Any advice?

Hi all.
I'm not a nurse. My wife is.
In 5 months it will mark her 4 years of being clean. She will no longer have to test or anything else to keep her license. For the past 1.5 years she's been nursing at the county health department. She loves her job and her employers truly love her. She's such a hard worker going above and beyond what they expected.

A few days ago the board called her and told her she tested positive for Ultram. She was devastated. They told her to stop working and that if she wanted the B sample run she could. But in all honesty, they said, the B samples never come back clean. We are racking our brains trying to figure out how this came to be. She has never (in her knowledge) taking any prescribed drugs without a doctors orders. She is totally clean. But the Nursing Board's hands are tied. They cannot accept any other test - hair or otherwise. They will only go by what they have in possession.

I have grilled her on what may have happened. She tells me she has not taken anything. She also says I have every reason not to believe her because of her past. But I do believe her. She has worked so hard. She has done so much to make things right after her first, and only, mistake.

Can anyone give us any advice on this false positive test? We are planning to run the B sample but feel that it will not help. I feel so bad for her. She is a mess. I love her and hate to see her in this situation without trying to help in any way I can. Please. If you know anything that we can do or should do tell us.

The only advice I could offer is to just sit tight and hope the follow up test will be negative...false positives have been known to occur. Was a split sample done? The reason I ask is because if the first sample is positive, they retest with the second (split sample). Please keep us posted and I'll keep your wife in my thoughts. My biggest fear is that I too will test positive for something when I know I'm clean.

There are some cases wher people who were taking paxil have teted positive for ultram. if you wife is taking any antidepressants this may be a factor.

hppy

She is taking an antidepressant but they were aware of it prior to the test. The week before she tested and it was clean. Then this one and there was evidence of ultram. And yes there was a split sample taken. We are so devastated. She is a mess right now and my heart is broken seeing her like this. She has done everything to stay clean for almost 4 years now. This happened right at the time she would have cleaned her records and the testing would have stopped. I hope the board takes this into account and all the positive monthly updates her supervisor has written to them.

In my extensive experience dealing with the California Board, a lot will depend on the mood/attitude of the people managing your wife's case. Most view the incidence of False positives as anecdotal or immpossible at best. With just 4 months to go on my Diversion contract I had a False positve Etg and was taken off work for 10 days while they tested and retested me before they would concede that it was probably a false result. In the end I finished my diversion program as scheduled. What I always say is that these are the challanges we (In recovery) face. If God brought you to it He'll get you through it. This too shall pass and all that.

Tell you wife to hang in there and keep doing the next indicated step. I will keep her in my prayers.

Hppy

hppygr8ful wrote:In my extensive experience dealing with the California Board, a lot will depend on the mood/attitude of the people managing your wife's case. Most view the incidence of False positives as anecdotal or immpossible at best. With just 4 months to go on my Diversion contract I had a False positve Etg and was taken off work for 10 days while they tested and retested me before they would concede that it was probably a false result. In the end I finished my diversion program as scheduled. What I always say is that these are the challanges we (In recovery) face. If God brought you to it He'll get you through it. This too shall pass and all that.

Tell you wife to hang in there and keep doing the next indicated step. I will keep her in my prayers.

Hppy

Thank you so much. I believe it really does lie on the board's mood. My wife has been a hard worker and has had no incidents prior to this. She is solid. Please keep praying for us - her especially. This job means so much to her. She loves it and the people she works for. My heart was heavy this morning. I knew she wished she was getting up to go to work. She misses it.

We are still waiting on the B sample and then what the board decides.

The 'B' sample came back the same. We are waiting for the Nursing Board to tell us what they have decided.

We're praying for a miracle. My wife just doesn't understand. All that time (4 years) of being clean, working hard, doing what was right, then this.

I guess this can be a warning for all. Send in ALL OTC meds you are taking, DO NOT take even the most identifiable OTC pain meds from anyone. Even your family. Be more cautious than ever. Or you may find yourself in our situation.

The good thing that has come out of this so far. I have grown closer to her. I see just how good she is as a wife, mother, and employee. She has received cards and phone calls from her coworkers telling her how much she is missed. She misses being at work. She absolutely loved her job. She has told me many times even during tough days that this was the best job she has had. She's a people person. She has a great attitude and a genuine care for each patient. I'm hoping for the best.

She lost her license. She lost her job. She is devastated. And it pains me to see her this way.

It hurts to know that she didn't take anything (knowingly) that could have caused the positive test results. She was taking Comtrex the week before when she had a real bad cold. That was it. Two weeks before that her results were clean. And, ironically, she was called to take another drug screen yesterday right before the nursing board called to revoke her license. I'd like to know how they came back. She knew to stay clean because she loved her job so. She has been tested a lot. So I just can't imagine why she would do something intentionally to botch any test that would be taken.

