Legendary Green Bay football coach Vince Lombardi once observed that “Once you learn to quit, it becomes a habit.” While Vince was almost certainly painting the idea of quitting in a negative light – as quitting isn't usually a winning mentality in sports – those who are wrestling with negative habits can take hope in the idea that quitting, in and of itself, can serve as a victory over an unhealthy behavior. Yet, as anyone who has ever struggled with substance abuse knows, getting to the point of halting use in its tracks is – initially – the entire battle. Quitting, while life-changing in the best ways, can feel all but impossible when a substance abuse issue is raging out of control.
If you are struggling with substance abuse challenges, your situation may be affecting every aspect of your life. From your health to your relationships, your finances to your career, your struggles may feel consuming. And, if your life's work involves nursing in Montana, your professional license may already be on the line as a result of these challenges.
If so, the first thing you need to understand is that you're not alone. Partially as a result of the stresses placed upon the U.S. healthcare system due to the COVID-19 pandemic, substance abuse rates for nurses have soared nationwide. Overall, in 2022, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that 48.7 million Americans were struggling with substance abuse disorders. There is no shame in these statistics. Substance abuse disorders are medical concerns that need to be addressed, not personal vices that others should feel free to judge.
With that said, untreated and unmanaged substance abuse challenges can be dangerous to both users and those who depend on them. As such, when a nurse's substance abuse issues affect their ability to provide proper patient care, the Montana Board of Nursing may express concern and intervene. Depending on the situation at hand, a nurse could face significant disciplinary action that could endanger their livelihood. Thankfully, however, the state does offer a program that serves as an alternative to formal disciplinary action. Participation in this program isn't right for everyone, but it is potentially an option for you. Therefore, if the Board is currently scrutinizing your professional conduct or you're concerned that the Board could be notified of your struggles, it's important to be proactive about assessing your options and learning about your rights.
The client-focused members of the Lento Law Firm's Professional License Defense Team are here to discuss your eligibility for this alternative program and the specifics of your situation. If your license is potentially on the line, know that our knowledgeable team has the experience and the skilled to both help you to make an informed decision and to help you safeguard the career that you've worked so hard to earn. You're not alone. Call us today at 888-535-3686 or schedule a consultation online to learn about how we can help.
Montana Nurse Regulatory Body
The Montana Board of Nursing (MBN) is the state agency that has been tasked with licensing nursing professionals who work in Big Sky Country. It is also responsible for disciplining licensed and certified nurses if it concludes that they have engaged in professional wrongdoing. The MBN oversees licensing and certification for nurses and nursing-adjacent professionals who practice in Montana, as well as those who maintain Montana licenses or certifications but work in traveling capacities.
At a minimum, the Board regulates the following professional positions:
- Advanced Practice Registered Nurse (APRN)
- Certified Nurse Midwife (CNM)
- Certified Nurse Practitioner (CNP)
- Certified Nursing Assistant (CNA)
- Clinical Nurse Specialist (CNS)
- Certified Registered Nurse Anesthetist (CRNA)
- Licensed Practical Nurse (LPN)
- Medication Aide (MA-C)
- Registered Nurse (RN)
The MBN is made up of nine board members, each of whom has been appointed by the Governor and confirmed by the Senate. At any given time, the Board seats five RNs, two LPNs, and two members of the general public.
It can be undeniably frustrating to think that the fate of a career that you've spent years cultivating could potentially rest in the hands of nine strangers. Thankfully, you don't have to weather Board-related disciplinary concerns, investigations, or even proactive self-reporting alone. The Lento Law Firm's Professional License Defense Team is available to advocate in a client-focused manner on behalf of your interests in whatever way is most likely to result in a favorable outcome to your circumstances. This is true whether you're already under investigation or you're thinking about approaching the Board proactively in an attempt to safeguard your nursing license or certification.
Board Investigation Scam Alert
According to the state's Department of Labor and Industry, a scam related to nursing license investigations has been reported. The scam involves nurses being called and told that they need to speak with the caller urgently about a Board of Nursing investigation.
Accordingly, the MBN has stated that it “will never let a licensee know of an investigation in this manner.” Written communication about an investigation will always be sent before any telephonic communication would occur.
If you have been contacted via phone about a licensing investigation and you want to verify whether this communication is legitimate, you can call 406-444-6880 for personalized information. Any scam attempts should be reported to local law enforcement officials.
Notification of Substance Abuse to the Montana Board of Nursing
The MBN may already be aware of your struggles with substance abuse. If not, you may be concerned that someone will report you for alleged misconduct before you achieve sobriety. Either way, it is important to understand your rights and options under the law so that you can make informed decisions about your circumstances.
