There are few situations that are more stressful than having one's life work called into question by those in a position to compromise it. If you serve your patients as a nurse in Oklahoma and the stability of your career either is or could soon be called into question by the Oklahoma Board of Nursing due to substance abuse issues, the stress that you're almost certainly grappling with is likely profound. Yet, while it can be difficult to see the light at the end of the tunnel you're journeying through, it's important to know that you don't have to navigate it alone and that there are ways that you can potentially safeguard the career you've worked so hard to cultivate.
Recent Shifts Are Providing New Reasons for Hope
In recent years, nursing boards across the country have increasingly begun to treat substance abuse issues as the medical conditions that they are. Once matters that were handled only as disciplinary concerns, substance abuse challenges are now often viewed as personal struggles in need of treatment, not shaming and isolation. This shift in approach has partially been inspired by the sheer magnitude of the nation's struggles in this regard. In 2022 alone, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) concluded that 48.7 million people in the U.S. age 12 and older were grappling with substance abuse disorders. Additionally, state nursing boards have not turned a blind eye to the fact that substance abuse challenges among nurses specifically soared both during the COVID-19 pandemic years and in the years that have followed.
The stresses associated with being a nurse are nothing new. Yet, since the COVID-19 pandemic hit, lawmakers, educators, and healthcare professionals alike have garnered a greater appreciation for them and for the fact that they can exacerbate tendencies to self-medicate with alcohol, prescription medications, and/or illicit drugs. A greater understanding of the nature of addiction and its categorization as a medical condition has also helped to inform more thoughtful approaches to substance abuse challenges among nurses.
As a result of these shifts in knowledge and perception, policy changes have empowered the Oklahoma Board of Nursing to offer eligible nursing professionals an alternative to discipline in certain situations wherein their “competency may be compromised because of abuse of drugs and/or alcohol.” Participation in this program may be an effective way for you to safeguard your license and your future career. Yet, because there are significant drawbacks to participation, you'll want to consider your options carefully before committing to this opportunity. Take time to speak with the Lento Law Firm's Professional License Defense Team about your circumstances and your eligibility for the program so that we can provide you with personalized feedback designed to honor your unique needs, career goals, health concerns, and overall well-being. Call us today at 888-535-3686 or schedule a consultation online to get started. Let us help you during this challenging and consequential phase of your life.
Oklahoma Nursing Regulatory Body
The Oklahoma Board of Nursing (OBN) is a state agency. The Board is made up of eleven members, all of whom are appointed by the Governor. The Board is composed of three Licensed Practical Nurses, six registered nurses, and two Oklahoma citizens whose role is to represent the public interest. Each member enjoys a five-year tenure.
Its primary responsibility is to ensure the competency of those who serve as nurses or practice nursing in any way. To accomplish this broad purpose, the OBN engages in the following activities:
- Prescribing educational standards and overseeing educational programs related to nurse licensure or certification
- Administering the National Council Licensure Examination (NCLEX) and advanced unlicensed assistant certification examination
- Overseeing the licensure and license renewal of qualified applicants
- Maintaining records of nurses in the state and providing public access to these records in accordance with the Open Records Act
- Implementing the ins and outs of the Oklahoma Nursing Practice Act
- Providing services related to nursing education and practice
Additionally, the Board also investigates allegations of any violations of the Board's rules for nurses who practice in the state and violations of the Oklahoma Nursing Practice Act. In the event that allegations are sufficiently concerning, the Board is tasked with holding hearings to determine whether disciplinary action may be warranted, given a particular nurse's unique circumstances.
When the Board imposes disciplinary action, a nurse may be reprimanded or put on probation. In more serious cases, a nurse's license may be suspended or even revoked. With that said, the Board has specifically opted to offer an alternative to the disciplinary process in certain cases involving compromised competency due to substance use or dependency. This program is both voluntary and (ordinarily) confidential.
Oklahoma Nursing Laws
Every state is authorized to pass laws that ultimately govern those who practice nursing within its jurisdiction. In Oklahoma, the primary law of note is the Oklahoma Nursing Practice Act. Each state has passed a law that is similar to this one, although every state's approach to regulating the legal, ethical, and professional concerns of the nursing profession is distinct. Therefore, it's important to avoid making assumptions about what this law says based on knowledge of any other state's approach to nursing regulations. Speaking with our team can help you to better understand Oklahoma's law – which is particularly lengthy and complex – and how it may apply to your situation uniquely.
Notifying the Oklahoma Board of Nursing of Substance Abuse Concerns
There are two primary ways that the OBN may be alerted to your substance abuse issues. The ways in which the Board learns about your challenges will determine whether you ultimately move forward in a proactive or reactive way.
