Drug testing a RN while a patient in the er

[lori4367]

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 psychiatrist. As a patient I got drug tested three times. The first time was their standard test. The second time was because the standard test came back negative and since I had told my doctor I took klonopin to sleep as needed (it's prescribed) she thought I had used someone else's urine. Meanwhile, during the second test, she made another one of my coworkers watch me pee. First of all is that legal? We never do that for our regular patients. Ever. The third time was an employer drug screen. Can they drug screen you when you've already signed in voluntarily as a patient? All 3 came back negative so while it's not a big deal, I still have my job...I'm just wondering.

[Horseshoe, BSN, RN]

Wow, I forgot that used to be a topical anesthetic.

It's still used at a plastic surgery OR I occasionally work at. It's used in rhinoplasties sometimes.

[Esme12, ASN, BSN, RN]

It 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.

[Esme12, ASN, BSN, RN]

We 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!"

I am so sorry for your loss :hug:.....thanks for sharing.

[classicdame, MSN, EdD]

Seems to me that after the first time a serum test would have been more appropriate than having a witness. That way they have a chain of custody if needed.

[classicdame, MSN, EdD]

forgot to mention that I am sorry you had a meltdown and hope you are feeling better now. Nursing is so stressful. I hope you are given tools to help you control the panic.

[Wishinonastar, BSN]

COCAINE!!!! I never knew that! Lidocaine, xylocaine, procaine, yes but COCAINE???- never knew it had legitimate medical use since it was removed from Coca Cola in 1929.

[nurseprnRN, BSN, RN]

oh sure. one icu i worked in we had little 3cc glass screw-top vials of 100% pure medical-grade cocaine. we used to put qtips in it and the anesthesia guys would ram them up the nose for the semi-elective nasal intubation. since the qtips went from the nose to the trash, and there was always a little left in those little glass vials and it was nice and clean, some people took them home and evaporated them. (this was a looooong time ago.) not my drug of choice, but hey.

[Altra, BSN, RN]

Have seen it used once for epistaxis a couple years ago. Worked beautifully.

[Wishinonastar, BSN]

And here they always said it caused nosebleeds. LOL

[BostonTerrierLover, BSN, RN]

See there, forget everything you learned in Nursing School after boards, then run to allnurses!

[RN58186]

We had a nurse fired on one of the units I worked on. But we never knew it until after it happened. All we knew was a number of narcotic counts had been out and there was an investigation happening. Then one day this nurse was just gone. Not on the schedule anymore. Then we figured it all out.

Where I work now we don't have any stock meds, not even Tylenol. If staff needs it they know I carry Tylenol and Advil in my purse so they'll come ask me. (I work in an outpatient clinic and we do have drug samples in the clinic. However they are in locked cupboards that only the pharmacists have access to. But then again, who'd want lipid meds, oral hypoglycemics or antihypertensives?) We also have insulin samples in a fridge that I did take one once when I forgot my morning insulin before I left for work. But I signed for it and everyone knew I had taken it.

Nope, never heard of the cocaine thing either.

[Anna Flaxis, BSN, RN]

We use cocaine in the ED I work in, for epistaxis.