Nurses are just like everyone else; they are not immune to alcohol and substance abuse disorders. As a nurse, you may believe that nurses like yourself and other medical professionals are held to a higher standard. Still, addiction can and does happen to everyone from all walks of life, races, and economic backgrounds.
Being a nurse is a difficult job, physically and mentally. You deal with stresses others can't even imagine daily. The COVID-19 pandemic has only made life more overwhelming, stressful, and at times dangerously life-threatening. It is no wonder studies are showing an increase in nurses suffering from alcohol and substance abuse disorders.
If you are a nurse in Vermont struggling with an alcohol or substance abuse disorder, the Lento Law Firm Professional License Defense Team can help protect your health and your license. We know you fear losing your Vermont nursing license, career, and livelihood if disciplinary action is taken against you. Our Team can walk you through alternatives to the disciplinary process and assist you in weighing your options and making the best decision for you. Call the Lento Law Firm Professional License Defense Team today at 888-535-3686 or schedule your consultation online.
Vermont Nurse Regulatory Body
In Vermont, the Office of Professional Regulation oversees all professional licenses in the state, from dieticians and dental examiners to accountants and engineers. Through the Office of Professional Regulation, the public can access a list of licensed professionals and request the verification of an individual's professional license status.
In conjunction with the Office of Professional Regulation, the Vermont Board of Nursing provides governance, oversight, and enforcement for nursing professionals. They establish the educational requirements, standards of care, and standards of ethical conduct that nurses must complete and comply with. The Board of Nursing has a variety of responsibilities. They process new nursing license applications, renew licenses, and verify the status of nurses practicing in Vermont.
The Office of Professional Regulation website is where complaints are accepted and sent to the relevant board. For nurses, the Board of Nursing is the regulatory body that processes complaints about nurses that are submitted to the Office of Professional Regulation. The Board of Nursing is the entity that can take disciplinary action against nurses and their licenses. These disciplinary actions include suspension, probation, reprimand, and revocation.
Although the Board of Nursing has these disciplinary options available, there are situations in which it will determine they are not the appropriate course of action in response to a complaint. Some complaints off the bat are recognized to be false or do not justify further investigation. Alternatively, there are some valid and concerning complaints regarding alcohol and substance abuse where the Board of Nursing needs to take action but will pursue action outside of the formal disciplinary process. The non-disciplinary action option can be the Alternative Program, which will be discussed in further detail below.
Vermont Nursing Laws and Regulations
Vermont law authorizes the Board of Nursing to adopt rules “establishing a program to serve as an alternative to the disciplinary action process for nurses and nursing assistance with chemical dependences or other professional license practice issues as designated by the [Board].” Under this law, the Board of Nursing has created a rule housed in Vermont's Administrative Rules establishing the Alternative Program for licensees and applicants eligible for licensure.
What is the Alternative Program?
The Alternative Program allows those with a Vermont nursing license who are dealing with chemical dependence, also referred to as a substance use disorder, to avoid disciplinary action before the Board of Nursing. The Board of Nursing defines a substance use disorder as the misuse, dependency, and addiction to alcohol or legal or illegal drugs. The program is rehabilitative instead of a punitive action intended to punish the nurse. The Alternative Program is administered by a Disciplinary Alternative Program Committee appointed by the Board of Nursing.
According to the Board of Nursing, the Alternative Program aims to protect public safety by permitting eligible nurses, for whom formal discipline is not necessary, to participate in chemical dependency rehabilitation or practice remediation alternatively.
The Board of Nursing outlines the objectives of the Alternative Program as follows:
- Provide a voluntary and non-disciplinary process to facilitate safe practice and ongoing recovery for nurses with a substance use disorder
- Encourage early identification, evaluation, and entry into treatment for nurses with a substance use disorder
- Assure that the nurse maintains necessary treatment and does not practice until it is safe to do so
- Provide information and resources to licensees, employers, treating professionals, and the public regarding substance use disorders and the Alternative Program.
Fortunately, nurses whom the Board of Nursing permits to enter the Alternative Program have their records kept confidential. Although there are a few exceptions to the confidentiality rule, situations that allow disclosure are:
- Only to employers or others as determined by the Alternative program to the extent necessary to monitor and assure compliance with the Alternative Program's requirements
- When disclosed by the participating nurse to another licensing authority
- When the nurse's participation in the program may be considered in any future disciplinary matter
Eligibility for the Alternative Program
Just because a nurse has a chemical dependency does not automatically qualify them for participation in the Alternative Program. The Board of Nursing's appointed Disciplinary Alternative Program Committee has full discretion in deciding whether a nurse is an acceptable candidate for the program. The Disciplinary Alternative Program Committee will review relevant documentation in determining eligibility.
