A question for other healthcare practitioners

From the time I've spent here I know that some of you are nurses or other healthcare professionals, and now I have a question for you: To disclose, or not to disclose?

I'm due to renew my nursing license next month, and there is a question on the application that asks if you have any physical or mental illness that could affect your ability to practice. Not if it has affected it, or is affecting it......only if there was a ghost of a chance that it MIGHT.

There are a couple of problems with this. For one thing, I've been a nurse for over 15 years and bipolar for a lot longer than that; the only difference is that now I carry a diagnosis. For another, disclosing involves a lot of hassle which will probably necessitate my getting a letter from my pdoc attesting to my mental capacity to safely perform the duties of a nurse, and writing an essay of sorts explaining how I will be able to practice nursing as a psychiatric patient.

OTOH.....if I don't disclose, and if I were to be reported to the board of nursing---and in today's world, a nurse can be reported for any reason or just because somebody has it in for her---they'd probably yank my license. The BON has a long arm and they investigate all complaints, and they can look at your medical history, legal history and even credit history during the process.

Now, there is no way that anybody with even a halfway decent knowledge of medications could check my med list and NOT know that I am being treated for bipolar disorder. It's also no secret that I've had somewhere around a dozen visits with my doctor just in the past 9 months.....my insurance company likes to remind me of this by sending me health tips for people with my illness.

So, it's kind of a choice between the lady or the tiger: guess wrong, and I'm screwed.

My husband and sister say I should disclose. A couple of my nurse friends have told me not to because the BON can be so narrow-minded about mental illness, even though I've never come to their attention at any time during the 17 years I've been a licensed healthcare practitioner (first as a CNA, then as an RN). I'm at an impasse: I don't know WHAT the hell to do.

Have any of you who are nurses, doctors or other professionals faced this issue, and if so, how did you deal with it? What was your experience with your licensing board? And most importantly, what hoops did you have to jump through in order to keep your license?

Thanks in advance.

I think you only need to disclose if your employer has to make reasonable adjustments to accommodate employing you and as you have been a practicing nurse now for 15 years, I don't see why you need to suddenly disclose this. I presume your employer is aware you have some health issues as you would of had health screening. As long as you are mindful of your condition, you are safe to practice.

I'm not a nurse, however, I would suggest that you not disclose. "Could" is insanely vague. Are you supposed to be psychic? You could get a cold and not be clearheaded and make a mistake. Are you supposed to inform the board of nursing every time you have the sniffles? Many things could interfere with your job. Or they might not.

I think of you were investigated, you would be able to argue that your condition was well-controlled enough that no MD had ever told you that you needed to be mindful because your condition would affect your work. You had never been advised that you were a potential danger. And I think a good lawyer could easily defend against this omission.

After all, I imagine that on the application they don't have a checklist of conditions that could affect your work and conditions that could not. Why should BP automatically potentially affect your work and other conditions not? They didn't directly ask you if you have BP, right?

Good luck,
EJ

I am with Eliza Jane.

I am not sure if I can't help you on this one. I practice in Canada and my licensing body does not ask for this information. The employer cannot ask this either, because it could be used to discriminate in hiring employees. After reading your situation, I am happy that our labour laws allow us to keep this information private.

^^^ agree

I am on SSDI since 2000 (victim of progressively worsening domestic violence; stopped working when abuser came to my hospital and threatened to kill me there) and my doctor has now agreed I can return to work per diem (critical care nursing, mostly cardiac).

For a number of years I was too affected by PTSD to even consider working but I am less affected now and renewed my RN license recently. I had to reveal to the board of nursing that I was disabled and explain why. I said I had PTSD and would require accommodations in that I should not care for patients who were victims of domestic violence or those with gun shot wounds. I said my bipolar was controlled by meds and would not require accommodations. I guess they were okay with that much information because I got no further Q. I plan to buy updated reference books, Cardiology 3 stethoscope, scrubs and all in Jan so it will be tax deductible and then start looking for a job.

Eliza Jane makes a great case for many of the first things that popped into my head upon reading your post, BRN. Insanely vague indeed. Quite sure lawyers rub their hands over being able to get their chompers into such vague language. Gives 'em so much to work with from all sorts of angles(!) And what of those with anger management issues? Forgetful natures? Minds that are elsewhere because they can't leave their personal life at the workplace door? Just plain bad and jaded attitudes? These sorts of things come from their brains, and therefore are mental issues. Even if one cannot be diagnosed with with these things (ie. "illness" if that is the exact word, and alright, it probably is. Still...) Let's face it -- someone with a bad and jaded attitude is affected by this in the performance of their job EVERY SINGLE DAY. No "could" about it.

First thing I'd look into is if the question is even legal.

Personal viewpoint: Until it becomes relevant and necessary, I won't answer certain things. For instance, social security number. They ask on every single application, and it's none of their damn business! There are actually very few instances where one is legally compelled to give it. Doesn't stop them from asking though. Once it actually becomes relevant and necessary, I give the information. But I don't need that info floating around for no good (or even legal) reason, you know?

Sorry to jump in on this, as I'm not in the medical field (and have not even been posting lately), but it just really fries my bacon that you should even have to deal with such nonsense.

I have worked in the medical profession all my life.. I say HELL NO ! there is no reason to disclose. I have seen nurses that are drug addicts come to work stoned or hungover so bad that they would ask ME if they pulled the right medication to give patient X ..

