Chemically Dependent Nurses - page 2
I'm doing a paper on this topic for my BSN. Has anyone had to deal with this? Are there any "laws" on reporting a coworker? I hear many nurses have an idea of a peer using drugs and not reporting... Read More
Nov 26, '06Quote from puggymaeAre ALL the staff who test positive for narcotics fired on the spot? Sent home? I'm seriously not trying to stir anything up, just genuinely curious. I'm wondering what happens to the staff member who is taking narcotic medications under the supervision of a physician, and therefore shows up 'hot' on a urine screen.If you work with a person who you suspect is stealing drugs and is impaired if you do not report them you are as guilty as they are. I have reported several nurses over the years to our nurse manager - everyone of those nurses failed the drug test given by the facility when the complaint was generated. (If you make that complaint to the manager then everyone working at that time is tested - including the person who makes the accusation, the manager, even students and their instructor. That way nobody knows who is being investigated.) Often other nurses test positive also. Our facility has a zero tolerance policy for this and those nurses are reported to the BON and are fired.
I've only worked in places that ask the employee in question to test, not the entire staff. That's a good way to protect the privacy of the accused, though.
Nov 26, '06Quote from rach_nc_03The purpose of drug testing is to test for ILLEGAL drugs. What defines the drug as illegal, is anything that is EITHER against the law to take or is not prescribed to you specifically, because you are not supposed to be in posession of it in the first place.Are ALL the staff who test positive for narcotics fired on the spot? Sent home? I'm seriously not trying to stir anything up, just genuinely curious. I'm wondering what happens to the staff member who is taking narcotic medications under the supervision of a physician, and therefore shows up 'hot' on a urine screen.
I've only worked in places that ask the employee in question to test, not the entire staff. That's a good way to protect the privacy of the accused, though.
So, you are going to be in hot water if you are on coke or something of the like, but if you were taking a narcotic, and have a prescription for it, you are fine...but if it's for your husband, and not you, as far as they are concerned, it might as well be coke.
Nov 26, '06A legit script is one in your name by your MD and must be less than 1 year old (6 months in some cases). Now if the scenerio is say you really sprained your back last night at work and it's just killing you today...your husband has a script for percocet from a knee injury last week. You take only one of his percs which does the job and go back to work 2 days later. Random drug screen pops up and your dirty. They can not only fire you but report you to the BON and it would be treated no differently than if you were using illicit drugs and got caught. You would undergo the same investigative process and most likely the same IPN program and other restrictions, cost, loss of work etc that you would have if you were an abuser. Also the same goes for pre-employment drug screens, they can and have been known to report you to boards for a dirty ua even though you werent employed by that company when you took it. Also consider that even if you have a legal script it doesnt mean they cant allege you were "impaired" while on duty. Documentation errors anything of the such can be used to strenghten that allegation.
Nov 27, '06I am wondering if it would be legal for them to fire you if you had a script that was over a year old but was actually prescribed to you. I know that if you have a written prescription that it's valid for a year, but AFTER it's filled, and you have the pill bottle with the pills, I can't see how it would be illegal to take it.
I never throw away leftover medicine unless it's two years old and make sure the pharmacy marks what it's for. I have been stuck in the middle of the night with this ailment or that one, and for me, that prevents a trip to the ER until I can see my regular doctor, and I'm sure alot of people do the same.
Nov 27, '06From my experience with nurses that have and are currently in these type situations the BON's look at it this way....1 year it's no longer a valid script in relation to narcotics/controlled substances. You would have to check with your particular BON but that's the general rule with most. Most bon decisions are done on administrative law also if there is no criminal charge. They are entirely 2 different entities in decision making. Also the 1 year rule is pretty standard in relation to narcotics if you have them in possession in relation to driving under the influence or a traffic stop in which a search ensues during my time as an Officer.
Nov 27, '06from pa sbon winter 2004 newsletter, pg 4:
mandatory reporting requirements for licensees
by martha h. brown, board counsel
are you aware of what you as a licensed nurse or dietitian-nutritionist are required to report to the state board of nursing, with regard to the actions of other licensees?
both the professional nursing law and the practical nurse law (practice acts) contain the requirement that any hospital or health care facility, peer or colleague who has substantial evidence that:
1. a licensee has an active addictive disease for which he or she is not receiving treatment
2. a licensee is diverting a controlled substance or
3. a licensee is mentally or physically incompetent to carry out the duties of his or her license must report these facts to the board.