First, your employer, a colleague, a patient, a concerned loved one, or even a “random” member of the public may choose to notify the Board at any time. If the Board receives a complaint in this way, it will be compelled to investigate its validity and determine whether a hearing is warranted. This situation will place you in a reactive posture.
Second, the Board could learn about your situation directly from you. By reaching out proactively, you can seek assistance in a way that may help you to safeguard your license more transparently and in good faith. Sometimes, self-reporting is preferable because it demonstrates a willingness to embrace accountability and seek treatment. If your situation is rapidly deteriorating and it is, realistically, only a matter of time before the Board finds out about your struggles anyway, taking a forward-looking approach to protecting your license can help you to take action in healthy ways that eliminate your risk of unintentionally causing harm to your patients.
Eligibility for the Oklahoma Board of Nursing's Peer Assistance Program for Substance Use Disorders
Whether the Board is alerted to your situation via self-reporting or a complaint filed by a third party, you may be in a position to take advantage of the OBN's alternative-to-discipline opportunity known as the Peer Assistance Program. If you are either not eligible for this opportunity or you opt out of it, you'll likely be subject to a more traditional disciplinary hearing process.
The Peer Assistance Program is a voluntary endeavor. The main eligibility requirement for this program – other than a willingness to participate – is personal circumstances that render a nurse's competency to practice compromised due to abuse of alcohol and/or drugs. The drugs in question can be prescription medications and/or illicit substances. The goal of the program is recovery, not shaming. As a result, as long as a nurse remains in compliance with the program's mandates, their participation and personal information will remain confidential. Ideally, the outcome of the program is effective treatment and a safe return or continuance of their practice of nursing.
Before a nurse whose ability to practice safely due to substance-related impairment concerns can participate in this program, they must demonstrate proof that they meet all additional eligibility requirements per state law. Specifically, an applicant must:
- Be in possession of a current license to practice nursing in Oklahoma (unless a referral exception applies)
- Be free of any pending felony charges or criminal convictions that would potentially prevent the participant from practicing nursing
- Be willing to practice nursing only in Oklahoma while participating in the Peer Assistance Program
- Have a record free of disciplinary actions imposed by any board of nursing (unless a referral exception applies)
A referral exception related to current licensing requirements and/or disciplinary record concerns may be made at the Board's discretion. In the event that the Board refers a nurse for participation in the program who would otherwise be ineligible to take advantage of this opportunity, that nurse must (if applicable) secure a current license to practice within 60 days of their date of acceptance into the Peer Assistance Program in order to retain their ability to participate in it.
If these eligibility criteria can be effectively met, a nurse can then submit their application for participation to the Board.
Peer Assistance Program Requirements
Being granted approval to participate in the Peer Assistance Program is only part of one's journey toward safeguarding one's nursing license and regaining one's health. Successful participation in the program itself is the next major phase of this journey.
Before a nurse can enter into the program, they must sign a contract – which is an enforceable legal agreement – that outlines their rights and responsibilities related to their participation. Signing this contract will involve consenting to the following:
- Maintaining abstinence from alcohol and drugs, with the exception of prescribed medications used as directed, for the length of the program
- Submitting to random body fluid testing both regularly and on request
- Receiving treatment for substance abuse disorder(s) at the discretion of the program
- Participation in mandatory ongoing recovery maintenance activities that may include 12-step meetings and Nurse Support Group attendance
At first, nurse participants will not be permitted to practice nursing. Only after a “sustained period of ongoing recovery has been established” will a participant be permitted to return to nursing practice under supervision.
Each nurse will benefit from an individualized and structured plan of recovery, compliance monitoring, support, and ongoing education. The length of the program will last between two and five years, depending on a nurse's unique needs and how long it takes a participant to achieve all of their required program goals.
Pros and Cons of Participating in the Peer Assistance Program
When individuals are cited for traffic violations or accused of criminal wrongdoing, the vast majority opt to plead guilty instead of fighting back. Oftentimes, people simply don't feel that they have any other choice but to “give in,” even though they technically have the option of fighting back. Just as it's important for those, who have been accused of wrongdoing on a criminal level to know that they have real options to choose from, so it is important for those whose professional licenses are in jeopardy to understand that they have options available to them as well.
It's important to carefully consider your unique rights and options before committing to participation in the Peer Assistance Program or rejecting the opportunity to participate in it. Either decision you make will be consequential in terms of your health, career, and well-being. With that said, you don't have to make this decision on your own. By talking through your circumstances with the Lento Law Firm's Professional License Defense Team, you can evaluate the pros and cons of this opportunity in informed ways as they apply to your unique situation. Thinking about the following broad potential benefits and drawbacks to participation is a good way to start wrapping your brain around this decision-making process and its potential implications.
