If you have a substance abuse problem that you report to your state’s nursing board, there are a few potential outcomes of your report. Those outcomes vary substantially in their impact on a nursing career, so it is important to weigh them carefully before proceeding with reporting your struggles.
Many nurses who report their substance abuse issues are diverted to a treatment program overseen by their state’s nursing board. These are referred to as alternative-to-discipline (ATD) programs. While each state’s primary ATD program is unique, they generally allow nurses to get treatment without losing their license to practice.
However, some nurses who report substance abuse can be “rewarded” for their honesty with disciplinary action. If a nursing board believes that the nurse endangered patients or violated provisions of the Nurse Practice Act, the board may pursue discipline—possibly even suspending or revoking the nurse’s license.
Knowing these two polar outcomes are possible, you surely have more questions, including: So, should I report my substance abuse or not? We will answer this and other pressing questions in this article.
First, know what to do if you or a loved one is currently debating whether to report a dependence-related condition to your state’s nursing board. Call the LLF National Law Firm Professional License Defense Team today at 888-535-3686 or contact us online for reliable, personalized guidance about how you should proceed.
Why Do Nurses Hesitate to Report Their Substance Abuse Problems to Their States’ Nursing Boards?
It’s no secret why nurses read articles like these rather than reporting their behavioral health challenges to the board without second thought. They’re scared, uncertain, and untrusting that the nursing board will show them the compassion and understanding they deserve.
Our Professional License Defense Team gets that nurses:
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Understand (more than most) how important patient safety is, and how their admission of substance misuse could expose them to accusations of compromising patient safety
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Fear of personal and professional stigma that might stem from their admission
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Strive to uphold the public’s perception that they are invulnerable to weaknesses (almost superhuman, even)
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Recognize that nursing boards may protect the interests (and image) of the collective over the individual—and that might mean sanctioning a nurse that the board considers a liability to their image
Nurses have legitimate concerns that admitting their battle with one or more substances may be a defining moment in their careers (and not in a positive sense). If a nursing board reacts to the nurse’s admission with unanticipated coldness, outrage, or even hostility, that honest nurse will quickly regret their decision to be forthcoming.
Know this: While your concerns may be valid, there is also a real likelihood that sharing your struggles will elicit a compassionate response that leads to a commendation for your honesty, treatment, and your return to your old self.
Is It Mandatory for a Practicing Nurse to Report Unhealthy Substance Use to the Board?
Most Nurse Practice Acts stop short of mandating that a nurse report a substance use disorder. Instead, they use language that implies a nurse should determine whether the substance use impairs their ability to practice safely—if it does, the nurse is typically expected to report their dependency issues.
The Texas Board of Nursing’s guidance serves as an example of the sort of language nurses encounter when determining if they must report their substance-related struggles to a nursing board:
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The Texas Board of Nursing explains that “some circumstances” may affect a nurse’s “fitness to practice,” and those circumstances can include “substance use disorders”
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The Board adds that, if “the nurse’s practice is impaired by chemical dependency or drug or alcohol abuse,” they are expected to report it
This language leads to an obvious conclusion: If the nurse does not believe their substance use impairs their nursing practice, they would not be required to report it to the board.
Why Might a Nurse Report Their Substance Use, Even if Nursing Statutes Don’t Require Them To?
If a nurse does not have to report their substance use, they have a judgment call to make. They can either keep their struggles to themselves (and deal with them as they see fit) or report them to the board voluntarily.
So why would a nurse report such a sensitive matter if they’re not mandated to do so? A few possible reasons include:
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They believe the nursing board might find that their substance use did impair their ability to practice—even if the nurse disagrees, this could expose the nurse to discipline if they fail to self-report
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They want to enroll in a nursing board-sanctioned treatment program, which would necessarily require them to reveal their struggles
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They interpret their nursing board’s statutes to mean that self-reporting is mandatory
These are the kinds of judgment calls that can come to define a nurse’s career. Allow our Professional License Defense Team to advise you in such matters, as our perspectives are priceless for those who need to make such high-stakes decisions.
Are There Any Alternative Approaches a Nurse Might Take, Rather Than Reporting Their Substance Use?
If a nurse does not have to report their risky substance use and does not trust their nursing board to handle the issue reasonably, the nurse might elect to:
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Pursue recovery on their own
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Structure outpatient recovery so it does not conflict with their nursing responsibilities
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Take a leave of absence if they require inpatient recovery (they may not be required to disclose the reason for the absence, depending on their unique personal circumstances)
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Take other measures that allow them to address their substance use without overtly notifying the nursing board of the issue
There may be risks in pursuing treatment without notifying your state’s nursing board. We will apprise you of any such risks, as well as any leeway nursing statutes afford you to keep your substance use to yourself.
Might I Face Discipline After Reporting My Substance-Related Challenges?