Per the Board's administrative rules, nurses are required to report any misconduct of their nursing colleagues that violates professional standards enforced by the state. This means that even if your colleagues hold you in high regard, they may be risking their own license or certification if they don't report any misconduct that they witness, which could, for example, result in harm to a patient because you are high, drunk, or going through withdrawal.
Patients, their loved ones, your own loved ones, your employer, and concerned members of the public are also empowered to report their concerns to the MBN. As a result, many nurses who struggle with substance abuse feel as if they're “walking on eggshells” while trying to hide their challenges from anyone who might report them to the Board.
If you're feeling this way, and the Board has not already been notified of your substance abuse issues, you may benefit from coming forward proactively. This isn't the best choice for all nurses, but those who are interested in safeguarding their licenses by participating in the Board's alternative-to-discipline program can build goodwill with the MBN by being forthcoming and demonstrating an active willingness to pursue recovery. Making this effort can also minimize the chances that those who are struggling will ultimately find themselves in front of the Board anyway, after they've made a mistake while impaired or in withdrawal, and possibly harmed a patient in the process.
Eligibility for the Montana Nurses Assistance Program/Montana Recovery Program
For most serious nursing infractions, the MBN investigates the merits of a complaint and, if it has found that a nurse has engaged in significant misconduct, disciplines the nurse in question in accordance with its judgment, state law, and its own administrative rules. However, when nurses either self-report substance abuse issues or the Board investigates issues inspired by substance abuse struggles and approves a non-disciplinary approach, nurses can potentially avoid formal discipline for their substance-related misconduct.
Recently, Montana transitioned the Nurses Assistance Program for those with substance abuse issues to the broader Montana Recovery Program, which also serves physicians, pharmacists, dentists, medical examiners, and other healthcare providers whose substance abuse issues may compromise their ability to safely provide patient care.
Eligibility for this program generally requires self-reporting and a request to enter the program or a referral from the Board during or following an investigation into a complaint related to alleged wrongdoing.
What Are the Requirements of the Alternative Program?
It's important to understand that the Montana Recovery Program is not a treatment program, per se. It is a monitoring program. This means that participants are expected to meet certain requirements, and the Montana Recovery Program keeps track of an individual's recovery and compliance. The Program also offers support in various capacities, but if you opt to participate in the Program, you will need to seek personalized recovery services simultaneously.
The primary goal of participation in the Program is to safeguard your employment record from official discipline and to safeguard your license from the risk of administrative suspension, long-term disciplinary suspension, or revocation. Participating in personalized recovery services, on the other hand, will facilitate healing. This is not to say that by participating in the Recovery Program, you'll be insulated from temporary suspension of your license until your sobriety is established. However, you will be spared the significant consequences of formal, disciplinary-based suspension if you complete the terms of your program, as required.
The length of time that you'll be prohibited from practicing while you work to achieve sobriety will be influenced by a number of factors. The following issues may impact the amount of time that you're ultimately required to refrain from nursing while you're starting your recovery journey:
- Your mental health history
- Your substance abuse history
- Whether you remain “clean” from substance abuse while being monitored or you relapse
- The results of any clinical diagnostic evaluations that you undergo
- Whether you could be considered a risk to the public
- Your current medical conditions
- Whether you diverted substances from patients or your employer while you were still practicing
- The progress of your participation in the Program more generally
Once you return to work, you will be required to comply with a workplace monitoring situation for as long as the Program deems necessary.
When participating in the Program, you will be held to the terms of a participation contract. The terms of your contract will be unique to you and your situation, as program administrators will develop a specific treatment program tailored to your needs as they perceive them. You may be required, for example, to attend an in-patient or out-patient treatment program, in addition to an aftercare program, support meetings, and random substance screenings. While the personalized nature of the Program allows for greater flexibility when it comes to a particular nurse's needs, there is also a concern that you won't know what you truly agree to do to fulfill the requirements of your contract until it has been drawn up and tailored to your situation.
Regardless of how your particular contract is tailored, you will be required to refrain from using alcohol or drugs for the length of your monitoring period. The sole exception to this rule involves legitimately prescribed medications that are necessary for your health, which must be taken as directed.
Once your sobriety has been established, the Program may assess that you are ready to return to the workplace. However, restrictions may be placed upon you for a period of time. For example, you may not be permitted to access or administer controlled substances initially. The Program insists that its “objective is to return all professionals to safe practice,” which is a hopeful mission. Yet, you will need to place a certain degree of faith in the idea that the Program means what it says.
Most participants are monitored for a three- to five-year period. This includes time spent in initial recovery and away from nursing, as well as a monitored return-to-work period, likely subject to restrictions.
What Are the Pros and Cons of Participating in the Montana Recovery Program?
