all areas of the county, nurses can be implicated by actions taken completely out of context. Therefore, any allegation needs to be regarded with the utmost seriousness, and every nurse needs to know where to turn for the best measure of defense.
Colorado's licensing board will launch an investigation into a nurse's personal and professional life to uncover any evidence of substance abuse, including digging into one's family history. Sometimes, zero-tolerance policies related to substance abuse and even failing to report others can disrupt a nurse's career in a significant way, leaving nurses unable to practice in other states. Additionally, the board has the discretion to limit a nurse's practice or suspend them altogether if it believes the public health and welfare are at risk.
Nurses in Colorado are threatened by licensing board investigations and sanctions, and they need professional assistance to maintain their credentials and reputation in the healthcare community. The Lento Law Firm Professional License Defense Team is well-known in Colorado and nationwide for defending nurses from licensing board implications. Nurses are an invaluable part of society, giving life-saving care to patients every day, and it's vital that they can continue to work free from allegations or the consequences of disciplinary actions. If you're a licensed Colorado nurse dealing with accusations of substance abuse or sanctions from the licensing board, call the Lento Law Firm now at 888-535-3686 or visit us online to schedule a consultation.
Colorado Nurse Substance Abuse Protocols
The Colorado Board of Nursing expects its licensees to act professionally in the field, which means making sure they refrain from illicit substances and not allowing alcohol or prescription drugs to affect their performance. State law asserts that the Board of Nursing has the grounds to implement disciplinary action if a licensee "excessively or habitually uses or abuses or has engaged in excessive or habitual use or abuse" of the following:
- Alcohol
- Controlled substances
- Habit-forming drugs
- Other substances defined under the Controlled Substances Act of 2013
However, the Colorado Board of Nursing can move forward with investigating a nurse for more than just excessive or habitual use of drugs and alcohol. A licensee may also commit seemingly inconsequential acts that can garner suspicion from the state board. For instance, licensing nurses may incur discipline if they fail to notify the board of the following situations that may affect their ability to practice:
- Physical illness or condition
- Behavioral health disorder
- Mental health issues
- Substance abuse
- Diversion of medication
Any number of situations can threaten a nurse's license. From taking prescriptions without notifying the proper officials, accidentally diverting medication to binge drinking on the weekend, or working with patients while recovering from a hangover, the Colorado Board of Nursing can take action. Yet, there is an outlet for nurses seeking to manage the situation they may find themselves in and receive help for substance abuse before the state board gets involved.
Colorado Peer Assistance Service
To help nurses and other healthcare professionals work through substance abuse and mental health issues, Colorado has the Peer Assistance Service (PAS). This voluntary program is designed to assist healthcare professionals, including nurses, who may struggle with substance abuse. PAS aims to provide support, intervention, and rehabilitation to ensure public safety and help professionals regain their ability to practice safely and effectively.
Once in the program, nurses undergo a comprehensive evaluation to determine the extent of substance abuse and other factors. PAS will also assist with case management and monitoring for nurses experiencing physical, emotional, and psychological problems that could result in impaired practice. Upon intake and evaluation, nurses will sign a Rehabilitation and Monitoring Contract that may include but is not limited to the following during treatment:
- Random drug testing
- Attendance at support groups and meetings
- Therapy
- Pain management, including alternative medication
- Relapse prevention programs or exercises
- Nurse practice modifications
- Further evaluations and treatment plans
The length and requirements of the program vary depending upon the individual and involvement of the Colorado Board of Nursing. While PAS is required to report a nurse to the board once they are referred—either voluntarily or from a colleague—the board is given only the assigned PAS ID number. However, the board reserves the discretion to either confidentially monitor the nurse or disclose their identity.
Admission into PAS means that a nurse cannot practice as a healthcare professional until the program determines it is safe to allow them to resume. To do so, they must adhere to all the stipulations in the signed agreement and demonstrate "evidence of rehabilitation." Nurses may also request early termination from participation in PAS after completion of a minimum of 75 percent of the period outlined in the agreement and the following other requirements:
- Have a successful evaluation from a board-approved facility or provider.
- Provide written recommendations from employers and treatment providers.
- Maintain total abstinence from all mind and mood-altering drugs, substances, and alcohol.
- Respond to all drug tests.
- Have no more than two missed calls to the drug testing service within any six-month period while participating in the program.
- Have to no more than two dilute UAs within any six-month period while participating in the program.
- Submit all reports on time for at least six months.
- Complete PAS work requirements, if applicable.
- Remain free of investigation by the board or in any other criminal matters.