To be considered for participation in the Alternative Program for chemical dependency rehabilitation, the nurse must meet the following criteria:
- Holds a Vermont nursing license issued by the Board of Nursing or is an eligible applicant for a Vermont nursing license
- Voluntarily request admission to the Alternative Program
- If requested by the Disciplinary Alternative Program Committee, the nurse must undergo a comprehensive alcohol or substance abuse assessment from a pre-approved qualified provider based on criteria determined by the Disciplinary Alternative Program Committee.
Vermont regulations on the Alternative Program detail that an applicant may be, but is not guaranteed to be, ineligible to participate if the nurse has any of the following:
- Has pending felony charges or felony convictions related to chemical dependency
- Has, within the proceeding five years, a restricted license for conduct that would constitute unprofessional conduct in the state of Vermont
- Has diverted controlled substances
- Has consciously taken or disregarded a substantial risk of harm
- Presents an imminent danger to the public
- Has a recent history of chemical dependency and failed treatment
- Has an independent alcohol or substance abuse assessment upon which the Disciplinary Alternative Program Committee determines that the nurse is not an appropriate candidate for the Alternative Program
What is an Alcohol or Substance Abuse Assessment, and How Do They Work?
As stated above, the Disciplinary Alternative Program Committee may require a nurse to complete an alcohol or substance abuse assessment by a qualified provider. An alcohol or substance abuse assessment is an evaluation generally done by a physician or an advanced practice registered nurse with a specific certification in addiction. It is possible, but unlikely, that your regular primary care physician has this certification, but you can call their office to confirm.
The nurse must get the provider approved by the Board of Nursing before completing the assessment. There are different certification programs that the Board of Nursing will accept to meet the necessary qualifications. One common certification program recognized by state boards of nursing throughout the county is certification through the Addictions Nursing Certification Board.
It can be difficult to find a certified provider; as mentioned, it isn't common for primary care and other doctors you might frequently see to have this certification. There are a few organizations that assist nurses in finding certified providers. The American Academy of Addiction Psychiatry and the American Board of Addiction Medicine also have search functions that allow you to identify qualified providers in your area.
One thing to keep in mind when finding a provider for your alcohol or substance abuse assessment is that they can be expensive. Assessments can cost anywhere from about $250 to $500, depending on your area. Most often, you will be responsible for the cost of the assessment; the Board of Nursing will never cover it. When investigating providers for your assessment, you may want to call your insurance and see if assessments are covered and if there are specific providers that your plan is in the network or will partially or fully cover.
How Does the Alternative Program Work?
The Alternative Program requires the nurse to enter into a legal written contract with the Board of Nursing. The Alternative Program will be individualized so that each nurse can address the Disciplinary Alternative Program Committee's concerns adequately. Contracts will include a set extended period for which the nurse will be monitored to confirm compliance with the Alternative Program. The contract will detail all the terms, conditions, costs, and restrictions the Disciplinary Alternative Program Committee decides are appropriate. Typical contract conditions may include:
- Substance abuse counseling and treating professional reports
- Participation in recovery group meetings and submission of a quarterly log
- Random drug and alcohol testing
- Abstinence from drug and alcohol use, except prescribed medications
- Professional practice only with Program approval, work restrictions, supervision, and employer reports
- Six-month prohibition on administering controlled substances
- Self-assessment reports
The contract is considered a formal order from the Board of Nursing; if the nurse violates the contract, disciplinary action consequences will occur. So long as the nurse complies with the requirements, they should not anticipate any disciplinary actions to be initiated in the future, at least not an action based on the chemical dependency conduct for which the nurse entered the Alternative Program. If the nurse completes and meets all the requirements detailed in their Alternative Program contract, they will be discharged from the program.
If a nurse participates in the Alternative Program, the Board of Nursing must deactivate the nurse's multistate licensure privileges for the duration of the nurse's participation in the Alternative Program. Once the program is completed, the Board of Nursing can reinstate the nurse's multistate licensure.
How Can I Learn More About the Alternative Program and Its Application Process?
Applying for the Alternative Program can happen at a couple of different times. The first is if a complaint has been filed against you and the disciplinary process has begun. After a complaint is filed against you, you will be notified of the complaint and impending investigation. These beginning steps of the disciplinary process are kept confidential.
During this time, you can apply for the Alternative Program. Still, the consequence is that if you are rejected from the Alternative Program, you have admitted guilt to the allegations in the complaint against you. This doesn't mean the Alternative Program should be ruled out as an option; you just need to be aware of this as a point of discussion for you and your Lento Law Firm professional license defense attorney.
You can also apply for the Alternative Program before any conflict arises or complaints are filed. You don't need to be on anyone's radar to apply. If you feel that you need treatment for your alcohol or substance use disorder and that it is impacting your life, you can do that. Often, nurses reach this point after a near miss of an accident. This could be almost getting in a car accident while under the influence or an event that could have caused a patient serious harm or injury, such as confusing a patient's medications. There are many ways to get treatment, and you can pursue treatment with or without the Alternative Program.
