As a nurse in West Virginia facing substance abuse allegations, you may be considering signing a settlement agreement, sometimes called a consent agreement, with the nursing board to resolve outstanding misconduct allegations. While signing this agreement may seem straightforward, signing one of these agreements too quickly can come at a high cost. Consent agreements typically require ongoing drug testing, performance evaluations, and therapy groups, most often at your expense. While all of these can be beneficial to someone battling substance abuse, doing them under the strict guidance of the Board of Nursing may not be optimal.
Before signing a consent agreement, contact the Lento Law Firm's Professional License Defense Team. Our Team assists medical professionals throughout West Virginia who are facing misconduct allegations. Contact a member of our Team today by calling us at 888-535-3686 or by filling out a brief contact form.
Factors Contributing to Substance Abuse in the Nursing Profession
Demanding Work Schedules
Not only are their schedules inconsistent and workload demanding, but they must consistently show empathy and understanding to patients despite it all. These overwhelming workloads can result in burnout, and nurses may resort to using substances to cope with physical and emotional exhaustion. What starts as a glass of wine after work to unwind or a cup of coffee mid-shift to keep going can quickly become a form of substance dependence.
Compassion Fatigue
Compassion fatigue, identified by psychologists as a form of vicarious trauma nurses feel after caring for a patient's emotional needs, also leads to substance abuse in nursing. As nurses devote much of their time to caring for patients with complex needs, their ongoing commitment can drain their physical, mental, and emotional reserves. This fatigue depletes nurses' energy, pushing them towards unhealthy coping methods like substance use to detach from work-induced trauma.
The West Virginia Board of Registered Nurses
The West Virginia Board of Registered Nurses oversees the state's nursing profession by setting minimum licensure standards and providing nurses with professional development and continuing education opportunities. The Board is granted authority pursuant to Chapter 30, Article 7 of the state's statutes. These statutes outline the legal requirements of the West Virginia nursing profession as well as the steps the Board is permitted to take while investigating instances of nursing misconduct, including substance abuse.
Substance Abuse Violations Under the Nurse Practice Act
Section 30-7-11 of Chapter 30 discusses the various misconduct allegations that can trigger disciplinary proceedings. In addition to misconduct issues such as fraud and negligence, the Board is authorized to pursue disciplinary consequences where a nurse is “habitually intemperate.” or “addicted to the use of habit-forming drugs.” Other grounds for substance-abuse-related misconduct investigations include:
- Substance-related arrests, misdemeanors, and felony convictions, including failure to self-report these instances to the Board.Top of Form
- Abnormal prescribing or dispensing practices.
- Unfit to practice due to negligence, “habits,” or other causes.
What is Nursing Substance Abuse Disorder?
The Nursing Council of State Boards of Nursing (NCSBN, 2014) describes Substance Use Disorder (SUD) as a spectrum of behaviors, ranging from misuse to addiction, involving substances such as alcohol and both legal and illegal drugs. Substance Use Disorder is recognized as a complex and dynamic concern for nurses, often leading to physical, emotional, financial, and legal ramifications. The prevalence of SUD in the nursing field is notably high. Some of the critical signs and symptoms of SUD among nurses are addressed below:
Behavioral Signs
- Preferring to give the highest dose of medication to patients.
- Frequently volunteering to be the one who administers medication.
- Frequently wasting or breaking medication.
- Having issues with managing medications that are strictly controlled.
- Receiving complaints from patients that their pain medication isn't working well.
- Liking to work shifts when there's less supervision.
- Showing sudden changes in mood, being anxious, or having emotional outbursts.
- Struggling to get along with colleagues and bosses.
- Being forgetful or having trouble remembering things.
- Taking many breaks or being away without explanation.
- Often being late, not showing up for work, or calling in sick, especially after days off.
- Keeping messy or confusing records.
Physical Signs
- Trembling or shaking hands.
- Slurred speech.
- Falling asleep suddenly.