Pros
If you have concluded that it's time to get help, taking advantage of all that the Peer Assistance Program has to offer may be a great way to get started. After all, the program is tailored to professionals who understand your unique job-related challenges and stresses. Additionally, this opportunity serves as a way to seek help and safeguard your license at the same time. You deserve to live a full, healthy, and fulfilling life. If remaining accountable to outside authority is going to help you achieve that end, taking advantage of this program may be in your best interests.
With specific regard to your nursing license, choosing to enter the Peer Assistance Program can help you avoid disciplinary action that could put that license at temporary or permanent risk. Avoiding the risk of a disciplinary record can help to ensure that you're positioned to continue advancing in your chosen profession without the weight of “a past” holding you back.
Ultimately, it sometimes takes a specific kind of “outside” motivation to inspire someone with substance abuse issues to learn to manage their challenges in meaningful, sustainable ways. If this program is the push you need to invest in yourself in this way, all of the program's drawbacks may be worth weathering.
Cons
Recovery is not always a straightforward journey. In the words of a wise Japanese proverb, it is sometimes a “fall seven times, get up eight” situation. As such, it's important for nurses who are thinking about participating in the Peer Assistance Program to understand that defaulting, having their participation terminated, or dropping out of the program could potentially result in more significant consequences than submitting to a traditional disciplinary hearing might.
According to state law, “The Executive Director of the Board shall suspend the license of a licensee who applied and entered the peer assistance program by choice without any order by the Board immediately upon notification that the licensee has defaulted from the peer assistance program, and shall assign a hearing date for the matter to be presented to the Board.” In the event that a nurse was originally directed to apply to the program by the Board, their default will result in whatever consequence was detailed in the Board's notice of what would happen if they failed to comply.
Additionally, nurses who participate in this program are responsible for all costs associated with that participation. Depending on how good your insurance is – or isn't – you could be looking at mounting bills at a time when you will likely not be earning nursing-related income, at least for a while. Conditions will be placed on your license for the duration of your participation in the program, and the nature of these conditions will vary based on the Board's discretion. You will, for sure, not be permitted to practice nursing until you've established a sustained period of ongoing recovery. Leaving your ability to earn income up to chance is a significant risk to take if you and your family count on your capacity to bring home the bacon.
Finally, it's important to keep in mind that recovery only tends to be successful when someone who is struggling is truly willing to work in order to improve their circumstances. If you're not yet in a place where you're willing to be held accountable for your actions by outside authorities for years on end, you're likely not going to benefit from this program specifically, and you'll be out the costs of participation if you choose to leave.
Are There Any Alternatives to the Peer Assistance Program That Can Preserve My Nursing License?
There are two ways that nurses can participate in the Peer Assistance Program. First, they can voluntarily apply for participation. Second, they may be referred by the Board for participation. In this scenario, the Board will outline the alternative consequences that a nurse will be subjected to if they don't participate. This generally only happens as a result of an investigative process and/or disciplinary hearing. Most of the time, participation is the result of a voluntary self-referral.
As noted in the “cons” discussion above, participation in the Peer Assistance Program isn't the right opportunity for everyone. As a result, it's important to understand that you don't have to apply to participate, nor do you have to participate if referred, provided that the alternative consequence laid out by the Board is preferable to you.
If the Board is alerted to your substance abuse challenges, you may opt to go through a traditional investigation and hearing process. While there is a significant risk of being formally disciplined at the end of this process, this turn of events is not a foregone conclusion. Your Lento Law Firm Professional License Defense attorney will work to build the strongest possible case in your defense, which may result in an outcome that is far less burdensome than participation in the Peer Assistance Program would be.
Especially if you suspect that an alternative recovery program is more likely to meet your unique needs, speaking with our team about taking this path may be in your interest. You won't want to forego treatment and recovery altogether, as continuing to practice nursing while navigating unmanaged substance abuse challenges could lead to unintentional patient harm, self-harm, and the loss of your license forever. Yet, if telling your side of the story and pursuing a rigorous defense could lead you to a recovery path that would be better for you than the Peer Assistance Program would be, it may be worth the effort to forgo applying for participation in it.
Speak With the Lento Law Firm Today
When you have worked for years to cultivate a career in the nursing field, the idea that your license could be taken away due to a medical condition like substance abuse can be deeply distressing. Thankfully, the Peer Assistance Program and the opportunity to defend against allegations of professional incompetence are both available to you at this time.
The Lento Law Firm's Professional License Defense Team maintains a nationwide presence, so we can help you to make your case either way, regardless of whether you're currently residing in Oklahoma or you've utilized your Oklahoma license to assume a traveling position elsewhere. Regardless of whether you want to apply for the Peer Assistance Program or submit to an investigation and hearing, we can help you navigate the challenges of your situation and to weigh the pros and cons of each option, to make an informed decision based on your needs, and to help you work toward your specific goals. Call us today at 888-535-3686 or contact us online to get started. We look forward to speaking with you.