The board has the discretion not to discipline a licensee if they are participating in "good faith" in PAS or any other approved program designed to end substance abuse and get a nurse realigned with regulatory policy and the needs of their practice. However, that doesn't mean nurses won't face disciplinary actions. Therefore, it's critical to understand the nuances of the board's authority and how a nurse can complete the substance abuse program while keeping their credentials intact.
The Lento Law Firm Professional License Defense Team is here to counsel Colorado nurses on navigating allegations and issues with substance abuse. You've worked tirelessly for your education, practice experience, and credentials, so you must know where to turn for the best possible outcome.
Substance Abuse Complaints
The Colorado Board of Nursing and the Nurse Practice Act compel any nurse who has knowledge of any healthcare professional's misuse of controlled substances—including diversion and abuse—to the state board or other authorities. However, allegations can come from anywhere.
Complaints regarding substance abuse can be filed by patients, colleagues, family members, or other individuals requesting to remain anonymous. The public can file a complaint to the Colorado Division of Professions and Occupations (DPO), which oversees the Board of Nursing. DPO will review the complaint information to determine if a violation of the rules occurred, which may or may not include meeting with or interviewing the licensee and the accuser.
At this stage, complaint information about a nurse remains confidential, but if it leads to formal discipline by the licensing board, then it's public knowledge and submitted to an online database. There are instances when complaints are dismissed before they get to the official investigation phase, however. For example, the following may warrant the agency deciding not to pursue formal charges:
- The complaint is outside DPO's jurisdiction.
- There is not enough evidence to support that a law, regulation, or professional practice act was violated.
DPO or the state board may decide to dismiss a case with a Confidential Letter of Concern. This means the governing body does not think that a violation occurred but is still concerned about the practice of the licensee. The letter may contain various steps the licensee can take to address specific issues.
Investigations and Hearings
When the DPO determines that it is probable that the licensee committed the violation listed in the complaint or other allegation reviewed, it's referred to the Office of Investigations. The timeframe of an investigation is unique to every case. DPO asserts that investigators make their best effort to complete the process within 180 days.
Investigators act as impartial fact finders and will contact both the licensee and the complainant for more information, including obtaining pertinent evidence, and may retain expert consultants to review the case. The investigator will then prepare a written report forwarded to the Board of Nursing for review. The board may convene a hearing panel to discuss potential actions, and if it determines there is probable cause that a violation occurred, there are a few options:
- They may impose discipline, including but not limited to a public letter of admonition, fines, probation, suspension, or license revocation.
- The case is referred to the Office of Expedited Settlement.
- Referral to the Office of the Attorney General (OAG) for further proceedings.
The expedited settlement process aims to minimize the length and cost of proceedings and levying action without litigation. This process begins with a complaint being reviewed by the board, which determines the sanction offered to the accused. If they accept the terms, the matter is then closed and processed. If no agreement can be reached, the matter is referred to the OAG for a hearing.
Colorado OAG Case Hearings
OAG hearings are overseen by an administrative law judge (ALJ), and before the hearing, both parties will attend a pre-hearing conference to discuss any settlement possibilities. Then, the nurse and their representation and the state board will exchange relevant information, documents, and evidence through a discovery process. This allows each party to understand the other's case and to prepare their arguments.
Each party has the opportunity to present evidence, witnesses, and legal arguments to support their case during proceedings. After considering the evidence and legal arguments, the ALJ issues a written decision. This decision may include findings of fact, conclusions of law, and any recommended actions, such as the following:
- Affirming the Colorado Board of Nursing's original decision
- Modifying the sanctions imposed
- Reversing the state board's decision.
The ALJ's final orders must contain a statement of the procedures and time limits for seeking recourse through administrative or judicial review. Unless a licensed nurse decides to challenge the ALJ's decision, the sanctions imposed by the board remain in effect.
Sanctions for Substance Abuse
Disciplinary action for Colorado nurses goes into effect immediately upon the board's determination of responsibility for the allegations or the ALJ's final order. The potential sanctions a nurse may face include but are not limited to the following:
- Public letter of admonition: Despite a formal letter being one of the least severe modes of discipline, it will establish a disciplinary record for licenses.
- Fines: The board may impose a fine for various rule violations. However, it may include restitution for damages to the complainant.
- License probation: Nurses are required to abide by certain conditions and restrictions of their credentials and practice for a specific amount of time—typically one year to start. This may include regular drug testing, participation in board-approved treatment programs like PAS, or other specified requirements.
- License suspension: A temporary removal of the nurse's license for a specified period, during which the nurse cannot practice in Colorado or any other state.
- License revocation: Permanent exclusion of the nurse's license in Colorado. Many times, a nurse with a license revoked in one state may not apply for a license in another state.