- Watery eyes with unusual pupil size.
- Sweating a lot.
- Walking unsteadily.
- Having a runny nose.
- Feeling sick to the stomach, throwing up, or having diarrhea.
- Notable changes in weight.
- Wearing long sleeves or lab coats often to cover up.
What Instances Prompt Substance Abuse Referrals to the Nursing Board?
After discovering you're under investigation for potential substance abuse issues at work, your first thought is likely going to be, “Who reported me and why?” Sometimes, investigations are triggered by occurrences outside the workplace, like a DUI or an arrest. Most other times, they are initiated due to alleged misconduct at the workplace following a complaint. Complaints to the Board of Nursing can be made by many people, such as colleagues, supervisors, or even patients who suspect impairment, and a formal complaint can be lodged by calling the Board or utilizing the state's online portal.
Each complaint will differ based on the specific situation. Still, you might have been reported if others believed you were under the influence of drugs or alcohol during work hours or if they believed you showed up to your shift hungover. Other concerns that could lead to a complaint include the following:
- Positive drug tests during pre-employment screenings or when conducted for specific reasons.
- Indications of alcohol consumption, such as noticeable odor or behaviors linked to impairment.
- Unlawful consumption, improper disposal, or non-adherence when managing medications or administering them to patients.
- Inconsistencies in documentation or the manipulation of medication tracking systems.
What Happens After Being Reported for Possible Substance Abuse?
Investigation
As the subject of the complaint, you'll first receive a formal notice informing you of the complaint, the allegations, and the terms of the investigation. You have 14 days to respond to the claims upon receiving this notice. It's important to note that failure to comply with an investigation can be seen as a separate form of misconduct that can trigger additional disciplinary consequences.
The investigative process can range from case to case. Still, it will typically include things such as interviewing witnesses, collecting evidence, reviewing documents, or the use of other assistants and consultants throughout an investigation.
After the investigation, the investigator will determine if sufficient evidence exists to advance through the disciplinary proceedings. Alternatively, they can find insufficient evidence and close the case.
Formal Consent Agreements
A consent agreement is a legally binding agreement that is signed between the nurse in question and the Board of Nursing. In substance abuse-related cases, consent agreements often include terms and conditions that nurses must continue to meet for a specified period in exchange for a “resolution” of their outstanding disciplinary claims. These conditions may require nurses to enroll in a rehabilitation program, undergo regular drug testing, and adhere to workplace supervision protocols.
Administrative Hearings and Appeals
If the parties cannot agree to the terms of the settlement agreement, the matter proceeds to an evidentiary hearing consisting of evidence, testimony, and argument. These hearings operate like a small trial and take place in front of a neutral decision-maker. If a nurse is not satisfied with the decision issued after the hearing, they can opt to pursue an appeal.
If you have already turned down a consent agreement and are facing an administrative hearing or an appeal, our Professional License Defense Team can help. Do not feel like your chances of succeeding are gone because you were not able to reach a settlement agreement with the Board of Nursing. Contact a member of our Team today by calling us at 888-535-3686 or by filling out a brief contact form.
Why Consider a Consent Agreement?
Nurses might feel inclined to enter into a consent agreement for a variety of compelling reasons. At the top of the list, consent agreements can be attractive because they offer the opportunity to bypass a formal disciplinary hearing. Other nurses may feel that signing the agreement will allow them to continue their professional practice without the complication of license suspension. This may be especially appealing for those facing economic pressures such as providing for their families. Other nurses may even feel That agreeing to a consent order is also perceived as an act of professionalism, showcasing their efforts toward sobriety and recovery.
It's important to note, however, that while the immediate effects of signing a consent agreement may seem beneficial, nurses should carefully consider the long-term implications that these agreements can have on their career and professional reputation. Consulting with our Professional License Defense Team can provide you with valuable insights and help you explore alternative options.
