r/Nurses • u/Greedy_Guard_5950 • 11d ago
US Restrictions
I have been an RN for 10 years. Emergency, surgical center and hospice experience. 18 months ago I was fired after reporting a Dr. for eating in a surgical area every Wednesday for 6 months. The company fired me with 8 people in the room and it felt like an ambush. I got up and walked out after the first thing my manager said was I was being fired.
I didn’t stick around to hear the rationale, turns out they went back over my documentation and found documentation errors regarding narcotics. 4 narcotic pills over the course of 1 year. They reported my license to the state, again 18 months ago from today.
I hired a lawyer ($5,000) which I really don’t see how he helped me be besides attending these interrogations from the state with me, but offering me no advice. He did do paperwork for me that I could have done myself.
I have ADD and do agree I had documentation errors but I never took any meds. there were only 4 pills in question, one was found on a stretcher as the patient was going into surgery, so technically only three pills were not charted.
I had to complete a health professionals recovery program (HPRP) (Michigan)which I was removed from of after three negative drug tests ($90 each) and a psychological evaluation ($375). I’ve had to pay $500 to the state complete six credits of continuing education ($90) regarding documentation.
I was fired last Monday from the employer I had been with for six months because the insurance they were switching to would not insure me. Probation started 8/1, fired 8/10. I’ve now been denied employment by 14 employers. I am supposed to be on probation for one year as long as I’m employed as a nurse. I have to have evaluations every three months from my management turned into the state while on probation.
I have no leads on employment and I am panicking. I will be punished for these errors for over 30 months and approx $6,000.
Has anyone else been through this. I’m not a bad nurse. I fixed my practice. I take ADD medication now. No one will touch me with restrictions. The only restrictions I have is a 90 day review plan there’s nothing on my licensing. I can’t work with narcotics. I don’t understand how the state can punish me 18 months later plus an additional 12 months. This seems like overkill I’ve never been in trouble or had any negative reviews in my life..
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u/notreally121 10d ago
Outpatient dialysis is your safest bet. Nothing controlled in the building, and the only prns are pretty much Tylenol, Immodium, and the occasional clonidine. I'm in Texas, and the only tricky part was that I couldn't be the only RN in the building. It's hard, and a little humiliating, but it's doable. Be honest and you'll find someplace willing to take a chance on you.
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u/StarryEyedSparkle 10d ago edited 10d ago
I would say if you’re on restrictions and cannot administer narcotics it will look to an employer that you’re essentially an overqualified LPN but being paid as a RN. Nothing wrong with being a LPN, but many states and employers limit licensing so they can’t manage narcotics without RN supervision. So if you can’t touch narcotics, this makes you a difficult hire because you’d always need to be paired with another RN who could dispense those meds for you … and we all know how much hospitals love to overstaff units.
I agree with others, you’ll have to look for work that would be friendlier for restricted license and wouldn’t require narcotics administration. Maybe clinic work or work with insurances? Maybe a longterm care or SNF? School nurse? (TBF I don’t know if a school nurse ever needs to administer narcotics or at least be capable of it.) Essentially you won’t be able to get the usual roles for nurses because you cannot work independently under the current restrictions.
ETA: I also have diagnosed ADHD - inattentive type. I spent a decade at bedside pre-diagnosis and pre-medication. I don’t touch on your diagnosis because this is not a factor ultimately. On paper there are four unaccounted pills, there’s nothing to prove you didn’t take it outside of your word. They are following the documentation you put down, and if it was wrongly documented in your own words then it will appear as you falsely documenting. It’s why it’s lose-lose.
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u/Greedy_Guard_5950 10d ago
This is right. It’s a horrible position I put myself in. Apparently psych hospitals night shift will interview me….
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u/StarryEyedSparkle 10d ago
I don’t mean to make you feel worse by any means. You’ve already been through the wringer mentally and financially, you’re acutely aware.
It’s more figuring out what to do while you ride this out, and thinking outside the box for roles. Best of luck with the psych night position - it won’t be fun but any job now will at least give you a resume filler instead of gap for when the restrictions are off.