(see 63 p.s. 224.1(f) and 63 p.s. 666.2)
reports of this nature are made by downloading a complaint form from the department of state website at department of state
(link to complaints) or by calling the complaints office hotline at 1-800-822-2113 (if you are calling from within pennsylvania) or at
1-717-783-4854 (if you are calling from outside pennsylvania) to request a statement of complaint form by mail.
any person or facility who files a complaint of these items in good faith and without malice is immune from any civil or criminal liability
arising from such report. failure to report within a reasonable time of knowledge of the impairment will result in a fine of up
to $1,000 on the person or facility. please note that any person or facility who acts in a treatment capacity to impaired professionals in
an approved treatment program is exempt from this mandatory reporting requirement.
licensees as individuals are also required to report when they have had any disciplinary action taken in other states. see 63 p.s. 221.1
and 663.2. this report must be made on the biennial renewal form or within 90 days of the final action in the other state, whichever
comes first. the duty to report disciplinary action in other states does not apply to hospitals, health care facilities or employers. the
board is presently seeking a legislative change which would require licensees to also report criminal convictions within the same timeframe as disciplinary actions in other states.
finally, the standards of nursing conduct require that a nurse shall act to safeguard the patient from the incompetent, abusive or illegal practice of any individual. a nurse also may not knowingly aid, abet or assist another person to violate or circumvent a law or board regulation. see 49 pa. code 21.18(a)(3) and (b)(1); 21.148(a)(3) and (b)(1). this may mean filing a complaint with the department
of state, bureau of professional and occupational affairs if the incompetent or abusive individual or individual undertaking criminal acts with regard to a patient is a board licensee.
keep in mind that the requirements above are only for reports made to the board through the department of state, bureau of professional and occupational affairs. these do not affect the other reporting requirements of the department of health, the child protective services law, the older adults protective service act, and other state and federal laws and agencies.
advises that a complaint should be filed by anyone who believes that a licensee of the board has engaged in illegal activities which are related to his/her professional responsibilities.
alabama board of nursing administrative code, chapter 610-x-6-.02(10) states, the registered nurse and licensed practical nurse shall accept individual responsibility and accountability for timely reporting of illegal, substandard, unethical, unsafe, or incompetent nursing practice directly to the board of nursing.
some examples of reports the board expects to receive based on the requirements of the law are:
impaired behavior at work
medication errors that result in patient injury or death
positive drug screens, whether pre-employment or for cause
refusal of a nurse to submit to a drug screen
working as a rn or lpn or advanced practice nurse without the proper credentials
violation of patient boundaries
falsifying credentials or employment records
grounds for disciplinary action are outlined in alabama board of nursing administrative code, chapter 610-x-8, disciplinary action, available for downloading from the board’s web site.
the board investigates each complaint and determines whether the nurse violated the law. the process is outlined below.,,,
almost all states have mandatory reporting requirements.
check your state practice act, links here:
Last edit by NRSKarenRN on Nov 28, '06 : Reason: fixed link
Nov 27, '06Quote from CHPN in So CalI went through the state's program for 5 years and failed because I messed up on their paperwork. My complaint was returned to the BON and I went through their probation program for three years. The two are very similar, but if I knew in the beginning what I know now, I would have bypassed the diversion program and gone into probation. The two are very similar but the problem with diversion was the inconsistencies and the shaking fingers attitudes of the committee, and the amount of control they have over your life. You can't even leave town for vacation without permission. The probation program was much more realistic to life.....not easier or more lenient, just more realistic. No the original complaint was not expunged. Yes, anyone checking on my license will know I was disciplined for something. Do I care? No. That's the attraction that gets nurses to choose diversion over probation, but after so many years sober, if a new employer has a problem with the fact that I am in recovery and have been clean for almost 13 years, I don't want to work for them.I didn't have to go through the state sponsored drug diversion program, as I never recieved any complaints against me. But I've attended some of their meetings and I know the program is very burdemsome ie recovery meetings at least 3 x week, random drug tests which the recovering nurse pays for as well as a required on site supervisor once they approve of the nurse working again, who watches over holds on to the nure's narc keys. Overall, what I've heard from nurses who have completed the program is that it was horrible but it saved their lives. Also, any nurse who successfully completes it can have the incident expunged from their record.
Nov 27, '06The opinion of addicted nurses vary from one person to another. Like Tazzi I was never reported to the board and never convicted of a dui or anything like that. I did quit nursing for a couple of years because I
1) was terrified at being caught and
2) I was afraid I was going to hurt someone.