Potential Drawbacks to Signing a Consent Agreement
Opting for consent orders might appear appealing at first glance, but the reality is that they can be misleadingly advantageous. West Virginia nurses should deeply consider all of the possible extensive consequences of these agreements before relinquishing their independence, incurring debt, or even admitting to a substance abuse violation that did not occur. Some of the potential drawbacks of consent agreements are explored below.
Professional Repercussions
Although consent agreements are typically “confidential,” many nurses with active agreements have a hard time hiding this from their colleagues and supervisors. Frequent drug tests, support groups, and professional monitoring forms can create conversations, changed schedules, and distractions that other people notice.
Consent orders might also become a part of a nurse's professional record, potentially impacting their future employment opportunities and professional standing. Even if nurses can maintain their current jobs, their prospects for career advancement could be compromised, especially when aiming for higher-level positions that necessitate a clean disciplinary record. Furthermore, nurses seeking to practice in other states through a multi-state compact license or work as agency nurses could find their paths obstructed by the presence of consent orders in their history.
Restrictions and Monitoring Burdens
Many nurses are unaware of the significant restrictions, time constraints, and monitoring burdens that life after a consent agreement can bring. Drug testing, group therapy, and frequent performance monitoring can significantly interfere with a nurse's professional commitments and personal responsibilities. Even in instances where nurses may be led to believe that these agreements are “private,” it may be much harder to hide frequent testing and discussion of performance evaluations at work than they realize, resulting in even more workplace gossip and increased observation.
Legal Implications
Consent orders are legal agreements that, if violated, may automatically result in the suspension or revocation of a nurse's license. Even when suspensions or revocations do not occur, the Board of Nursing usually keeps a record of any failure to comply. As a result, any subsequent allegations of misconduct can bring harsher repercussions since the nurse's history of non-compliance may influence the decision.
Consent orders are legal agreements that, if violated, may automatically result in the suspension or revocation of a nurse's license. Even when suspensions or revocations do not occur, the Board of Nursing usually keeps a record of any failure to comply. As a result, any subsequent allegations of misconduct could face harsher repercussions, influenced by this history of non-compliance.
Financial Consequences
Many nurses also may not understand that by accepting a consent agreement, which includes enrollment in rehabilitation programs, they are agreeing to pay for the program's costs themselves. The financial burden of these programs can vary widely based on their duration and type, potentially leading to significant expenses. Moreover, the fees for routine drug testing can increase cumulatively based on the required frequency of the tests.
Stress
Although the stress from a misconduct investigation is apparent, it often becomes more bearable once the investigation concludes, and nurses are at least not left wondering what lies further down the road. On the other hand, stress related to consent agreements can persist indefinitely. Although the disciplinary matter is said to be “settled,” nurses continued to suffer from a loss of independence, increased surveillance, and continuous professional monitoring. Throughout these rehabilitative programs, nurses are also frequently reminded that should they fail to meet the terms of their program ideally, they could face further, harsher consequences.
Alternative-To-Discipline Programs
Alternative-to-discipline programs act as rehabilitative measures that many states offer to nurses dealing with substance abuse issues. These programs often come as part of consent order agreements and include a variety of requirements. Common elements of such a program might entail participation in a formal treatment program, continuous professional monitoring, counseling, regular drug tests, and support to address the root causes of substance abuse. Generally, nurses are allowed to continue working while they participate in the program, as outlined in their respective consent order agreements. In West Virginia, this alternative-to-discipline program is known as the "Impaired Nurse Treatment Program," which we will delve into further below.
West Virginia's Impaired Nurse Treatment Program
The Impaired Nurse Treatment Program is a program administered by the board of nursing that offers support to nurses struggling with alcohol and substance abuse rehabilitative support through treatment, counseling, and ongoing check-ins. Although the program is “voluntary,” the Board of Nursing typically requires nurses to agree to the program as part of a consent agreement.
The Board's primary objectives for operating the program include:
- Protecting the public's health and safety by providing a program that assists nurses struggling with alcohol abuse and chemical dependence.