Suppose you have questions about the Alternative Program, eligibility, the application process, etc. In that case, you can contact the Board of Nursing's Discipline and Alternative Program Manager (also referred to as the Case Manager). You can do this without disclosing your personal identifying information to the Board of Nursing. Consultations with the Alternative Program Manager are confidential. Gaining this information while containing your anonymity allows you to control the situation. With this new information, you and your Lento Law Firm attorney can determine which treatment or program options work for you.
What are the Pros and Cons of Entering the Alternative Program?
The Alternative Program can be a great option for many nurses. Still, it is unwise to jump into applying for it without thoroughly discussing it with your Lento Law Firm professional license defense attorney. There are some scenarios where the Alternative Program is the best way to go; this could be if you are guilty of the allegations made against you in a complaint, and your actions would most certainly result in losing your license if disciplinary action is taken. But, most cases, like most things in life, are more of a gray area. Our Professional License Defense Team will help you assess every option before deciding. Once you have decided, we will guide you through the process, whether it be the Alternative Program or otherwise.
The Alternative Program is designed to get you the real help you need. If you are at that stage in your life and your alcohol or substance abuse disorder that you are ready to take the next step, this can be a great opportunity. You deserve to get treatment and receive the same level of medical and emotional care and support you have provided your patients throughout your career. And to return to doing your job at full capacity, being the best nurse you can be for your patients and the best colleague to your coworkers, you need to feel healthier and better equipped to handle the challenges ahead.
Entering the Alternative Program is, in a way, admitting to violating the Vermont nursing laws and regulations. This can be a pro and a con (the con will be discussed in the section below). The pro to admission through the Alternative Program is twofold: your guilt isn't associated with malice or causing actual harm or injury to a patient. It should not impact your nursing license status.
When there have been no serious and damaging consequences of your alcohol or substance abuse disorder, you look proactive rather than reactive. Being proactive comes with respect and more support from friends, family, and colleagues. And, because the Alternative Program is confidential, you largely have control over who in your life is privy to information about your problem and program participation.
The Alternative Program offers a structure that is beneficial during alcohol or substance abuse disorder recovery. While no one, especially adults, appreciates being monitored, the Alternative Program and its requirements will hold you accountable for your sobriety.
The Alternative Program seems great on paper and in words for many nurses, but there are strings attached you may have missed in your research. The Alternative Program somewhat ignores the realities of having an alcohol or substance abuse disorder. Most people, nurses or otherwise, do not complete a single treatment program and become all better; that just is not realistic and not how alcohol and substance abuse disorders work. Relapses are normal, happen, and are unfortunate, but nothing you should be ashamed of. And you certainly should not be ashamed or deterred from getting the additional help you need.
One problem with the Alternative Program is that it is a bit of a “get out of jail free” card, but it only works once. There isn't leniency for relapses, even if you are committed to immediately getting additional treatment. This means that you can face disciplinary action if you cannot complete your program, or even if you complete the Alternative Program, you cannot participate in it again. Completing the program will not make you immune to disciplinary action for relapses that come to the attention of the Board of Nursing through a complaint or otherwise.
The Alternative Program can be a long journey. At first glance, you think, ok, I just completed my treatment, took my drug tests, and finally graduated from the program to never hear from the Board of Nursing again. This is rarely, if ever, the case. Your Alternative Program may go on for years; these are years of monitoring and burdensome requirements with the Board of Nursing always looking over your shoulder.
Are There Any Other Options That Preserve My Vermont Nursing License?
If you are not yet on the Board of Nursing's radar, you can consider getting treatment for your alcohol or substance abuse disorder outside the channels controlled by the Board of Nursing. Although this can be incredibly difficult logistically and financially, it may be worth considering. In an ideal scenario, you will have time off from your employer, whether paid or unpaid, to discretely participate in an extensive treatment program covered by your insurance. Most likely, you will have limitations on your time off, ability to take unpaid leave, ability to set familial responsibilities and obligations aside, and financial ability to manage the cost of a treatment program.
If a complaint has been filed against you that is false or doesn't tell the full story and you do not have an alcohol or substance abuse disorder, don't be tricked into thinking the Alternative Program is the easy way out. You might be thinking that since I don't have a problem, meeting the requirements will be easy, and I will go on with my career without any damage to my license. But the Board of Nursing will be on your back, especially since you have admitted guilt; they don't care if you are innocent once you claim you have an addiction. Going through the formal disciplinary process, where you and your Lento Law Firm attorney can tell your side of the story, may be the better option.
Retain the Lento Law Firm Today
If you are a Vermont nurse with an alcohol or substance abuse disorder or facing an allegation for such, the Lento Law Firm can help. Our Team wants what is best for you and your license; we are here to guide you through the multiple options and vigorously defend your Vermont nursing license. Call us today at 888-535-3686 or contact us online.