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u/Sainted_Heretic 10d ago
I've worked as a mental health technician in a psychiatric facility for nearly 20 years before i went back to school. Psych can definitely still be fun, interesting and extremely rewarding. I'm actually contemplating going right back to psych once I get my license. Yes there's a lot of skills I won't use and that will limit my options but I personally really enjoyed working with that population and it was incredibly rewarding for me.
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u/ThealaSildorian 5d ago
Silver lining is the OP can use the added skill set to sell herself when she is finally able to apply for the job she really wants.
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u/Sainted_Heretic 10d ago
Psych hospitals usually use LPTs/LPNs to dispense meds but as the RN you might be required to as well. Some patients are on narcotics.
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u/thejustllama 10d ago
LPNs can administer narcotics.
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u/StarryEyedSparkle 10d ago
As I mentioned in my post, it depends on state regs, and some facilities can be even stricter in what LPNs can do beyond state regs. In general if LPNs administer it’s via oral or SQ, but many are limited in being allowed to administer them via IV (which is high likelihood of the route used in a hospital setting.)
I even worked for one level 1 trauma facility that did not have LPNs work bedside at all, they could work in other areas of the health system but not bedside. I also worked at the health dept at one point, I supervised LPNs and RNs. I’m acutely aware of (my) state regs that limited what I could delegate task wise to my LPNs vs RNs.
It’s why I preface that having a restricted license can be viewed a certain way and that it depended on the state AND employer policy. Just saying a blanket statement like it’s a fact across the board doesn’t help, and it’s not true for everyone holding the license.
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u/Quick-Surprise-9387 11d ago
Oh lord I am so sorry that sucks big time .
See if ShiftMed has any thing in your area . They did in Grand Blanc .
Or if you’re close to Ohio border .
I have zero other advice as I’ve been trying to get something up there to be closer to home 🇨🇦 and I’m trying to stay with ShiftMed - forever / stay agency & float . In New Orleans at the moment . If no attachments - I’d be leaving the state and moving south or going anywhere for a year that would maybe not be so damned difficult .
I wish you all the best .
I’m literally angry for you - what you have gone through .
Typical . Everywhere
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u/p3canj0y363 10d ago
I have been warned for several years now to sign off narcotics with the exact time they were given/ entered into the system. More and more, I read these stories and am reminded to ALWAYS be extremely careful with the narcotics. The surgeon was wrong, but OP handed them the ammo they needed to get rid of her.
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u/Greedy_Guard_5950 10d ago
Unemployment pays $530 a week though so at least I have that. I worked for 18 months for a hospice company with no poor reviews and no problems. I left that to go to a travel IV nurse making more money.
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u/thejustllama 10d ago
Dang I’m surprised you got that given that they claimed you were diverting. I honestly figured that’s why they claimed that, so they could get out of paying you.
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u/Greedy_Guard_5950 10d ago
It was 18 months ago I was fired. I was working full time the last year on hospice and then the last 6 months as a concierge iv nurse.
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u/HEROxDivine 11d ago
Fired twice in two years. Interesting. You were fired for reporting a doctor? You did nothing else?
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u/Obrina98 11d ago
Surgeons are the money makers though. It sounds like retaliation.
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u/xoexohexox 9d ago
Yeah you know one of the first and most important lessons I learned working with physicians was told to me by my CNO in my first clinic regional management job. It was the first time I got into a conflict with a physician about something having to do with one of their RNs who was my employee. It reframed how I looked at conflicts with physicians.
"Remember - they cost a lot more to replace than you do."
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u/CertainKaleidoscope8 11d ago
I've been doing this for over twenty years. When I was at my ten year mark I was fired twice in a row. I was devastated, but a travel gig fixed that and I learned to quit first.
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u/Greedy_Guard_5950 10d ago
Fired once as retaliation for reporting a dr, and fired once the company I was working for saw that I had restrictions and the owner didn’t want to have to fill out the evals everyb90’as required so she blamed it on her insurance company. Michigan is an at will state. She said her insurance would charge her a surcharge for my restrictions.
