In 2021, the Journal of Nursing Regulation conducted a study known as the Nurse Worklife and Wellness Study to estimate substance abuse and related issues among registered nurses.
The study found that about 18% of the nurses screened showed signs of some sort of substance use, with just under 7% of those showing signs of a substance abuse disorder (SUD). In addition, prescription drugs were used almost twice as much as illicit drugs: 9.9% compared to 5.7%, suggesting that workplace access can be part of the problem when other factors exist.
The study also found that nurses working in home health, hospice, and nursing homes were much more likely to suffer from an SUD, and overall, female nurses were at a much higher risk than their male counterparts.
Perhaps the most disturbing acknowledgment in this study, however, is that the fear and stigma surrounding substance abuse make self-reporting hard to validate. That means that these numbers may be much more conservative than we think.
As awareness about the severity of this problem continues to grow, more and more states are seeking out better ways to help nurses get the treatment they need. One such example is the Board-sponsored “Alternative to Discipline” (ATD) programs that many states have adopted.
The problem, of course, is that ATD programs are not uniform; the terms and conditions can vary from state to state and from case to case.
That means that your livelihood could rest on the fine print of a Consent Agreement you didn't draft and a treatment program you didn't choose… so don't try to navigate this process alone. If you're a nurse accused of substance use or abuse in Minnesota, you need to call the Lento Law Firm today.
Our Professional License Defense Team has years of experience navigating the disciplinary process for medical professionals, and we can help you achieve the best possible outcome. Our law firm has worked with nurses as well as other medical professionals across the country, and we can help you, too. Contact the Lento Law Firm today at 888-535-3686, or tell us about your situation online.
How Are Nurses Regulated in Minnesota?
The United States extends regulatory authority over nurses to the individual states and legal territories. These states and territories are referred to as Nursing Regulatory Bodies (NRBs) in legislative-speak. Each NRB creates and enforces its own version of the Nurse Practice Act (NPA), and it is this document that the state uses to manage and regulate the nursing profession.
As in most states, Minnesota utilizes a Board of Nursing (Board or BON) to oversee this regulation, with support from the National Council of State Boards of Nursing (NCSBN). For incidents involving a mental illness or substance abuse disorder, the Board works in cooperation with its Health Professional Services Program (HPSP).
Who Is The NCSBN?
Because nurses are so important to our healthcare system, the state nursing boards decided it would be beneficial to pool resources and efforts. To achieve this goal, they created an additional layer of oversight and governance known as the National Council of State Boards of Nursing.
This is a not-for-profit organization that allows state BONs to compare and collaborate on the different governing concerns, such as training, examinations, and licensing. The NCSBN also makes it easy to ensure all states are using a similar set of standards. This becomes especially important as more states join the Nurse Licensure Compact (see below).
What Is the Health Professional Services Program (HPSP) In Minnesota?
The HPSP is Minnesota's ATD program. This branch of the Board focuses on health professionals with specific illnesses, such as substance abuse and mental health disorders.
The goal of the HPSP is to protect the public and “promote early intervention, diagnosis and treatment for health professionals with illnesses, and to provide monitoring services as an alternative to Board discipline.”
As we mentioned above, many states have adopted this type of ATD program because it allows the Board to act quickly, catch potential cases of abuse earlier, and offer healthcare professionals the help they need in a private and non-disciplinary manner.
Once in the program, nurses have the opportunity to address their use or disorder – through “intervention, diagnosis, treatment, and monitoring” services – without risking their license or enduring the disciplinary process.
As long as the nurse can remain sober and complete the program successfully, they can retain their license, and the SUD does not become public record.
Who Is Eligible for Help Through The HPSP?
Minnesota state law extends help through the Health Professional Services Program to a long list of healthcare professionals. These include:
● Licensed Practical Nurses (LPNs)
● Registered Nurses (RNs)
● Advanced Practice Registered Nurses (APRNs)
● Emergency medical professionals (such as technicians and paramedics
● Dieticians and nutritionists
● Chiropractors
● Dentists, dental assistants, and dental hygienists
● Optometrists
● Occupational therapists
● Podiatrists
● Nursing home administrators
● Acupuncturists
● Athletic trainers
● Respiratory care therapists
Note that this list includes professions regulated by Minnesota health licensing boards as well as some that are regulated by the Department of Health.
What Should I Expect If I Enroll in Minnesota's HPSP?
Once you contact HPSP, an assessment will be made to determine if you meet the criteria for the program.
If HPSP determines that your illness or condition qualifies for HPSP monitoring, you'll be asked to sign a “Participation Agreement.”
This is a contract, also sometimes referred to as a “consent agreement,” that explains the terms and conditions of your program. Your Participation Agreement will include:
● The amount of time you'll be enrolled in the program
● The expectations that you'll be required to meet
● The conditions/actions/behaviors that would constitute non-compliance.
It should be noted that your Board will typically be notified of non-compliance. However, if it is determined that your situation does not require HPSP participation, your case will be closed, and the Board is not notified.
Is There a Cost to Participate In HPSP?
