Henry Ford once said, “When everything seems to be going against you, remember that the airplane takes off against the wind, not with it.” These wise words will hopefully serve as comfort if you are currently struggling as a result of substance abuse challenges. Whether you have been using alcohol, prescription medication, or illicit substances in unhealthy ways, it's important to understand that working through these challenges is not only possible, but doing so can help you achieve a brighter, healthier, and more dynamic future. While learning to manage substance abuse and confronting any consequences of this situation that you may be facing won't be easy, making an effort is well worth your while.
If you have cultivated a career as a nurse in Oregon, you may be understandably concerned about how your substance abuse challenges could impact your current professional life and your future career. You have every right to be concerned, but it's important to understand that you're not the only one dealing with this particular challenge. In 2022, in the wake of the worst of the COVID-19 pandemic, 48.7 million Americans were grappling with substance abuse disorders, according to the federal Substance Abuse and Mental Health Services Administration (SAMHSA). For obvious reasons, many of those struggling with this challenge were healthcare workers.
Whether your substance abuse challenges started when using rates skyrocketed among healthcare professionals during the pandemic, you were using long before COVID-19 rocked the medical community, or they developed more recently, the stresses of your job probably aren't making your situation any easier. Thankfully, there are programs tailored specifically to assist nurses who are grappling with substance abuse concerns.
Yet, depending on the specifics of your situation, you may be more concerned about safeguarding your career right now than you are about cultivating your health and well-being. Perhaps a patient, colleague, or employer has reported your substance abuse issues to the Oregon State Board of Nursing (OSBN). Or perhaps you're “simply” afraid that the Board will find out about your struggles before your substance abuse challenges have been managed effectively. If so, it's important to understand your rights and options under the law when it comes to safeguarding your license and the career you've worked so hard to build.
If the OSBN does express concerns that could endanger your license, know that you may be in a position to participate in a program as an alternative to formal discipline. Yet, you shouldn't jump at this opportunity without careful consideration, as it will result in consequences that will affect your life in considerable ways. By speaking with the Lento Law Firm's Professional License Defense Team about your eligibility and the specifics of your situation, you can place yourself in a stronger position to make informed decisions about your options. Our client-focused team can help you assess your situation in ways that carefully consider your career goals, overall health, and personal well-being. Call us today at 888-535-3686 or schedule a consultation online to get started. You don't have to make a decision about what to do next on your own.
Oregon Nurse Regulatory Body
The Oregon State Board of Nursing (OSBN) is comprised of nine members, each of whom is appointed by the Governor and each of whom serves three-year terms. The nine members consist of four registered nurses, one certified nursing assistant, one licensed practical nurse, one nurse practitioner, and two members of the public. As an agency of the state, the OSBN functions as part of the executive branch.
The Board works to facilitate five primary functions:
- Issuing nursing licenses and renewals
- Evaluating and approving nursing-related training programs
- Providing testimony to the legislature and other relevant bodies
- Maintaining the state's registry of nursing assistants and administering nursing assistant competency evaluations
- Investigating complaints and initiating disciplinary action against those license-holders who are found in violation of the Oregon Nurse Practice Act
Per state law, the Board maintains the authority to license or certify – and subsequently, investigate and discipline accordingly – individuals in the following professional positions in Oregon:
- Advanced practice registered nurse (APRN)
- Certified medication aide (CMA)
- Certified nursing assistant (CNA)
- Certified registered nurse anesthetist (APRN-CRNA)
- Clinical nurse specialist (APRN-CNS)
- Licensed practical nurse (LPN)
- Nurse practitioner (APR-NP)
- Registered nurses (RN)
If you serve in one of these professional capacities and the Board has either already been alerted to your substance abuse challenges, or you're concerned that it might be made aware of your situation soon, it's important to understand your rights and options. That way, you can make an informed decision that will best serve your career, health, and overall well-being.
Oregon Nursing Laws
The practice and profession of nursing are regulated in distinct ways per the laws of each state. This is partially why it's so important for nurses who accept traveling positions to understand their rights and obligations under the law wherever they're practicing, as these realities aren't static across the U.S.
In Oregon, the state's Nurse Practice Act (NPA) governs the legal, ethical, and practical concerns of the nursing profession. This Act is made up of laws codified in the state's Revised Statutes and Chapter 851 of the state's Administrative Rules. The Board additionally crafts supplemental rules designed to help it implement the Nurse Practice Act. These supplemental rules have the practical effect of law. It is the Nurse Practice Act that prohibits certain behaviors related to impairment within the profession of nursing and compels the reporting of such behaviors to the Board by fellow nurses and employers alike.