Anyway. Thank you all for praying for us. Continue to do so. We will be in a huge mess for the next few months trying to pay bills and put food on the table. But we've done it before when it happened the first time. I guess we can do it again.

I'm so sorry to hear about the license loss. I wish there was some recourse for you. Maybe another opportunity will surface, something even better than nursing. It's so cliche' but true, "when one door closes, another door opens". I'll pray for you both. Thank you so much for sharing your story.

tpc wrote:She lost her license. She lost her job. She is devastated. And it pains me to see her this way.

It hurts to know that she didn't take anything (knowingly) that could have caused the positive test results. She was taking Comtrex the week before when she had a real bad cold. That was it. Two weeks before that her results were clean. And, ironically, she was called to take another drug screen yesterday right before the nursing board called to revoke her license. I'd like to know how they came back. She knew to stay clean because she loved her job so. She has been tested a lot. So I just can't imagine why she would do something intentionally to botch any test that would be taken.

Anyway. Thank you all for praying for us. Continue to do so. We will be in a huge mess for the next few months trying to pay bills and put food on the table. But we've done it before when it happened the first time. I guess we can do it again.

Why won't they allow hair to be tested?

You might want to consider having her hair tested. If the results come back negative for the time period they say her urine was positive for the Ultram, you might have a strong case for over-turn of the nursing board's decision.

Here's a link to FAQ about hair testing
Omega Laboratories - Hair Testing FAQ

Jack

An afterthought...did the lab your wife used follow a chain of custody protocol? If they did not, or the protocol they use isn't up to standards, you might have an avenue to follow in that direction as well. We all assume the labs must know what they are doing. You'd be surprised at how many simply don't follow strict protocol.

You might also consider hiring an attorney familiar with dealing with this sort of issue. The American Association of Nurse Attorneys should be able to provide you with names in your area.
The American Association of Nurse Attorneys (TAANA)

Keep us posted.

Prayers for your family.

Jack

CRNAspa wrote:An afterthought...did the lab your wife used follow a chain of custody protocol? If they did not, or the protocol they use isn't up to standards, you might have an avenue to follow in that direction as well. We all assume the labs must know what they are doing. You'd be surprised at how many simply don't follow strict protocol.

You might also consider hiring an attorney familiar with dealing with this sort of issue. The American Association of Nurse Attorneys should be able to provide you with names in your area.
The American Association of Nurse Attorneys (TAANA)

Keep us posted.

Prayers for your family.

Jack

Yes. Chain on Custody was followed.

I truly believe something got into her system that flagged it as Ultracet. She never took anything. She's been clean for 4 years. Even the test prior to this one came back clean. And as far as we know, the one after since we didn't get a phone call. Just this one sample. Well A and B samples. We scoured the internet to see what may have caused it. Possibly the Comtrex. But since she signed a contract, nothing matters. The nursing board can do exactly what they wanted in this situation.

tpc wrote:Yes. Chain on Custody was followed.

I truly believe something got into her system that flagged it as Ultracet. She never took anything. She's been clean for 4 years. Even the test prior to this one came back clean. And as far as we know, the one after since we didn't get a phone call. Just this one sample. Well A and B samples. We scoured the internet to see what may have caused it. Possibly the Comtrex. But since she signed a contract, nothing matters. The nursing board can do exactly what they wanted in this situation.

Is this a permanent revocation of her license? If so, and she didn't take Ultram (which I believe she didn't), pursuing any and all options can't make anything worse as it pertains to the board of nursing.

Your wife's situation is exactly why the first question I ask of anyone contacting me is, 'do you have an attorney'. Most nurses make the decision regarding an attorney based on 2 things; I can't afford it and the board will be angry and be harder on me. Nurses also have have the notion that the board will make decisions based on what's best for the nurse. In reality, the board's only concern is protecting the public. When you combine that mind-set with an appalling lack of understanding of the disease of addiction, you get a group making decisions based on what I call the "3Ms"...Myth, Misbelief, and Misunderstanding. Not a combination that leads to good decisions. Consulting an attorney to see if there may be avenues that may help your wife eventually regain her license might be money well spent. Doing nothing guarantees she won't practice again.

Having a sample of your wife's hair tested by an independent lab using the same chain of custody could open the door to this situation. It's very difficult to tamper with a hair sample. Urine has several problems with being the single method of definitive testing. One advantage that hair testing has over urine is it gives a record of substances ingested over several weeks or months, depending on the length of the hair. Hair grows at a rate of 1/2 inch per month. Depending on the length of the sample taken, the lab can determine what substance was ingested and at what time of the month.

Just some things to think about. Let me know if I can be of any further assistance.