No matter where in the U.S. nurses choose to practice, they need to think carefully before deciding whether to participate in a non-disciplinary alternative program focused on addressing substance abuse concerns. However, this is arguably especially important in Montana for reasons that we will discuss below. With that said, when you speak with the Lento Law Firm's Professional License Defense Team, we can help you to make informed decisions about this opportunity as it applies uniquely to your situation. The initial “pros and cons” explored below serve simply as an introduction to the considerations that you'll want to weigh carefully before committing to a plan of action.
Pros
Certainly, it cannot be emphasized enough that by participating in this alternative-to-discipline program, you'll be spared the licensure, employment, and reputation-related consequences of formal disciplinary action. This is not an insignificant advantage. When applying for promotions, new jobs, volunteer opportunities, and transfers, you won't have to report that you've been subject to formal discipline. This can help to ensure that you can continue to pursue career advancement in whatever ways you please, as many employers will shy away from hiring or advancing someone with a formal discipline record.
Additionally, if you thrive on accountability, close monitoring for an extended period of time may help you achieve sustained recovery in ways you haven't yet been able to earn. Sometimes, people who struggle with substance abuse challenges can't make sustainable progress until they know that someone is looking over their shoulder. The Program will certainly help you to benefit from such an arrangement, if this kind of accountability suits your needs and personality.
Finally, if you are unlikely to get the initial substance abuse treatment and aftercare that the Program will require unless you sign a contract to that effect, participating in this Program could end up saving your health, your career, and possibly your life. That is an opportunity for hope that you unquestionably deserve.
Cons
Three to five years of monitoring is not the healthiest arrangement for everyone. While some people thrive when being held accountable, others can become so anxious as a result of the pressure that accountability of that kind inspires that their health may suffer as a result. While virtually every recovery program insists on some degree of accountability, it may or may not be in your best interests to sign on for three to five years of professional monitoring in addition to whatever accountability your medical care and support teams require of you.
You will also be held responsible for any costs associated with your participation in the program. In addition to recovery and aftercare costs, you may be held accountable for substance abuse screening, diagnostic screening, and any number of additional financial burdens. This can be a particularly challenging reality if you support yourself and/or your family, as you will be unable to practice nursing for an undetermined length of time as you work to achieve sustained sobriety.
Finally, it is worth noting that the private-sector administrators of Montana's Recovery Program – who are employees of a company called Maximus – have an unusual degree of flexibility in crafting the terms of participants' contracts. In most states, there are specific participation criteria and “graduation” criteria that must be met for substance abuse discipline alternative programs. By contrast, and as discussed above, Maximum has been granted discretion in virtually every aspect of a participant's experience. This degree of control, and a host of other concerns, led to a critical high-profile investigative report in the Montana Free Press in 2023.
Are There Any Alternatives to the Recovery Program That Can Preserve My Nursing License?
Participation in the Montana Recovery Program is voluntary. If this program isn't the best fit for you, that's okay. If the Board has not yet been alerted to your substance abuse challenges, you can potentially achieve sustainable sobriety by utilizing outside resources, and you can preserve your license by taking your sobriety seriously. If, however, the Board has been alerted to your situation already – or a complaint has been filed regarding your alleged misconduct and was based on a misunderstanding because you do not suffer from substance abuse challenges – you do have the option of presenting your case to the Board. If your efforts are successful, you can avoid both discipline and the rigorous monitoring and costs associated with participation in the Recovery Program.
If pushing back against any complaint that has been filed against you is an option that interests you, know that the Lento Law Firm Professional License Defense lawyer will work diligently to advocate for your interests and protect your rights as your situation evolves. Navigating the complexities of a professional license investigation is neither an easy nor a straightforward undertaking. However, the Lento Law Firm's Professional License Defense Team has been helping nurses like yourself to do so successfully for many years. We also practice nationwide, so we can help you defend the integrity of your Montana nursing license regardless of whether you practice in Big Sky Country or you are practicing in a traveling position.
Contact the Lento Law Firm Today
You have spent years studying and taking care of patients to build the career that you have earned. Although the idea of defending your license or entering into the Recovery Program can seem overwhelming – and you may even be tempted to walk away rather than deal with this situation at this exact moment in time – you deserve the chance to keep your license and to regain your health at the same time. And, thankfully, you don't have to do any of this alone. The Lento Law Firm's Professional License Defense Team employs a dedicated and client-focused approach to license defense cases. We can help you make informed decisions while treating you and your case with the utmost respect and consideration.
We have helped so many nurses in Montana and across the U.S. to advance their health, careers, and well-being. Allow us to help you, too. To learn more, call us today at 888-535-3686 or contact us online. We look forward to hearing from you.
