Drug testing a RN while a patient in the er - page 3

by lori4367 9,765 Views | 50 Comments

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... Read More


  1. 1
    Quote from nursemarion
    Only in health care are we automatically guilty of something.
    I 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.
    BostonTerrierLoverRN likes this.
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    How 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.
    Esme12 likes this.
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    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.
    Gold_SJ and Esme12 like this.
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    Quote from grntea
    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.
    wow, i forgot that used to be a topical anesthetic.
    Esme12 likes this.
  5. 1
    Quote from BostonTerrierLoverRN
    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 likes this.
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    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.
    BostonTerrierLoverRN likes this.
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    Quote from BostonTerrierLoverRN
    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 .....thanks for sharing.
    Gold_SJ and BostonTerrierLoverRN like this.
  8. 0
    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.
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    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.
  10. 1
    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.
    Esme12 likes this.


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