Following nursing school, I plan on moving back home for a few years to pay off student loans and save some money. Home is in Massachusetts, and I plan on hopefully working in Boston. I will be taking the Massachusetts NCLEX examination. Massachusetts does not issue temporary licenses and does not take part in the Nurse Licensure Compact. To practice in Massachusetts, you must be licensed by Massachusetts Board of Registration in Nursing. An application for the Massachusetts RN by first time exam can be done either web-based or manual/paper-based. The application requires a certificate of graduation and official final transcript. This must be sent directly from the education program or school to the Profession Credential Services. Applicants for initial nurse licensure by Massachusetts Board of Nursing must comply with the “good moral character” requirement. This requires applicants to answer “yes” or “no” to questions related to criminal or disciplinary history to provide specific documentation for this evaluation directly to the Board.

An impaired nurse is defined as the inability to practice nursing with reasonable judgement, skill, and safety by reason of alcohol, or drug abuse, use of other substances, a physical or mental illness or condition, or any combination of the foregoing. Any nurse who holds a valid license and who directly observes another nurse engaged in abuse of a patient, substance abuse impairment, or diversion of controlled substances must report it to the Board. When evidence is shown of violation of conducts or law that could pose a risk to patients, the board may sanction a nurse’s licenses. Disciplinary measures depend on what the Board believes in necessary to ensure that this situation does not happen again. External resources that are available for impaired nurses in Massachusetts include Massachusetts Nurses Association Peer Assistance Program, weekly nursing support groups for substance abuse, Massachusetts Board of Nursing Substance Abuse Rehabilitative Program, self-help groups, SMART Recovery, faith based recovery programs, and detoxification and rehabilitation facilities. Practicing as an impaired nurse or observing someone practicing as an impaired nurse is a serious issue and must be reported.

With this in mind, I will always be sure to go by the book during clinical practice. Even though it may take more time, I must protect my license at all costs so that I can continue doing what I love. I do not intend on putting myself in any position that would impair my nursing practice or put it at risk. If I have any questions during clinical practice where I am unsure about something, I will be sure to check with a supervisor or charge nurse prior to making any action. When it comes to mandated reporting, I will live by the motto, “expect the unexpected.” When hearing from the individual who shared his story about diverting medication, he expressed that he was well known throughout his unit and even won awards for his exceptional practice. Nobody suspected that he was diverting narcotics. With that being said, it was not for a while until he was caught. Even the best nurses can suffer from substance abuse. As a nurse, it is my job to keep the patients safe as possible. If I suspect there is a colleague is jeopardizing the safety of any patients, it is my responsibility to report this issue and I will stick by that.