The Board will pay for your enrollment in HPSP, but you will be responsible for any assessments, treatment, and toxicology screens if required.
The costs for these services will depend on the provider. Toxicology services can range from $20 to $70 per visit, for example, depending on your location; the cost for assessments and treatment sessions would also vary, depending on both location and the level of service needed.
What Happens If A Complaint Is Filed Against Me?
If you are accused of substance use or abuse, a member of the Board's staff will be assigned to the case, and an investigation will proceed.
You will be notified that a complaint has been filed, but this typically happens after some investigation has occurred, and the complainant's information is kept confidential at this stage. Different circumstances will obviously dictate the specific steps, but generally, the investigation will include interviews with the complainant and others aware of the incident or behavior, as well as a review of any related records, files, or documents.
Once the Board member determines that there is substantial evidence of drug use or abuse, you will be notified of the allegations and asked to provide your side of the story. This may be done via written correspondence, or you may be asked to attend a meeting.
If it's the latter, the meeting will take place before a Review Panel of Board members and staff, advised by the Assistant Attorney General.
IMPORTANT: Please do not attempt to navigate this process on your own. You are entitled to have legal counsel during this time, and it is in your best interest to have someone by your side who understands all the nuances of this review process.
The Lento Law Firm has the experience you need to defend your nursing license and protect your good name. Our Professional License Defense Team has been helping nurses across the country for many years, and we're ready to help you get the best resolution possible.
Will A Substance Abuse Complaint Affect My Multistate (Compact) Nursing License?
The Nurse Licensure Compact is a multistate agreement created by the NCSBN that gives nurses the ability to move between member states without having to obtain new, stand-alone licenses for each state.
That means that nurses can go where they are needed most, a key feature given the nursing shortage that has hit so many states.
Not all states participate in this Compact, but most do, Minnesota included. And here's why this is important:
The Compact relies on the accuracy of the licensing information being shared. It allows LPNs and RNs licensed in Minnesota to practice in other compact states without having to sit for a new license exam because the neighboring states can verify the nurses in question are licensed and not under disciplinary action.
In fact, that is the first requirement for a multistate license: you must be in “good standing” in your home state. Any disciplinary action – including substance abuse allegations – would violate that requirement.
You also can't be under any active disciplinary actions in other states; that's one of the requirements, too, so any formal actions taken against you could have a direct effect on your continued ability to practice in other states.
It's also worth noting that any non-Compact states can still access your Minnesota licensing information through Nursys, an online database managed by the NCSBN and its member boards. Nursys provides nationwide licensing verification, along with disciplinary actions and practice privileges, for LPNs, RNs, and APRNs.
Nursys can also provide status updates and license expiration alerts for nurses who sign up and can send their credentials to another Board if they want to practice in another state.
How Is an ATD Program Different From Minnesota's Disciplinary Process?
All complaints must be submitted in writing and will go through the Board. The Board will then decide whether 1) the allegations have merit and 2) they constitute a violation of the NPA.
If those two conditions are met, a Board member is assigned to the case (as mentioned above), and the investigation proceeds. The difference is in how these complaints will be resolved.
Nurses accused of substance abuse have a unique opportunity to “bypass” the disciplinary process, receive the appropriate treatment for the addiction or illness, and keep their nursing license in the process. This is all part of the ATD program and will be outlined in your Participation Agreement.
Complaints that do not go through the ATD program will proceed through normal channels, and can include hearings, formal charges, and disciplinary actions ranging from fines and mandatory monitoring or treatment to restriction, suspension and full revocation of the nurse's license.
Should I Sign a Consent Agreement?
As we mentioned earlier, a consent agreement is a legally binding contract between you and the Board. It is a way to avoid a formal hearing and the potential disciplinary actions that could follow. Consent agreements are frequently used by BONs to work with nurses accused of wrongdoing and help streamline the disciplinary process.
That said, it's not always your best course of action.
The agreement is essentially a plea deal: you agree to accept responsibility for the actions alleged in the complaint, and you agree to accept whatever disciplinary action the Board has deemed appropriate. In exchange, the Board will not pursue further action; you don't have to go through a formal hearing, and the process is basically over.
When complaints are handled through the ATD, however, the formal disciplinary actions are waived in exchange for the nurse's agreement to and voluntary participation in whatever treatment and monitoring programs the Board deems appropriate.
This is the Participation Agreement we mentioned before. And on the surface, this can seem like an obvious win-win. But there are potential downsides you should be aware of.
Sign the agreement, and you've admitted to the charges. You're also typically waiving your right to a hearing, and that can make it harder to file an appeal down the road.
ATD programs do not involve formal disciplinary actions, so there's no public record to worry about, but there are some other stipulations that could still raise concern.
How is “successful completion” defined, for example?
And what happens if you have a relapse in the future?
There's also the question of guilt: some nurses have entered into these agreements because it was the easiest option, despite not actually having an addiction or substance abuse problem.
Does signing the agreement equal an admission of guilt? And will it be held against you down the road?