It's critical to understand that the specific disciplinary actions taken by the Colorado Board of Nursing depend on the individual circumstances of each case. The severity of the substance abuse, whether or not the abuse compromised patient safety, previous disciplinary history, and the nurse's cooperation with the board, PAS, and other programs, as well as others, will influence the final determination.
Consequences of Losing Your Nursing License
Losing a nursing license is a profound event that carries significant consequences, not only for the nurse involved but also for the healthcare system, patients, and the broader community. First and foremost, a nurse faces a disruption to their career and livelihood. Their license is not just a certification; it's the key that unlocks opportunities for employment and professional growth. Since Colorado is a member of the Interstate Nursing Licensure Compact, which allows nurses to practice in at least 40 other states without applying for a license, they will be banned from practicing elsewhere. Therefore, the loss of income, job security, and the professional identity that they have worked hard to establish is clear and present.
The personal and emotional toll of losing a nursing license can also be overwhelming. Many nurses are deeply committed to their profession, viewing it not just as a job but as a calling. Stripped of their ability to practice, they may grapple with the emotional impact that may extend beyond them to their families and support networks.
The impact extends beyond the individual nurse to the broader healthcare community. Patient care relies on a competent and trustworthy nursing workforce, and the revocation of a license raises questions about the nurse's ability to uphold the standards of care and ethical conduct. It erodes the public's trust in the nursing profession and the healthcare system as a whole. The loss of confidence in the integrity of nursing care can have lasting effects on patient outcomes and healthcare delivery.
Depending on the circumstances related to losing your nursing license, it may trigger legal consequences. Insofar as substance abuse is concerned, nurses may face state or federal lawsuits or criminal charges. Legal proceedings can further exacerbate the stress and anxiety experienced by the nurse, prolonging the resolution of the issues surrounding the revocation and other disciplinary actions.
Reinstating a nursing license after its loss is a challenging and often lengthy process. Even if a nurse successfully navigates the legal and regulatory hurdles, the stain on their professional record may limit future employment opportunities. Rebuilding trust with the Colorado Board of Nursing and potential employers becomes an uphill battle, and some doors that were once open may remain closed.
Even though nurses may want to abide by the will of the board, they must exercise every option of redress available. The Lento Law Firm Professional License Defense Team is an invaluable tool that ensures nurses have multiple opportunities to retain their credentials, including appealing the determinations of licensing or judicial authorities.
How Can the Lento Law Firm Help Colorado Nurses?
You may think hiring an attorney is a big step to take initially, especially if you know there are avenues of redress and programs geared toward helping nurses struggling with or accused of substance abuse. However, it's a common misconception that leaves many without the credentials they need to practice.
To promote the best outcome of your case, the Lento Law Firm Professional License Defense Team stands prepared to assert your right to fair proceedings and defend your nursing credentials. Our dedicated attorneys are well-known in Colorado and throughout the country for defending nurses and other healthcare professionals in licensing disputes related to substance abuse issues.
The Lento Law Firm Professional License Defense Team is a worthwhile investment for many reasons, like the following:
- Self-reporting to PAS: While Colorado's substance abuse program is voluntary, the state board will become aware, and they may seek disciplinary action. Let us advise you on how to proceed with obtaining help while protecting the status of your license.
- Corresponding with the Colorado Board of Nursing: When the licensing board becomes aware of substance abuse, they may propose a rehabilitation plan or alternative sanctions. Our team will step in to relay how you can approach defense against adverse action on your license.
- Protecting your due process rights: When nurses accept certain forms of discipline, including informal measures, they may waive their right to appeal. We will ensure every option for redress is available to you during every step of the process.
- Negotiating monitoring agreements: When nurses enter the PAS program, sometimes the wording of monitoring agreements can spell trouble with compliance in the future. Let us negotiate with PAS or the board to uphold your rights and advocate for a more beneficial resolution.
- Representing you in official proceedings: Whether your hearing is in front of the board, OAG, or any other body, they can have complex procedures to follow. Our attorneys will assist in the required processes—like maintaining a proper record, collecting evidence, and interviewing witnesses—that promote the best outcome in your case.
You have dedicated your life to becoming a licensed nurse and have a significant responsibility to the public as a healthcare professional. While substance abuse may breach Colorado Board of Nursing regulations, it is an on-the-job health risk that requires rehabilitation, not sanctions with long-lasting consequences.
The Lento Law Firm Professional License Defense Team is prepared to help any licensed Colorado nurse navigate complaints from the public, allegations from the board, and discipline surrounding substance abuse issues. You deserve a team that can represent you effectively, understand how the state manages nursing and license regulations, and can broker a resolution with state and judicial authorities. To gain stress-free assistance and keep your nursing credentials intact, get in touch with Lento Law Firm now by calling 888-535-3686 for help or schedule a consultation online.
