If you are a nurse practitioner and have been recently accused of diverting medication, there are only 2 scenarios:
1.) you did it
2.) you didn’t.
I have seen a great deal of both and neither of the scenarios is so great for the NP.
REPORTED TO THE BRN
If you have been accused of diverting medication, your employer will absolutely report you to the Board of Registered Nursing. You may wonder if they will tell you to go into the Diversion Intervention program, trust me they will. They MUST! Your employer is a mandatory reporter, and regardless of how beloved you are, I can promise you that they are not going to put themselves on the line by not doing what they know is required by law. You will be reported.
Your employer will also probably not require a drug test. This seems crazy because if you are being accused of diverting meds, wouldn’t the employer want to prove that those medications were in your system? Not always! Sometimes the easiest way for an employer to get rid of a nurse practitioner is to pin an accusation of diversion on them and terminate them. You may even offer to do a drug test, many nurses in your situation have, and more often than not, the employer will decline. This is because they DON’T WANT PROOF that you WEREN’T DIVERTING! If you know that the medication you are accused of diverting is NOT going to show up in a drug test, please go get one on your own…. IMMEDIATELY.
On the flipside, if you are offered a drug test and you know that diverted medications are going to show up on a drug screen, please decline the test! You may be fired for failure to comply, but here’s a news flash: if you’re suspected of diverting, you’re going to be fired anyway. Protect yourself and do not give the employer or the future BRN investigator all they need to unequivocally prove diversion.
INTERVENTION/ DIVERSION OFFER
Once you are terminated from your employment and reported to the Board, the BRN’s Diversion or Intervention Program will contact you. This will either be by phone or via a letter. Listen to what they have to say and then please hang up. Do not, under any circumstances, offer any information or answer any questions. If you’ve received a letter, you won’t be under so much pressure and you can do your own research on the Diversion program. Do NOT call them back without researching first thoroughly and do NOT call them back if you are NOT going to enroll.
If you did divert, only you can decide if the BRN’s Diversion or Intervention is right for you. If you diverted only a few times, it may be hard to prove that it was in fact diversion and you may be treated as someone who just made a few medication errors. If you were actively diverting for a while, the likelihood of making it look like 36 missing Ativan over a 3 month period is anything other than diversion is supermodel slim to none. Completion of the Diversion Program is the only way that this matter will remain “confidential”. It is the only way that the BRN will not file a public Accusation against you, and once a nurse is publicly accused of proven diversion, it makes it incredibly difficult to get hired as a nurse practitioner in the future. Please spend some time reading the Diversion section of the blog, for more information.
If you did not divert, you have no business in the Diversion program and this is NOT an effective or easy way to avoid the hassle or expense of the potential discipline. Please spend some time reading the Diversion section of the blog, for more information.
NO THANKS DIVERSION PROGRAM, WHAT’S NEXT? THE INVESTIGATION
This is where things can turn ugly for the nurse practitioner accused of diverting medication, but you didn’t. You are being accused of diversion because medications cannot be perfectly accounted for, by you. Perhaps you failed to properly waste a med. Perhaps you charted that a med was given and it wasn’t or that 10 mg was given when it was only 5, so 5 are missing. Allegations of diversion always stem from charting issues, always. In a few cases, we have even had a nurse accused of diverting because they GAVE more medication than other nurses… never mind that they were working tons of overtime, so of course, they were giving more!
This is a horrible catch 22 in which to find yourself because you are faced with only 2 outcomes as the BRN sees it: 1.) you diverted 2.) you were incompetent or negligent in your charting. Both of these options are violations of the Nurse Practice Act and cause for revocation of your NP license. Now hang on a minute…. You thought I just told you that Diversion was not a good choice, but it’s seeming pretty great to you now! Don’t start dialing that 1-800 number just yet… we can help!
The Board of Registered Nursing MUST investigate every allegation of diversion or violation of the NPA, and because you know the BRN already has been notified because they offered you the Diversion program, you know that they are going to investigate. It takes about 4-6 months for a BRN investigator to contact you. During this time, you’ve hopefully found a new job and are being absolutely fastidious about your charting. You have a clean drug test, that you got on your own. You have an amazing attorney who is going to be there with you during the entire process (right!?!?!?) For more on investigations, click here.
The Investigation is where the Board finds the proof that you diverted. If they can’t prove diversion, but can only prove a few charting errors, you are in much better shape. The charting errors must rise to the level of “gross negligence” or “incompetence” for the BRN to take further action against your license. There is much more on these accusations in the blog, make sure to familiarize yourself with what these terms mean and what the outcome can be.
PROOF = ACCUSATION
If the investigator concludes that you either did divert medication or that you were negligent or incompetent in your charting, they will turn your case over to the BRN’s attorney and the Attorney General of California will file a formal accusation against your NP license. These Accusations always call for revocation of the license, but in the thousands of cases we have defended, this has happened only TWICE to our clients (remember that earlier, super-subtle plug about the amazing attorney?) This process takes about a year from the conclusion of the interview, during which time you’ve been great at your new job without so much as an undotted “i” or uncrossed “t”. It is at this stage that your attorney gets to argue your case. We get a glowing testimonial from your new supervisor. We show them a box full of clean drug tests. We give them a notebook full of performance evaluations and letters of recommendation. We give them CEUs of classes on charting. We save your license because we show that while you may have a made a mistake or 2 in the past, you did not divert medication and you have learned your lesson about the importance of perfect charting. The worst thing that will happen to you is that your license may be subjected to some sort of discipline by the BRN, but you WILL get to keep it.
THE FINAL OUTCOME
The reason I said at the beginning that being a Nurse Practitioner accused of diverting medication doesn’t turn out so great for the nurse because, in order to properly defend yourself and save your license from being revoked, you are going to have to shell out some money. It is no secret that attorneys are not cheap, but losing your nursing license is a much bigger financial impact and participation in Diversion will cost you about $18,000.00 over the three or more years you are stuck in it. And who wants to go back to community college for accounting… yuck! However, if you’ve done any research, you may think that you’ll have to mortgage your house or cash out your 401K because fees can run in the tens of thousands. This may be the case with some law firms, but it is not the case with us.
We have defended thousands of NP’s facing the BRN. Saving nurses’ licenses is literally all that we do, and because of this, we know exactly how much time it takes, and therefore exactly how much it will cost you. It takes an average of 4 hours to review your case. It takes 12 hours for an interview. It takes 14 hours to negotiate an Accusation or 20.5 for a Hearing. Our fees are flat, so there are never any surprises and never any additional fees to us. I promise, you won’t need a 2nd mortgage on your home and your 401k can stay put until you retire… from NURSING… because we will keep your career safe.
Please fill out the contact form if you are reading this post because you are accused of diverting medication. I will spend as much time as you need listening to the details of your specific case, confidentially and without judgment. I will tell you whether Diversion is the only way to save your career. If possible, I will offer you a way to keep your nursing license, your job and your future as a nurse for a dependable, flat fee. We’ve made it our career to save yours.
Here as an asset to you,
Partner and Director, RN Guardian.