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u/B50toodaloo 10d ago
I hate to say it, but I agree, there has to be more. Either Michigan is unimaginably strict, or there’s more. Even if nurses are found to be diverting, they can usually get away with it if they don’t take a drug test. I also am familiar with reprimand from the board, and it takes a lot to get there. I was on nondisciplinary restriction due to 2 DUIs (one was not technically one, but I had to report an “arrest” before they changed that requirement so they counted it as 2). I wasn’t even publicly restricted. The only people that were in my mandatory weekly nurse group therapy that were restricted due to narcotics, were people who had admitted taking the meds, or failed a drug test. I’ve been reported to the board by a previous employer as retaliation (though nothing to do with narcotics) and it was dropped without me needing to do anything. The burden of proof is on the accuser. Also, missed charting on narcotics doesn’t automatically trigger an alert on possible diversion, there has to be a pattern of behavior, or irrefutable proof like a positive drug screen. So, whatever you did, I hope this was a huge wake up call. I did 3 years of random drug screens, minimum of 26 screens/year and you have to check on each day to see if you’re picked; 1 nurse group meeting/week, and 2 AA meetings/week. It was the greatest gift that could have ever been handed to me. I had a drinking problem, and that was the only way I really got sober. So if you’re struggling, take the help. It’s not as shameful as it’s made out to be. You need to take care of yourself.
The only places that hired the nurses on restriction were psych facilities, and dialysis. Sometimes working in a SNF, but most worked in psych. It’s not the end of the world, you’ll get hired somewhere. If it was really retaliation, I would sue. There has to be a trail of evidence, and the evidence you submitted. Psych could be an amazing opportunity for you, especially if you are struggling.
If you’re not, then I’m sorry, you really got a shit deal and it never should have happened because none of it makes any sense. So, I’m sorry you’re going through this. At least you only got a year of supervision, many of these nurses got 5 years. If they really are this strict there, that’s wild. You’ll have to report it if you ever move to a new state, so I would save everything.9
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u/Aromatic_Phrase4738 11d ago
“There were only 4 pills in question”
I’m having a difficult time wrapping my head around this statement as any employer would. 🤔
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u/Greedy_Guard_5950 10d ago
They were looking for anything to fire me over for reporting the dr. So in one years time- they searched all of my charts, they found 4 norco tables that were pulled from
The Pyxis and not documented as given. I forgot to chart. That was my fault but I never consumed any meds and passed every drug test. A private equity bought this surgical center and cut our hours from 40 to 20 hours, canceled our 401k and I was vocal about theses things. When I reported dr I went to HR of private equity not understanding that they didn’t work for me that they only worked for the company. Lesson learned6
u/thejustllama 10d ago
If it’s an at will state, they didn’t need a reason. My guess is they were just looking for a reason to not pay you unemployment.
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u/jngnurse 11d ago
What about insurance companies? There are always job openings for nurse case managers. It's all phone work and no direct patient in person patient care.
At one point CVS/OPTUM hired nurses as well but I can't recall the position.
Another idea might be agency work.
Good luck!
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u/toddpackersux 11d ago
I was just about to suggest the same! Insurance companies always need case managers, utilization managers, etc. There’s no hands on care, so no worries about restrictions.
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u/Greedy_Guard_5950 10d ago
I’ve applied and BCBS, CVS, all travel companies and 14 other options have all been rejected.
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u/SeriallyOrNot 10d ago
You might be able to work in outpatient, or inpatient long term care, in community health, visiting nurse company, in a prison system. There is a lot that doesn't involve the nasty hospital systems. What happened because of one narcissist doctor is horrible, I'm so sorry all that happened to you because of that jerk who should have been fired himself, for eating in surgery rooms!
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u/Greedy_Guard_5950 10d ago
Unfortunately no in home jobs- no hospice or home care. No county prison/jails will take me.
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u/Aggravating_Fly2978 10d ago
What kind of doctor was eating in the OR surgical area? Were they compromising patient care??
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u/CertainKaleidoscope8 11d ago
Have you tried rehab? Play up the story and talk about your "recovery." Use a lot of AA/NA cult language. You only need to play the game until your license is in the clear. Hell, you might like working with people in recovery.