Notification of Substance Abuse to the Oregon State Board of Nursing
There are two primary ways that the OSBN may be notified of your substance abuse challenges. First, a colleague, employer, patient, a patient's loved one, or member of the public may file a complaint directly with the Board. Second, you can self-report your struggles in an effort to be transparent and to move forward with treatment in good faith. While there is no guarantee that the Board will be more lenient if you self-report, it will place your arguments in a greater position of strength and may render your insistence that you want to seek help and preserve your license accordingly more believable.
Eligibility for the Oregon State Board of Nursing's Health Professionals' Services Program
Whether you opt to self-report or your issues are referred to the Board via a complaint, the Board will initiate an investigation into your circumstances. Per state law, there are three possible outcomes to such an investigation:
- A dismissal of the case if the Board concludes that no violation of the NPA has occurred.
- Discipline of the nurse, which usually results in probation but could potentially result in license suspension or revocation. This formal process is a matter of public record.
- Permission for the nurse to enter the state's alternative-to-discipline program, which is known as the Health Professionals' Services Program (HPSP).
The HPSP program is managed by the state's Addictions and Mental Health Services Division (AMH) and implemented by a third-party vendor. Participation in the program is not considered to be a disciplinary action. As such, it is not a matter of public record as long as a nurse successfully completes all of the program's requirements. There are some exceptions to the confidential nature of participation for those who operate in a “need-to-know” capacity for the purposes of health and workplace monitoring.
The Board may refer a nurse to participate in HPSP, or it may grant approval for participation following a self-referral. Cooperation, information uncovered during the investigation process, substance abuse evaluation results, and other factors may play into the Board's decision to approve a referral to the HPSP program.
Note that this program is only available to RNs, APRNs, and LPNs who hold licenses in Oregon. All other nursing professionals who face substance abuse challenges that may compromise their licenses or certifications can reach out to the Lento Law Firm's Professional License Defense Team for more information about their rights and options under the law.
What Are the Requirements of the HPSP Program?
Once an applicant enters into the HPSP program, they will need to comply with the terms of their treatment plan, submit to all required drug and alcohol screening requirements (including a minimum of 36 screenings year one, 24 screenings year two, and 18 screenings year three), and abstain from all mind-altering substances unless prescription medication is being taken appropriately and for necessary purposes. Most of the time, the length of this program spans four years, including two years of monitored nursing practice. During that time, employed nurses will have workplace monitoring reports sent in on their behalf monthly. They may also be subject to restrictions on their licenses.
A failure to successfully complete the HPSP program may result in a referral for probation and/or additional disciplinary action by the Board.
How Does Probation Differ from the HPSP Program?
Although not all disciplinary actions end in probation, if it is determined that a license holder has violated the NPA due to their substance abuse challenges and they either opt out of the HPSP program or are not approved for participation in it, it is very likely that they will be referred for probation, also referred to monitored practice.
The primary difference between probation and the HPSP program is that probation is a matter of public record. Therefore, if you're placed on probation, this formalized disciplinary action will be known to anyone who searches for information about your professional history, including any prospective employers. Especially for nurses who may remain in this profession for decades, having a formal disciplinary record can serve as a source of frustration when they want to advance within an organization or seek employment with a new one.
With that said, the remainder of the requirements associated with probation tend to be less restrictive than those imposed by the HPSP program. For example, probation monitoring only tends to last 24 months, as opposed to 48. Substance screenings occur on probation a minimum of 12 times annually, as opposed to 36-24-18. This is a particularly significant difference for those whose cost incurred per test reaches into the hundreds of dollars.
Similar to the HPSP program, probation participants are required to abstain from mind-altering substances, fulfill the terms of their treatment program, and are generally subject to workplace restrictions for the length of their monitoring period.
A failure to complete the terms of probation can lead to additional disciplinary action by the Board, possibly including the revocation or voluntary suspension of one's license. Reinstatement of one's license may be considered – but is not guaranteed – after three years. In essence, there is a greater safety net in the event of failure if a nurse starts in the HPSP program, as their likely fallback is probation. Failure to adhere to the terms of probation is more likely to lead to a temporary or permanent loss of licensure.
The Benefits and Drawbacks of Participating in the HPSP Program
It's important to understand that simply because the HPSP program is an option, you do not need to automatically default to requesting participation in this opportunity. As the Lento Law Firm's Professional License Defense Team knows, alternative-to-discipline programs are often beneficial for nurses who are struggling with substance abuse challenges, but they aren't the best course of action for everyone. By carefully evaluating your options and thoughtfully considering how each could impact your career, health, and well-being, you'll place yourself in a stronger position to make whatever choice is “right” for you.