Oh the stories I could tell. You have an illness that is well controlled and you are able to function and perform your duties. If it were me I would NOT disclose a damn thing.

Just my opinion.

What happened to those nurses?

I worked with some nurses who were shooting up with narcotics at work. One lost her license. The other went through addiction counseling and returned to work but can not access the narcotics.



I don't know what it is like in other states but here the BON is up your butt about everything. If you get a traffic ticket for speeding you have to report it to the BON. I don't like it but it is what it is.

I definitely would not disclose. If anything ever happens that "leaks" your mental health history and you're asked why you didn't disclose, you can legitimately say that you felt it was completely under control and you didn't foresee it being a problem.

I advised the DON and administrator ( was a nursing home/ long term AFL) they advised me that they would indeed investigate.. The nurse in question was given a drug test and failed her "lover" was/is a local GP and covered for her with fake office notes..

I was written up for "reporting her" and I found a new job with in a month or so...the druggie nurse also left about 2 months later for a job in a larger city. The terrible thing is... a few months after she started her new job , she was under investigation for "missing narcs" while this investigation was going on she gave the wrong medication to a patient and that patient died.

Sad but true story ...

My nursing board doesn't ask for that info. I think it is extremely intrusive.

It MIGHT be different if you hadn't been practicing successfully for 15 years.

I say don't give anyone ammunition to use against you and lie to them and/or future or present employers. I've disclosed only once, ironically as a psych nurse, and got NO
support whatsoever.

I'm not a nurse or a "professional," but I do work in healthcare. I'm just a secretary. But, disclosing was the worst thing I did at my job. It's better to be considered lazy than it is to be considered crazy. I thought disclosing would help me because I do struggle often. Instead it only gave them something to hold over me, my big fat 'fake illness excuse,' which is actually a quite valid reason for things that happen, yet that is how they see it.

I would say you've made it this far without disclosing. If you don't feel you need accomidations then I wouldn't do it.

I worked in Mental Health and I disclosed as I thought I better be up front with my employer and I was sacked on "ill health" grounds. Basically my work wanted rid of me and cause I hadn't put a toe out of line, had went off sick when I needed to and was seeing doctors/psychiatrists etc they couldn't sack me on anythign else. So they said they couldn't "place" me anywhere else?? I was happy where I was and I was made a Key Worker so why make me a Key Worker if you are gonna sack me??? I am now wary about disclosing when I go for interviews/get a job..... what if I can not carry on in my field?

I personally would say no to disclosing but I have had that bad experience that haunts me every day. Maybe in America it is different?

HE'LL NO! DO NOT!

Do you have to tell them you have cancer? No
Do you have to tell them your diabetic? No

Unless you ask for reasonable accommodations, they do not have to know. It's PHI and under HIPPA. Just because the question is there, doesn't mean you have to answer it?

What does it say? Something like asking if you have an illness that prevents you from doing job? You have an illness but it doesn't affect your job.

I just got terminated from a job ( has never happened to me before) I was in a mental facility for 4 days. My boss knew where I was. I had to give her the excuse from work. It's written on letterhead from a well known mental facility. After that they started picking on my work, and saying I couldn't keep up and I was improving. I was considered a star at my last job so this was a major blow. Since I was still in my 6 month probationary period, they did all the Hr crap, writing me up for dumb stuff to cover their tracks. 5 months in they canned me. They really acted very fake by saying they would help me, give more training, blah blah. I filed a complaint with HR which I had an hour meeting last Monday. Supposedly they were going to have a meeting with my managers last week, I haven't heard a word yet. I still have not gotten any of my final paperwork or the complaints from the doctors about my work. I also requested twice from payroll my final Paystub which I have yet to receive. It's holding up my unemployment case.

I think I'm going to file a complaint with the EEOC. They can determine if I have a case against them. It's not about the money, it's about letting them know they can't do this type of crap. I would like to see them shake in their shoes, so they know how it feels to be on the brink of termination.

Thanks to all of you who have provided feedback thus far. I think I'm going to say "No" to the mental illness question after all. I researched the monitoring program I'd have to go through, and it's focused on substance abuse.......I've been sober almost 21 years and never touched pills, so what's the point?? All it is, is a chance to charge me money out the wazoo, drug-test me and harass me on a weekly basis for years---IOW, treat me like a criminal instead of a nurse with a mental illness that I didn't ask for and that doesn't prevent me from doing my job.

Nope, no disclosure for me......don't wanna open up THAT can of worms. Guess I'll take my chances and pray I never come to the board's attention for any reason.

Good I'm glad you decided that.

I think too, I hate to say it, but the healthcare field seems to be even harder on employees with mental illness, than other fields.

You can say THAT again! We're harder on each other than anyone else could ever be. So how is the general public to learn that we aren't dangerous, and to stop stigmatizing us, if our very own industry turns on us??

I'm so glad you are taking that approach, BPRN.

Despite my huge fear of getting in trouble, I've learned to not invite trouble with excessive honesty. (And still am confident that I'm one of the most honest people that people I meet will ever know.). A long time ago, a cousin of mine had a perfectly legit concert ticket, but somehow still felt compelled to ask (see? we're related, lol) one of the security people. Which of course made them assume there was something wrong with it and kept her out(!) Learned a lot that day.

Btw, I don't know what part of OR you're in, but can say that as a health care client potentially in your area, I'd feel completely confident in your abilities if you were ever my nurse, and in fact, honored.

I can't say since healthcare is really the only place I've worked long term, so I don't know how other industries are. But I agree with your decision.