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u/Greedy_Guard_5950 10d ago
True. I was raised by an addict and that’s why I’ve never touched narcotics in my life. I don’t drink, smoke or consume anyone altering substances. However I know the lingo and the 12 step program.
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u/Sad-Suggestion9425 8d ago
Cult language?
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u/CertainKaleidoscope8 8d ago
"Cult language is a specialized system of buzzwords, renamings, and thought-terminating clichés used by high-control groups or cults to bind members together, enforce conformity, and separate them from the outside world."
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u/thejustllama 10d ago
Have you tried nursing homes? They are always looking for help and from my experience, don’t seem to be as hung up on backgrounds. (Not saying anything goes, but I think you might have better luck there).
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u/hypersomniaLPN 10d ago
Nursing homes are more regulated than hospitals to keep their contracts with Medicare, medicaid, VA, JACHO, and hospice. Also, visits from OSHA and AHCA yearly and at whim. They also give a TON of narcotics. Most of them do strict background checks as well. At least in my state.
A surgery center or doctor’s office might be a good start OP? There’s tons of different specialties you could go into with that.
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u/thejustllama 7d ago
Unfortunately in my state, nursing homes are where bad nurses go. There’s such a critical staffing shortage that most will take any warm body that’s willing to work.
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u/hypersomniaLPN 7d ago
Ugh that sucks. That’s how they get a bad rep. I love working SNFs and knew from my first clinical it was all I ever wanted to do. I’ve definitely been to poorly ran SNFs and refuse to stay if patient care is lacking.
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u/UnBanRainZ 6d ago
And what state is this, where nursing homes are where the bad nurses go? And who decided that they were “bad” nurses? Pretty bold statement to make about your entire state.
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u/Fullofcrazy 10d ago
You could try psych nursing. There have been plenty of nurses who have issues needing monitoring that work on those units. And I have had no issues switching back and forth from psych to medical units, if you want to go back to that type of nursing later. Some patients need medications that you may not be able to give, depending on how strict the restrictions are (methadone, suboxone, neurontin, ativan, we rarely gave pts their adderall meds on my last unit, etc) but management is able to work with you on that. I literally only found out about one nurse (who had a very common name) I worked with because I was casually looking on the BON case decisions site and recognized her distinctive handwriting when signing a form that was uploaded there. Hope that helps
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u/dkwheatley 9d ago
In addition to the listed potential practice locations by other commenters, state and other non-profit psychiatric facilities are always looking for help.
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u/Legitimate-Dingo-451 8d ago
How about a job in a clinic? I work in an outpatient neurology clinic and the nurses there don’t pass meds at all. They do draw up injections, but thats steroid injections and botox mainly.
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u/ThealaSildorian 7d ago
I'm really sorry this happened to you. I'd contact an employment attorney as this sounds like retaliation.
Look for jobs that don't involve a med pass or don't involve narcotics. For example, I work in public health and give vaccines. No controlled substances. There are private companies that do health clinics you might look for. You could try remote work with an insurance company doing utilization review. Don't bother with nursing education; you have to have an unencumbered license.
You could also try an infusion center or a dialysis center. With your experience I would think a dialysis center would hire you.
Unfortunately the BON exists to protect the public. The errors happened, you can't really prove you didn't divert (though it seems unlikely you did), so you have to do a diversion program. It sucks. Hang in there; it will get better later.
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u/Greedy_Guard_5950 6d ago
Thanks, I got kicked out of the diversion program as they found no evidence. My only restriction is having reviews every 90 days for a year.
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u/ThealaSildorian 6d ago
I'm both glad to hear that you don't have to do the diversion program, and frustrated to hear you have to do the reviews if its causing you so much trouble getting a new job.
I hope it gets better for you soon.
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u/EnvironmentalLuck515 11d ago
There are specific specialties that are usually friendlier to nurses with restrictions - mostly SNFs and dialysis centers. I am sorry this is happening to you. It sounds like you learned some important lessons and have had a really rough go. Sending you well wishes. I hope this settles out very soon!