What part of NO ALCOHOL don’t you understand?

Nurses who suffer from substance abuse or substance addiction and who are monitored by the Ohio Board of Nursing in either the confidential Alternative Program for Chemically Dependent Nurses Program or pursuant to a Consent Agreement or other public disciplinary action, are typically required to submit to random (often observed) toxicology drug screens. The screens will detect not only alcohol content in the body but can even detect the metabolites of alcohol (evidence that the body is processing or breaking down alcohol). The tests are very sensitive virtually any consumption or exposure to alcohol  in the 3-4 days proceeding such consumption or exposure will be detected.

Prior to initiating the screening process, nurses are advised that they may not consume any alcohol or any substances that may contain alcohol. They are clearly warned to not consume any alcohol, including: beer, wine, liquor, “non-alcoholic” beers and cooking wines. They are also warned to stay away from topical ointments that may contain alcohol and to stay away from cleaning products or aerosols that may contain alcohol. Nurses are usually surprised to learn that many cleaning products contain alcohol and they do not realize that hand sanitizers (the same kinds routinely used in hospitals, nursing homes, schools, etc.), aftershave, air fresheners (Febreze), contain some amount of alcohol.

Despite this requirement, nurses routinely test positive for alcohol or for the metabolites of alcohol in their system (positive ETG test).   Ethyl Glucuronide (ETG) is a direct metabolite of alcoholic beverages (ethanol).  Its presence in urine may be used to detect recent alcohol consumption, even after ethanol is no longer measurable.  The presence of ETG in urine is a definitive indicator that alcohol was ingested.

When questioned, many will initially deny use. Then, they will try to argue that they used a hand sanitizer or over the counter medications, which may have resulted in a positive alcohol or ETG drug screen.

However, while the tests (specifically the ETG test) are very sensitive and can detect consumed alcohol, the cut off for the screening is above the level that would test positive in an “accidental” exposure. Generally, merely cleaning your house with Lysol or spraying your couch pillows with Febreze should not result in a positive screen. However, consuming Nyquil for a cold will result in a positive screen.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to email me at beth@collislaw.com or call me at 614-496-3909.

What is a Nursing Board Consent Agreement?

Under the Ohio Nurse Practice Act, R.C. 4723.28, the Nursing Board can deny, revoke, suspend, reprimand, impose a fine or place limitations on a nursing license.

To take disciplinary action against a nurse, the Nursing Board first must  charge the nurse with violating some provision of the Ohio Nurse Practice Act. Notice is usually provided to the nurse in a citation letter, entitled, “Notice of Opportunity for Hearing.”  The Notice letter outlines the alleged misconduct (the basis for the action), specifies the section of the Nurse Practice Act that the nurse has allegedly violated, and provides the nurse with an opportunity to request a hearing before the Nursing Board concerning the allegations.

However, in some instances, the Nursing Board will send a nurse a document called a “Consent Agreement” without issuing a Notice.  The Consent Agreement is a contract between the nurse and the Nursing Board in which the nurse agrees that the specified violations of the Nurse Practice Act occurred, agrees to accept a specified discipline, and waives his or her right to a hearing. While signing a Consent Agreement may be the best route for the nurse, there are issues that should be considered before entering into a Consent Agreement with the Nursing Board.

A Consent Agreement is a formal disciplinary action of the Nursing Board and is a public document under the Ohio Public Records law (R.C. 149). As a public record, the Nursing Board must make the document available to the public and may post the actual agreement on their website. The Board will also list the name of the nurse and the discipline imposed in the Board ‘s quarterly Momentum magazine in the Disciplinary Actions section.

Negotiating the terms and condition of the Consent Agreement can result in changes and/or clarifications.  As with any legal, binding agreement, prior to signing the Consent Agreement, it is recommended to have it reviewed by experienced legal counsel so that you clearly understand what you are agreeing to in the document.

In addition, even after you complete any discipline imposed by the Consent Agreement, the Consent Agreement will always remain as a part of your professional record with the Nursing Board. Unlike some criminal cases, there is no way to seal or expunge a disciplinary action taken by the Nursing Board. Therefore,  it is important that you understand and agree to all the terms in the Consent Agreement and that the Consent Agreement accurately reflects the facts in your case.

As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please feel free to email me at beth@collislaw.com or call me at 614-486-3909.