I agree with CRNAspa...legal help would be beneficial. If there's a problem regarding affordability, there are resources out there that can help. Does your state have a Nursing Association? I'm in MA and we have MNA (Mass Nurses Association). Something like that could probably give you some options regarding legal avenues. And I don't know how you would go about this, but, maybe there's a way to get a hair strand test on your own????? I wish you all the luck, peace and happiness no matter what happens.

She was suspended for one year. And after she does everything the board has asked under contract, then they will consider giving her license back.

There's been so much going on right now, I haven't brought up legal council or hair sample testing. Maybe this weekend will be a good time. See where she stands on the idea and what she's considering to do about getting her license back.

Thank you again for your help. It means a lot.

tpc wrote:She was suspended for one year. And after she does everything the board has asked under contract, then they will consider giving her license back.

There's been so much going on right now, I haven't brought up legal council or hair sample testing. Maybe this weekend will be a good time. See where she stands on the idea and what she's considering to do about getting her license back.

Thank you again for your help. It means a lot.

Ahhhhhhh...suspended for a year. So there is hope she can get her license back. It's not a forgone conclusion that her license is permanently revoked, correct?

Until such time as you guys decide to have the hair test done and/or seek legal advice, she needs to focus on her recovery. Increased meetings, spend more time with her sponsor(s) (having more than one can be very helpful), really working on the 12 Steps (if she's part of a 12 Step group), etc.

Depending on spiritual beliefs, there are recovery groups provided by a variety of organizations and spiritual beliefs. I myself participate in Celebrate Recovery, which is a Christian based group started through Saddleback Church (Rick Warren's church in San Diego). There are Jewish, Quaker, Muslim,groups and more. There are also numerous secular organizations. Here's one example:

Women for Sobriety
P.O. Box 618
Quakertown, PA 18951
Tel: 215-536-8026
Welcome to Women For Sobriety, Inc.

You'll find an extensive list of support groups and organizations at this link:
Recovery Resources

Sometimes a setback like this can strengthen a person's recovery. The first step of the 12 Steps says "We admitted we were powerless over our addiction(s) , and our lives had become unmanageable." There are SOOOOOOOO many things in our life that are beyond our control. This could be one of those instances.

As the serenity prayer says so well:

"Grant me the serenity...to ACCEPT the things I CANNOT CHANGE (people, places, things)

The COURAGE to CHANGE THE THINGS I CAN (Me and my character defects, flaws, etc.)

And the WISDOM to KNOW THE DIFFERENCE!

I'm going to ask 2 questions which you may or may not answer (or can't answer). Why isn't your wife here asking these questions? Second, are you attending Al-Anon or some other support group to help you deal with those things the significant other and family/friends have to deal with? When I found out my daughter had an eating disorder and was addicted to cocaine and amphetamines, I discovered there was a whole different set of emotions and unhealthy things I had to learn to deal with as a result of HER diseases. While the things I've learned for my own recovery were helpful, there were a whole new set of things I didn't expect to experience that had to be dealt with in a healthy manner.

You and your wife are in my prayers.

Jack

CRNAspa wrote:Why won't they allow hair to be tested?

You might want to consider having her hair tested. If the results come back negative for the time period they say her urine was positive for the Ultram, you might have a strong case for over-turn of the nursing board's decision.

Here's a link to FAQ about hair testing
Omega Laboratories*-*Hair Testing FAQ

Jack

I can't believe that. I am curious what state you live in. I just lost my job for diverting and am facing the same long road. I feel like dying. That I really did this to my family. I am a good nurse and have never had any complaints against me in any way. Pharmacy caught the discrepency and Now I am without a job and I don't know what to expect. I self referred into the Diversion Program. I guess time will tell when I can go back to work if ever.

I have a question for Jack. I'm an RN and just lost my job with a big hospital. I referred myself to the BRN to the Diversion Program. I will find out if they will accept me or not soon I hope. I am devastated. Do I have a chance in working again as an RN?

09896star wrote:I have a question for Jack. I'm an RN and just lost my job with a big hospital. I referred myself to the BRN to the Diversion Program. I will find out if they will accept me or not soon I hope. I am devastated. Do I have a chance in working again as an RN?

There are variables in all cases that determine your ability to practice again. Which state you practice in, what the nurse practice act says about returning to practice, what the practice act says about criminal records (i.e. treatment in lieu of conviction), time away from practice, type of treatment required, return to work contracts, monitoring, report to the National Practitioner Data Bank and the Office of Inspector General, etc.

The bottom line is many health care professionals have successfully returned to practice. The main goal right now is to throw yourself into achieving and maintaining a solid program of recovery. Everything flows from that. No recovery, everything else falls apart.

If you have specific questions I'll do my best to find the information.

Jack

My wife is going today to look into it. She's skeptical because the board has spoken clearly that no other results would sway their decision. She signed a contract stating that only urine test would be taken and that's all they care about.