Nurses can be disciplined as a direct result of reporting their substance use. Most state nursing boards can discipline nurses whose substance use disorders:
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Impede their ability to practice
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Endanger patients
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Result in harm to even a single patient
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Put colleagues at risk
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Lead to criminal activity (such as diverting narcotics for their own use)
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Result in other violations of the state’s Nurse Practice Act
Texas nursing statutes, for example, cite “intemperate use” of alcohol or drugs as possible grounds for discipline. It defines “intemperate use” as “being on duty or on call while under the influence of alcohol or drugs.”
To discipline a nurse, however, the nursing board may need credible evidence that the nurse was under the influence while on call or on duty. If the nurse does not admit as much, they may avoid discipline after reporting their problematic substance use to their nursing board.
The possibility of a nursing board disciplining nurses for substance-related offenses underscores the need to protect yourself—by engaging our Professional License Defense Team—before you alert your state’s nursing board to your present challenges.
What Are Alternative-to-Discipline Programs for Nurses in the Grip of Unhealthy Substance Use?
Most nurses who voluntarily report their substance use seek admission to an alternative to discipline (ATD) program. While each state’s respective ATD program has distinct characteristics, it’s generally true that these programs:
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Allow nurses to get treatment for substance disorders and mental health problems without suffering discipline (so long as they abide by the rules and terms of the ATD program)
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Are confidential, so long as the nurse remains in good standing with the program’s administrators
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Can be operated in conjunction with third parties, including those considered experts in the treatment of substance use disorders
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Can be the pathway for a nurse to overcome their substance-related challenges and return to work
A nurse who completes an ATD program is often eased back into their professional responsibilities. They may have to complete a probationary period during which their nursing privileges may be restricted or modified. They may also be monitored for a period of time, subjected to periodic evaluations and tests that gauge their sobriety.
A Real-World Example of an ATD Program
In Florida, the Intervention Project for Nurses (IPN) serves as “one of Florida’s designated Impaired Practitioner Programs (IPP).” It has a contract with the Florida Department of Health, showing how third-party organizations often partner with state nursing authorities to provide treatment to struggling nurses.
The program’s stated objectives are to:
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“To supply a cost-effective avenue to help nurses”
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To provide an alternative to the disciplinary process for nurses who need treatment, rather than punishment
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To ensure nurses remain in the profession, rather than having to defect because of disciplinary action
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To “protect health, safety, and welfare of the public” by helping nurses overcome their challenges and return to service in a sober capacity
The enrollment process in the IPN starts with an evaluation. An IPN-approved evaluator conducts an “extensive interview,” reviews relevant documentation, and conducts any testing they deem necessary.
The IPN’s treatment and monitoring process is “very individualistic,” so the timelines for completing the program can vary from nurse to nurse.
This is the kind of program that most state nursing boards offer nurses who are seeking to overcome substance-related challenges. Our Professional License Defense Team will work to help you get into any ATD program that you desire to enroll in.
Which Nurses Are Eligible to Enroll in an ATD Program?
Admission to an ATD program is not guaranteed to every nurse living with a substance use disorder. Some of the standard criteria for nurses to be enrolled in an ATD program are:
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The condition they are seeking help for is one that the ATD program treats
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The nurse displays a genuine willingness to participate in the program, abide by its rules and procedures, and overcome the condition for which they are seeking treatment
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The nurse has not engaged in any criminal activity for which they are presently facing discipline (or legal consequences)
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The nurse did not harm or endanger any patients in the course of their substance abuse problem
ATD programs also have conditions throughout the treatment process. If a nurse enrolled in an ATD engages in prohibited drug or alcohol use, for example, they can expect to be removed from the program (and likely placed in the formal disciplinary process).
How Can I Protect Myself If I’m Thinking About Reporting My Substance Use to the Nursing Board?
Now that you understand the potential risks and benefits of reporting a substance abuse issue to a nursing board, you must protect yourself before taking the next steps.
“Protecting yourself” means:
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Speaking with the LLF National Law Firm Professional License Defense Team as soon as possible, as treatment cannot wait—but you should not move forward rashly or hastily
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Refraining from taking any action that might jeopardize your career until you have spoken with us (that may include reporting your substance use disorder to your nursing board)
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Weighing the risks of any given course of action, including reporting your substance use and keeping the substance use to yourself
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Trusting our guidance and advice, once you have engaged us as your representatives
Your career is worth preserving. By leveraging our extensive experience, you are advancing your professional interests and preventing mistakes that could place your nursing license at risk.
How the LLF National Law Firm Professional License Defense Team Will Help You Traverse This Crossroads in Your Career
Our Professional License Defense Team serves several vital roles for the nurses we represent, including:
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Answering the pressing questions we are sure you have for us
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Proactively advising you about the merits and drawbacks of any given course of action
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Advocating for you to be admitted to any ATD program that could benefit you
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Coordinating your reporting of the substance use issue to the nursing board, should you elect to report it
We are the team you can trust, and the team that every nurse deserves. Call the LLF National Law Firm Professional License Defense Team today at 888-535-3686 or contact us online.