I have worked with nurses that hate recovering nurses and recovering nurses.
I had one charge nurse that would take my check when they came out and make test every stinking week. I did what she wanted because I knew there wasn't going to be anything in it. but I made her watch me while I did pee in the cup. I finally got sick of it and quit. I learned later she did the same thing to another recovering nurse and ended up getting fired for it.
Now I work as a volunteer at the board of nursing on the peer assistance committee. I think with all my heart that these nurses deserve another chance at their careers. They have to jump thru a megaton of hoops for 2 yrs but at least now they know how to help themselves and where to go for it. AA and NA, CA Al-anon, group support for nurses and all that stuff.
You can PM me anytime if you want to.
Nov 28, '06Very nicely said Tazzi and Dalzac. That was a point I was making is no one really talks about the issue. Most nurses out there really dont have a clue what fits into those nice neat little words of what has to be reported. I have seen many nurses who truly needed the help then again a few who were reported for very simple things not drug related that any of us could have done at one time or the other out of malice. Either way when you get reported and under go any investigation with the BON's you are jumping through hoops, enduring a great deal of emotional pain, and believe me they dont make it easy at all. Mine was not called the ICU doc at 4 am to get an order to substitute Mylanta in lieu of his standard order of Maalox. The pt used mylanta at home and preferred it refusing maalox. I knew this MD well and there wouldnt be an issue with him. He had told us in the pass dont call me over that just change it to thier preferred brand. Well low and behold I gave report to my NM as my relief. I did 4 mo suspension, $500.00 civil penalty, 2 years probation, numerous cost for ceu in addition to my regular licensure renewal requirement, quarterly drug screens (hm whys this) at my cost, cost for therapy etc. This what I thought simple act of mylanta and maalox was considered no differently than Misappropriation of medication and to read that agreed order saying exactly that Mylanta in lieu of Maalox!! It cost me loss of work, loss of insurance, bankruptcy. I now do education for protecting yourselve. I advocate documentation, seeking attorney counsel etc. I say it too many times that Nurses have no clue of how fragile thier license is. Always always haveas you never know when the simplest thing will cause an issue. When I became re-employed the new employer tried to use my probationary status to blackmail me into false billing at a private case management company. I refused, She wrote up a false accusation and sent it in, thank goodness this investigator was the same and had been also my case worker knowing my case well and seen through it. I had also turned the company in the insurance fraud departmant of the company they were trying to rip off. These are things most nurses or nursing students dont think can happen to them. I thought the same thing. I wasn't using drugs, wasnt diverting, was careful on charting and an excellent well knowledged nurse. It happens.Last edit by Lacie on Nov 28, '06 : Reason: typo
Nov 29, '06This subject is definately something that is hush-hush in my opinion. I have been a tech for a few years and call me naive but it never occured to me that nurses could or would develope a drug addiction. I guess maybe I hold Nursing on a slight pedistool of invincability. Then Suddenly the harsh reality was opened to me when two of my fellow co-workers were trapped in drug addiction. Both Nurses were two seperate occassions. I was very close with both of these nurses and Absolutely devestated. I was More angry than anything, We were friends... And they never reached out for my help. I was also Angry at myself... As many of my coworkers also felt the same way about themselves. I was angry because I knew something was wrong with them. I knew something wasn't right but I didn't act immediately and I didn't Trust my instinct. In the begining I thought there was something Medically wrong with this nurse as did several other coworkers. This nurse was withdrawn, lost weight, complained of headaches, fatigue, loss of appeite and various other symptoms. Mentally they werent there.. During the shift they would disappear for hours no matter how busy it was. Several of us thought maybe this nurse had Cancer. One Night I was alone with this Nurse and I actually got up enough nerve to ask them if they were on drugs. The reaction was an over exaggerated NO and don't repeat that again that doesn't need to be going around in the department. Immediately I should of known then that the Real Answer was Yes. I guess I didn't want to believe it. Shortly after that this Nurse was no longer working there anymore. You know the evil Gossip factor of the hospital and I have to give the manager Kudos because the manager Held a meeting for the entire department to explain why this particular nurse wasn't there anymore. It was done in a Caring-professional manner. It was done because We are a family and we do care for each other. I learned some valuable life lessons.. #1 no one is untouchable, not even a nurse #2 Trust yourself when something isn't right #3 Being a real friend sometimes forces us to do things that are hard.. Aiding in them keeping it a Secret isn't going to help them get better.