But we will try. I'm really trying to persuade her to not give up on this.

I am so sorry to hear about your continued battle with this, especially when she has followed the correct path and gotten this far. I had a false positive for TCA (tricyclic antidepressants). I have never taken them so I was rather shocked, but my Second test came back negative. I don't think even that helped me, though because from that point on I was flagged.

My first test was I think a basic 5 or 7 panel, and the second split sample was a very detailed 5 or 6 pages that broke down every class of drug and listed the drugs within it. For example, it had the SSRI's (antidepressants) broken down into (generic names) for Prozac, Paxil, Celexa, Lexapro, etc. Everything was negative for the second test, but all I could figure was the decongestant I had been taking because that is all I was taking. At the time I had looked it up on the internet and found similar errors, but nothing of actually dealing with a nursing board afterwords or what happens if the errors weren't caught in the second test. This search was done 5 years ago.

Also the second sample was sent to a completely different lab than the first. do you have the records for the tests? I think it was rather odd that they told you the second tests always come back positive.

I had been testing through my family physician through their disclipinary contract, and although their was nothing in my contract about antidepressants, and although my second test came back negative, I think this was the reason for my longer contract in the end. Like I said, I was flagged.

I would suggest the same things you have already heard, get a hair sample done independently it may come in handy at the end of her suspension. I would also consult with a lawyer, if I had it to do over again I would have, at least for some information on the process.

You sound like a very supportive spouse who believes in his wife and her recovery, she is very fortunate and I wish you both well. I wish I had better answers for you.

tpc wrote:Hi all.
I'm not a nurse. My wife is.
In 5 months it will mark her 4 years of being clean. She will no longer have to test or anything else to keep her license. For the past 1.5 years she's been nursing at the county health department. She loves her job and her employers truly love her. She's such a hard worker going above and beyond what they expected.

I have grilled her on what may have happened. She tells me she has not taken anything. She also says I have every reason not to believe her because of her past. But I do believe her. She has worked so hard. She has done so much to make things right after her first, and only, mistake.

.

Dear TCP,
Please don't take my comment in offense. I just want you to consider the possibility your wife had a relapse. All the nurses here are well aware of the disease of addiction. We remind ourselves daily that even though we are “clean” we are still addicts. That “addicted self” never goes away and lies to us continually. It tells us that we really aren't addicted, that one pill wont make a drug test turn positive, or that since I just tested, I surely wont be called on to test again in the near future. Having a lot of clean time doesn't erase that fact. I find it interesting that you are the one posting here and not your wife. Have you been attending Nar-anon or Al-anon meetings? Has your wife remained active in her recovery and going to at least 2-3 meetings a week? There usually seems to be a co-dependent relationship between the addict and their partner. We seek out people who fit our needs as do our partners. I only bring up these issues because I have learned so much about myself and my relationships after going through and inpatient and two outpatients programs as well as more meetings than I can count. It may be that your wife's test was a false positive, but again, it may not be. I assume you are not an addict. In AA/NA, your types are affectionately called “Normies”. You take pain medication as prescribed, you can drink socially and never experience the compulsion that is addiction, therefore it's difficult to empathize. Please understand that in addiction, relapse is far more common than we all wish it were. Best of wishes to you and your wife. Again, please take my comments in the loving and caring spirit they were written in.

Well said TN.

Replace the word "addiction" with the name of any other chronic, progressive, potentially fatal disease. If the disease becomes active again, in other words, "relapse" occurs, what is the most common response? In most instances it's compassion, empathy, or sympathy. Sometimes there is even a, "That's not surprising", ot "I expected there would be since their diseae process had advanced so much before treatment."

No with this disease. It's shock, disappointment, anger. We wait until the person gets "caught" instead of intervening at an earlier time. Then we send them to "intensive" outpatient treatment that generally isn't intensive enough and most certainly not long enough. Follow up care is spotty. And then everyone is surprised when they "fail"? What is wrong with this picture?!?

For the original poster, have you done any research and reading of the disease process? Have you read anything about the process of relapse, how to recognize it, and how to intervene? Get the book "Staying Sober" by Terence Gorski. You and your wife should read it together and then use the accompanyin workbook to help understand the disease, relapse, and relapse prevention. It will enlighten both of you AND many times will strengthen your relationship in the process (sounds pretty strong already). I agree with others who have suggested you attend al-anon or nar-anon (not Narconon, which is a Scientology based program that can be quite dangerous).

This disease is cunning, baffling, and powerful. It takes concerted, lifelong effort to keep it in remission. Keep us posted.

Jack

I have heard the same thing. I also want to warn those out there that ANY vinegar has alcohol in it, not just those like Rice Wine vinegar or red wine vinegar. Apple cider vinegar has alcohol as well...you have to be VERY careful or greatly involved in the Psychic network to figure some of these things out!