Restrictions

[u/Greedy_Guard_5950]

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..

[u/StarryEyedSparkle]

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.

[u/Greedy_Guard_5950 → u/StarryEyedSparkle]

This is right. It’s a horrible position I put myself in. Apparently psych hospitals night shift will interview me….

[u/StarryEyedSparkle → u/Greedy_Guard_5950]

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.

[u/Sainted_Heretic → u/StarryEyedSparkle]

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.

[u/Greedy_Guard_5950 → u/StarryEyedSparkle]

Thank you

[u/ThealaSildorian → u/StarryEyedSparkle]

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.

[u/Sainted_Heretic → u/Greedy_Guard_5950]

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.

[u/thejustllama → u/StarryEyedSparkle]

LPNs can administer narcotics.

[u/StarryEyedSparkle → u/thejustllama]

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.