Benefits
Some people thrive when they're being held accountable for their actions in a structured environment. This is one of the reasons why certain rehabilitation programs work so well for people. If you have a certain personality, working through a structured program in which any slip-ups would be caught by drug or alcohol screening tests may give you the push you need to take your recovery seriously.
From a professional standpoint, successfully completing the HPSP will free you from the consequences of facing formal discipline, including the kind of negative notation on your employment record that could keep you from advancing, transferring, or seeking new employment in the future. Confidentiality concerning your situation may not seem like a significant “perk” of participation in the program at first, but it could make all the difference when it comes to achieving your professional goals down the road.
Drawbacks
With the notable exception of avoiding formalized discipline, there are not many differences between participating in the state's HPSP and participating in discipline-based probation monitoring, should your case not be dismissed after the Board's investigation into your circumstances. As noted above, many of the requirements associated with probation are far more lenient than the requirements associated with the state's alternative-to-discipline program. For example, in the grand scheme of things, submitting to the costs and burdens of monitoring for four years instead of two is not an insignificant consideration.
Additionally, you may feel strongly that you need more control over your approach to treatment than would be allowable under the HPSP. For example, say that you want to take time away from work to enter into a residential program before engaging in follow-up recovery work through some programs that may be perceived as too unorthodox for the Board's tastes. In this case, you may benefit from “rolling the dice” and trying to get your case dismissed rather than self-referring or hoping to be referred to the HPSP.
Finally, it is worth noting that the costs of either HPSP or discipline-based monitoring will fall completely on your shoulders. And should you not be able to pay the many thousands of dollars that participation in the HPSP would require, you'll likely be referred for probation anyway. Under these circumstances, if the Board doesn't yet know about your situation, getting serious about seeking treatment elsewhere may be to your advantage instead of self-referring in the interests of transparency.
Are There Any Alternatives to the HPSP That Can Preserve My Nursing License?
It is important to keep in mind that HPSP and probation (or another form of discipline) are not the only possible outcomes of a Board investigation into substance abuse and alleged professional wrongdoing. It is also possible that the Board will determine that no violation of the NPA has occurred. If this is the case, you'll be free to explore recovery options on your own terms and without the burdens and costs associated with monitoring hanging over your head and your budget.
When you meet with the Lento Law Firm's Professional License Defense Team, we can discuss whether it's possible to protect your license in this way. While no lawyer can ever guarantee the outcome of an investigation and hearing, your Lento Law Firm Professional License Defense attorney will explore every angle and employ their considerable skill on your behalf should you decide to push back against any allegations that you may be facing. Some cases are dismissed by the Board at the end of the investigative process. Depending on the ins and outs of your situation, yours could potentially be one of them.
Additional Resources
While it's helpful to know that the OSBN can help you hold yourself accountable during recovery, it's rare that a single resource can provide all that someone who is struggling needs in order to begin managing their condition effectively and sustainably. Thankfully, Oregon nurses have access to far more personalized sources of support than nurses in most other states.
For starters, the Nurse Assistance Network (NAN) is a program that receives direct support from the Oregon Nurses Foundation. Its focus is providing and expanding resources for nurses, and it features a committee that is specifically focused on expanding recovery-related support for the state's nursing professionals.
Nurses can also benefit from exploring the resources provided by Oregon Recovers, which describes itself as an ”inclusive statewide coalition comprised of people in recovery–and their friends and family—uniting to transform Oregon healthcare to ensure world-class prevention, treatment, and recovery support services for Oregonians suffering from the disease of addiction.”
Finally, the Oregon Health Authority offers a number of services via its Behavioral Health Care focus that may be valuable to those who are in need of recovery services, as well as those who are in active recovery.
Speak with the Lento Law Firm Today
The idea that the state's board of nursing has either already been notified that your professional competency may have been compromised due to substance abuse or that it could soon be notified of this concern can be overwhelming. It is important, therefore, to keep a clear head and to connect with proper support so that you can safeguard your health, career, and well-being as you navigate this challenging turn of events.
At the Lento Law Firm, our Professional License Defense Team understands how hard nursing professionals work to earn their licenses or certifications and how much energy they devote to their patients once they're permitted to practice. Trust that we will not let you weather this consequential time without empowering you to make truly informed decisions on your own behalf. Regardless of what path you choose, know that we have the experience and skill to represent your interests in front of the OSBN.
Whether you are currently based in Oregon or you've utilized your Oregon license to assume a traveling position, know that our team maintains a nationwide presence, and we can help you to fight for your regardless of where you're currently located. We can help you decide whether participation in the HPSP, participating in discipline-based monitoring, or fighting back in hopes of having your case dismissed is the best way forward. Call us today at 888-535-3686 or contact us online to get started. You are truly not alone.