- Decreasing the time between a nurse's acknowledgment of their substance abuse disorder and the timeframe in which they seek help.
- Providing a rehabilitative and therapeutic program for struggling nurses rather than a punitive one.
- Reaching nurses struggling with substance abuse disorders who may not receive treatment elsewhere.
- Assisting the Board of Nursing with ongoing monitoring and information in the event that the nurse does not remain compliant with the program's terms.
Criteria for Admission
Because participation in the rehabilitation program is voluntary, each nurse must apply or be referred. Applicants can self-report their dependency issues and request participation in the program, or they can be referred by another individual or a member of the Board's disciplinary committee. Once accepted, nurses will be provided with written information that details the program's procedures, including the rights and responsibilities of the nurse, as well as potential consequences for noncompliance.
Applicants for admission must also demonstrate that they willingly agree to participate in the program and they have or currently abuse substances in a manner that may affect the nurse's ability to practice nursing safely. Nurses may be barred from participating if they have been terminated from this or any other alternative program for non-compliance.
Barrs to Program Participation
The Board of Nursing can deny admission to the program if any of the following are true:
- The nurse is not eligible for licensure in the state of West Virginia.
- The nurse diverted controlled substances in a manner other than for self-use.
- Their participation in the program would create too great of a risk to other program participants or operators.
- The nurse has a current or past history of patient harm.
- The nurse has past or current legal charges that require disciplinary review, or they have a prior felony conviction.
- The nurse has a previous disciplinary action pending in another state.
Should I Self-Report My Substance Abuse Issues to the West Virginia Board of Nursing
Deciding whether to self-report a substance abuse problem to the Board of Nursing in West Virginia is a significant decision with complex implications. While a nurse may feel like surrendering their license is the appropriate and courageous thing to do, doing so without consulting our Professional License Defense Team can have drastic consequences. Although self-reporting can sometimes lead to more lenient decisions by the Board of Nursing in disciplinary hearings, self-reporting doesn't automatically guarantee immunity from disciplinary matters either.
As an alternative, you can consider seeking private treatment through a confidential healthcare provider that works in substance abuse. Many healthcare professionals have programs that are designed to help professionals recover discreetly. These programs may also be more tailored to your needs and schedule rather than one handed down to you by the Board of Nursing.
Some peer support groups for nurses or substance abuse disorders, such as Alcoholics Anonymous, may also be a good alternative, providing you with the opportunity to engage in these programs voluntarily rather than under the thumb of the Board. Doing so voluntarily may make you more open to the contents of the program or make it easier for you to form healthy connections with peers who are going through the same struggles.
Ultimately, the decision to self-report should be made with careful consideration of both the benefits and risks. Remember, the goal is not only to address the Board's concerns but also to ensure you receive the support necessary for recovery and to continue your nursing career.
Consult Our Professional License Defense Team Before Agreeing to a Consent Order
Before considering a consent agreement with the West Virginia Board of Nursing to resolve substance abuse misconduct, it's essential to consult with our Professional License Defense Team. You deserve to have a comprehensive understanding of the potential ramifications that may ensue and what life after a consent agreement can look like.
Although you may believe you have no choice but to accept a presented consent agreement, this is not accurate. The truth is, you may not be aware of all of the various strategic defenses or alternative routes that can help you avoid a cumbersome agreement. Our Professional License Defense Team can also propose alternative solutions or compromises that the Board might not initially offer. These terms may encompass less rigorous program participation requirements or an understanding that the agreement will remain confidential if signed, thereby minimizing its impact on future career opportunities.
Contact The Professional License Defense Team Today
Our Team has successfully navigated nursing misconduct allegations nationwide, especially within West Virginia. Our Team is ready to help you consider whether a settlement agreement with the West Virginia Board of Nursing is proper for your unique circumstances. Contact a member of our Professional License Defense Team today by calling us at 888-535-3686 or by filling out a brief contact form.
