Drug testing a RN while a patient in the er - page 2
Hi! I work in a busy level 1 trauma center's er. A couple weeks ago due to the stress in my life I had a meltdown at work(I cried). I ended up signing in as a patient in to my er to talk to a... Read More
Mar 28, '12All of our psych/medical clearance patients who present to our ER get a UDS (urine drug screen). It's our policy for medical screening prior to calling behavioral health/psych. I'm sorry you were treated that way, though. Two was excessive, let alone three.
As a military person, I've had to pee in a cup quite a few times while under observation ... we have "Operation Golden Flow" just about every month, and we get chosen to participate "at random." It does get annoying! You have to take off your ACU jacket (the outer coat) before heading to the toilet because geez, you might just bring a cup of drug-free pee in there with you ...
Mar 28, '12I have been in ER several times for psych reasons (although never went from work) and have never been asked to provide a urine sample. Not once. And in more than 15 mental health admissions, no urine samples on the units either. I have been in psych ER at every hospital in my city, including the one I work in and it has never even been suggested. I have always been honest about what meds I take and still never been tested. I am not sure how I'd react if I was asked to take a test, I'd probably be willing to do one but more than that I'd probably turn into a real miserable patient......
Mar 29, '12We had a diverter in our ER that I was very close too, I feel like beating my head against a wall still that I missed any sign, and looking back, honestly I still can't believe this nurse was diverting (not that addiction was a choice, it's a disease, and she was sick.) But, what I mean, I know the signs/symptoms, and she was never late, absent, first to help you, last to complain, didn't take frequent breaks, no track marks, etc. Drug counts/wastes 100% accuracy. She was very well kept, never sleepy, well liked by staff, and just a great person.
But anyway, we all came in to work and they had all the staff with narcotic access quarantined off in a pt. room, even people that were off shift. (I thought something horrible had happened, but once they started calling us out, one by one, I knew what it was.
They called it a random screen, but everyone there was witnessed (I by a female), which I was kind of wierded out by it (I was 19 and the DON was 54 (took me like 5 minutes to pee, and then drop, by drop, by drop. "bladder shy," when I came out with my urine, I seen her confessing, and handing them vials (before her screen, she was next). I ran back into the bathroom and vomited, I was in shock. I knew the road ahead for her (she has since been found dead of an overdose,) but I was hoping it would JUST be red tape, financial strain, and hoop jumping. But it took her life. I feel partially to blame. I will always feel that.
These situations are horrid, nasty, and disgusting to do. Addiction is worse. It leads you to one of 3 places, Death, Prisons, or Institutions.
I am sooooo sorry this happened to you! Though, Justice provailed.
Random and Suspect Drug Screens save lives, they might make that life a living HXXL for a while, but thats Temporary.
Death is Forever.
It's amazing how your views change with age. That feeling of, "Please sweep this under the rug for her, she supports her children financially, alone, and has no one else!" "Give her time off to handle this!" "She's an Awesome Nurse and a good person with a bad problem." All of these lines of thoughts walked her to her grave. She quit, and was at another hospital diverting before BON could address her.
"I still had those old attitudes, and thought she was treated unfairly, but had the reporting worked, and alternative program/discipline began, by now she might be in the ER making us laugh this weekend again!"Last edit by BostonTerrierLoverRN on Mar 29, '12 : Reason: spelling error, probably more I missed.
Mar 29, '12I don't know if this would make a difference next time, but perhaps saying " I don't feel good, I have to go home", leave, then go to the ER, that way workers comp may not have to be involved. Sucky thing all around. I hope your feeling better
Mar 29, '12BostonterrierloverRN this is such a powerful story. Please consider writing more about it sometime as a separate post or article. I once knew a nurse who had an injury and took some Darvocet. Back in the day access was easier. She did it for a short time only and never signed it out to a patient. Still it made me think. Never knew anyone else that I suspected of diverting. We always watched each other waste. I know it is still a problem in some places. Your friend sounds really tragic and it sounds like a lesson we need to hear about.
Mar 29, '12Clonopin doesn't show up in standard screen, you have to look for it with a specific test -- don't get me started on the night I had a pt who'd OD on clonopin and the doc kept telling me, "the screen's clean" as I watched her become symptomatic....so that would explain why they did the additional tests -- they probably thought it should have showed up and they were getting a false negative.
Take care of yourself.
Mar 29, '12The whole key to the UDS is the worker's comp issue. If there is a potential for any w/c claim they will drug screen every single incident. This is a requirement of the insurance carrier for W/C.
This just happened to me last week...and what makes it funny is I work as a case manager for insurance companies....in a carpeted office....and I was really injured on the job..
....long story short, the office has known uneven floors, I took a "flying Wallenda" fall and landed on my face...literally.
Concussion, possible broken facial bones-still not sure-sprained wrist, knee and multiple contusions...lovely black eyes...
anyway, one of the first things that they did when I got to the clinic was to drug screen me....but since I work for insurance companies, I understand that this is Standard Operating Procedure....
No one's rights were violated...this is just how it is...the worker's comp insurance requires it.
Mar 29, '12Quote from nursemarionI don't know that it is only in HC. I had a pt who worked on a moving van. While on the job, he strained his back pretty bad to the point he could hardly walk. Came in for a w/c claim...his immediate supervisor (who was there in the van iwth him when it happened) was with him. During his workup the supervisor pulled me aside and said that he had just talked to his boss and that we MUST do a drug screen on this individual as part of our workup. Pretty sure any drug use would not have played a role in this incident, but it was what they required...for a non-heathcare worker.Only in health care are we automatically guilty of something.
Mar 29, '12How do you know what's in a syringe and being wasted in front of you? Any self-respecting addict would have diverted the drug and put water in the syringe.
Mar 29, '12seen that. also was there one day when they were counting the narcs and one of the nurses picked up the little sealed tinfoil cup tht held cocaine for nasal intubations, stopped, looked at it thoughtfully, and said, "this feels light." a few others did, too. so they called the supervisor and opened them all in the presence of two witnesses, and lo and behold, somebody had taken a syringe and aspirated all the coke thru a teeny, tiny hole right up under the rim.
Mar 30, '12Quote from grnteawow, i forgot that used to be a topical anesthetic.seen that. also was there one day when they were counting the narcs and one of the nurses picked up the little sealed tinfoil cup tht held cocaine for nasal intubations, stopped, looked at it thoughtfully, and said, "this feels light." a few others did, too. so they called the supervisor and opened them all in the presence of two witnesses, and lo and behold, somebody had taken a syringe and aspirated all the coke thru a teeny, tiny hole right up under the rim.
Mar 30, '12Quote from BostonTerrierLoverRNIt's still used at a plastic surgery OR I occasionally work at. It's used in rhinoplasties sometimes.Wow, I forgot that used to be a topical anesthetic.
Mar 30, '12It is still used (rarely) in the ED with severe epistaxis when an ENT is called. We used to use it on lacs as a per lido move ....it was called TAC, topical adrenaline and cocaine.