Nursing Licenses and Substance Abuse

Nursing Licenses and Substance Abuse

Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) often find themselves on the front lines of the drug and opioid epidemic. Nurses, many of whom work in emergency departments or critical care units, are required to “waste” narcotics or throw away drugs even if only part of the dose has been used on a patient. With hectic schedules and work requirements, RNs and LPNs regularly have access to those discarded drugs. With ready and regular access, it is not difficult to imagine an RN or an LPN who struggles with addiction to succumb to the temptation provided by the access to narcotics including drugs like Fentanyl, Norco, and morphine. But what happens when they do?

Like many other professions, registered nurses and licensed practical nurses are regulated by the State of Indiana and are issued licenses that are regularly reviewed and renewed. In the case of an RN or LPN, that license is issued and reviewed by the Indiana State Board of Nursing. Pursuant to Indiana Code 25-1-9-9, a rules violation can be cause for disciplinary sanctions which may be imposed singularly or in combination including censure, letter of reprimand, probation, suspension, and permanent revocation, and the imposition of a fine in any amount up to $1,000 per violation.

Because a person that has been issued a license is entitled to due process, it is the State’s burden to provide that an individual has violated one or more standards established by the Board. Those standards include but are not limited to engaging in fraud, committing a crime, violating a state or federal statute or regulation and others.

In some instances, the law provides the Indiana State Board of Nursing to refer matters or investigations of registered nurses or LPN to the Indiana State Nurses Assistance Program, which is commonly referred to as ISNAP. ISNAP is a program funded by nurses’ licensure fees collected by the Indiana State Board of Nursing. The program offers consultation, referral and monitoring for nurses whose practice is impaired or potentially impaired, due to the use, abuse or dependency of alcohol and other drugs. A referral to ISNAP may be made by the employer, Employee Assistance Plan (EAP), co-worker, family member, friend or the nurse themselves.

In many instances, a nurse will enter into an ISNAP monitoring contract, which is known as the Recovery Monitoring Agreement (RMA). That agreement typically requires the nurse to provide reports of his or her recovery process from specialized addiction professionals, updates from his or her employer, and submit to random drug tests. The successful completion of an RMA can impact the State’s pursuit of a violation or the sanction of a violation or violations if one is pursued or found.

By design, ISNAP is supposed to be a confidential program. If an RN or LPN who self-reports to ISNAP and stays in full compliance with the RMA or the monitoring agreement, his or her name should not be presented to the Nursing Board for a public hearing. However, if a nurse or LPN is noncompliant, it is possible, if not likely, that their file will be presented and pursued by the State before the Board at a public hearing. The Nursing Board regularly meets in Indianapolis at the Indiana Government Center South building. It is fair to say that the ISNAP program encourages self-reporting and full compliance with the RMA.

Do you need a nursing lawyer that has experience practicing before the Board of Nursing? Contact the attorneys at Keffer Hirschauer LLP today! We stand ready to provide our clients with trusted representation and accurate information regarding the law and its application to their individualized case. Act now and contact us today at 1-800-NOT-GUILTY or (317) 857-0160.


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