We know this can be overwhelming, and agreeing to the program may seem like a fast way out of an uncomfortable situation, but the best time to protect your rights and interests is now.
The Professional License Defense Team at the Lento Law Firm will work with your Board to achieve the best possible outcome. We'll make sure your interests are represented, and we'll help you navigate this process so that there aren't any surprises down the road.
Mandatory Reporting: Could You Be Accused of Substance Abuse?
In addition to the direct discovery of substance use and abuse, Minnesota – like most states – has mandatory reporting requirements. That means that allegations of use and abuse can be reported by just about anyone.
This applies to all healthcare professionals, facilities, peers, organizations, and insurance companies, meaning that allegations could be lodged based on certain behaviors and actions.
There are a number of signs that suggest a substance abuse issue, for example. These can include:
● Unusual or drastic physical changes in appearance
● Becoming isolated from friends, family, and colleagues
● Unexplained emotional outbursts
● Confusion or memory lapses
● Errors in narcotic counts
● Altered patient records and/or frequent complaints from patients that pain medications aren't working
● Offering to work more shifts than normal for extended periods of time
● Extended and unexplained absences from the assigned unit
● Frequent trips to the bathroom
● Excessive mistakes
Now, the presence of any one of these signs doesn't automatically mean that a nurse has a substance abuse problem. In fact, there are a number of other reasons you might exhibit these behaviors.
But if a problem is suspected by your co-workers or a supervisor, you could be called in to explain your actions. Depending on the circumstances, you could find yourself faced with a mandatory treatment program when one isn't actually needed.
Should this happen to you, don't wait! You need to speak with a member of our Professional License Defense Team as soon as possible.
How Can I Make My License “Legally Defensible?”
Just as you build an impressive resume to obtain the top nursing positions, you can use a similar strategy to help protect your license and reputation as a professional.
Sometimes referred to as making your license “legally defensible,” this strategy refers to actions and behaviors that can reinforce your expertise and value as a nurse.
These actions can range from simple protocols and practices, such as providing clear communication and detailed documentation in patient charts, to more involved endeavors, such as advanced training and education.
Think of it this way: should your status as a nurse ever come into question, it helps to have a “resume” of experience and examples to show your commitment to your practice.
Your reputation, your performance reviews, your references—it all comes into play.
And you can use these resources to build a nursing practice that's almost impossible to tarnish.
What A Professional License Defense Team Can Do For You
The bottom line is this: you've worked hard for your nursing license. You have built a career through your hard work and commitment. Don't let it be taken away because you're not in a position to negotiate the best possible deal.
The Professional License Defense Team at the Lento Law Firm can help you navigate every stage of this process and protect your rights along the way. We have experience working with nursing boards, and we know how to prepare a defense, should that become necessary.
In fact, we can help you every step of the way – even before a formal complaint has been filed – by providing a variety of services. Some examples include:
● Analyzing your case and offering guidance on your best course of action
● Negotiating the terms of your Consent or Participation Agreement
● Gathering evidence and witnesses to help support your defense
● Negotiating with the Board
● Negotiating with employer or facility
● Filing a formal response to the complaint, should that become necessary
● Defending you at a formal hearing, if necessary
● Negotiating the term for your return to full privileges
● Representing you in all interactions with the Board
● Helping you gather evidence of your commitment to your nursing practice
Our law firm has worked with nurses and other medical professionals across the country. We have many years of experience negotiating agreements. We know how to work with an ATD program. We understand the complexities of negotiating a consent agreement. And we definitely know how to fight for your rights and protect your interests.
With the Lento Law Firm Team on your side, you can get the peace of mind you need to get through this challenge and preserve your practice.
We're here to help you.
Does The Lento Law Firm Serve All Of Minnesota?
Yes! Our law firm works with nurses, doctors, and a wide range of other professionals nationwide. That means it doesn't matter if you're in some of Minnesota's smallest cities, such as Dover, Darwin, and Wood Lake, or if you work in larger metropolitan areas, such as Rochester, Plymouth, and Minneapolis.
It also means we can help you protect your multistate practice as well, whether it's negotiating terms for a substance abuse program as we've explored here, or you need help defending your license against other allegations of misconduct, such as theft, fraud, patient neglect, or practicing outside the scope of your license.
In fact, the Lento Law Firm can help you protect your license – and your practice – no matter where you live and work.
Don't Wait. Contact The Lento Law Firm Now To Protect Your Nursing License
We know this can be scary. But that's why you have us.
Having an attorney who understands both ATD programs and the nursing disciplinary process in Minnesota can make all the difference as you address the allegations against you and seek the best possible outcome.
You should know that the Board has plenty of resources to conduct their investigation, explore any legalities, and determine a program of treatment. Shouldn't you have that level of support too?
There's no reason to face these allegations on your own. It doesn't make sense to “go it alone” when you can have an experienced Professional License Defense Team at your side.
The Lento Law Firm is ready to give you the support and experience you need. We can help you see your way through this difficult time.
Don't wait. Call us today.
Contact the Lento Law Firm Team today at (888) 535-3686, and let's talk about how we can help.
