Pt. being forced to sig form or dropped

BabyLady, BSN, RN · Nov 7, 2010

Hello I'm new to you all but have 30 + years in Nursing. I have a background in Federal Corrections
I recently saw my attending for medical problem from nursing, T1 Latex, heart and lung problems.
this vist strated like all others today the office nurse handed me a form and says fill it out and sign it.
It is called a Control Substance Form. I have never seen one befor but have to say I thought I just walked into a drug program.
The thing start out with you need to sign and if you don't sign you will be fired as a pt and the local police contacted!! There was also a place where if you were called into the office by the staff for a **** test or blood draw of pill count you must be there with in 24 hr or the police will be called. All test will me on you
The last one say I wave my right!!!! the doc can talk to anyone family or others about any signs of abuse.
at anything a urine or blood test should show + for illegal drugs the police will be contacted
Well I got oeed off and refused to sign. I an also a Federal Law Enforcement Agent and have my background checked every 5 years as does the wife. Sent some of the form to TBNE they dont handle Clinics. knew they dont haddle Federal agency so what do they handle.
This bugs me in 2 ways 1st as a RN how can we allow this to happen to or pts. We are to stand up for them. everyone is being givin the form no matter age so a 5 year old needs this?
2nd for me the pt. I understand there are many Seekers out there we have all seen them. I have not had a change in med for 10 years yes I take Xanx .5 bid prn after I was beat badly in a Mac unit. and ambean 10 nites out of 30
Is this the norm for out on the streets now if so I have to say Federal i/m do get better us than most of us.
I dont feel giving up any right is a good thing. there are laws in place that cover CS they just dont enforce them. Help me out here it this our current mode of care to or pts or not ans if not point me in the way to get some help as I will not sing and already have been see the dark side of this

Such a form won't hold up in court and they can call the police all they want, and they are not going to do anything.

The only drug test is that is criminally required is the one ordered by a court...physician or facility request doesn't count.

Physicians have the right to refuse to treat, but they must have a valid reason not to treat.

That "waiver" isn't worth the paper it is written on...signed or not.

Hesstx · Nov 7, 2010

First of all I need to tell you that I found your post difficult to read with the many spelling and grammar issues, as well as just a generally hard-to-follow flow to the post.
I think that any facility should be able to do drug testing at any time. Having worked in a detox center I know very well that anyone can end up addicted. I personally don't have an issue with this. Yes, I do understand that you, and likely others, may be taking prescribed medications that are controlled. Generally, if you are able to provide documentation from the prescribing physician that explains what you are currently being prescribed they should not have an issue, as long as you are taking it legally. With a urine dip you only get a + or - for each drug class/type, but with a blood tox screen you get a breakdown with actual drug levels. The prescribed controlled substances that you report taking would be submitted to the lab as well, sometimes with the dose. The lab techs can tell what would be a normal, expected level of a drug for a given prescribed dose.
If you are not abusing drugs random drug testing should not be that big of a deal. All the hospitals I worked in had a standing policy that they could do random testing. Not a big deal.

Thanks for the reply. As for the writing and such, I can thank 2 strokes for that, it is always nice that we feel to need to comment on such things. But hey we are all professionals right.

If you believe this is right, you should have no problem losing more and more freedom just because there are criminals out here who dont care about anything but what they want.

HX has shown making new rules to prevent old problems dont work. We just get more Big brother looking in.

Me I fought in an unpopular war for what I thought was to keep our freedoms here at home so when someone starts to step on them I get upset

Just noted this statement

All the hospitals I worked in had a standing policy that they could do random testing. Not a big deal.

That is and employers right to do not a PCP. Federal employment demands complete Background check q5 years and random drug testing. That is what we know going in.

One neat thing is they are not discriminating R/T age, everyone must sign the form even a 3 yr old?

TDCHIM · Nov 8, 2010

Even for a pain management facility, threatening to contact the police and forcing the patient to waive all rights to confidentiality is a little strong.

I've been with a very strict pain clinic for almost a decade now. While I've had to sign a controlled substances form that gives them the right to test me on demand at any appointment and to call me in for one with a 48 hour turnaround, I've never seen or heard of one threatening to call in the police if you don't sign the form! I'm not familiar with the conditions governing workers' comp, so if that's a part of this scenario, perhaps it changes things for federal employees.

Controlled substance contracts governing patient behavior and cutting the patient off from treatment in the case of illicit drug use or drug-seeking from other providers/facilities are pretty common (and quite necessary) for pain management clinics. I haven't hear of many PCPs who require them. Based on the information you've provided, I'd say you're justified in seeking another provider or at least asking for clarification.

Hesstx · Nov 8, 2010

more info re: your situation would be helpful in order to help you. is this your private prescribing MD for your healthcare or works for your employer to determine your fitness for duty? big difference. under HIPPA you are entitled to your privacy unless you give written consent for your info to be shared. under HIPPA if this is employment related your employer is entitled to your medical information... read more on the US fed govt website for specifics. if you feel this health provider is violating your privacy rights you can file a complaint right on the US govt website and they can investigate the situation.
check which forms for consent you signed for your employer related to your situation. you can also see a different provider and get an independent eval if employment is your concern that says you can do your job and are being treated for your condition.
as for any RN participating in calling the police due to your labs and prescribed use of meds, clearly outside the scope of an RN license in all 50 states. consider a formal complaint on the individual's license to the state licensing board. I support you not signing any of these forms until your situation is clear to you how this affects you. consider also a license complaint to the MD board in your state regarding this office calling and reporting you to the police. healthcare providers should not be involved in using healthcare to "punish" patients. it is not criminal to use controlled substances, generally a crime to obtain them illegallyand behaviors that are criminal. hope this helps.

Thanks

Yes this is the attending and is private not with work.

I believe they should be covered by HIPPA.

The Dr ,who I like very much and respect saves it is what he has to do to keep TX Health happy.

The TX BNE has responded by saying they dont handle Clinic P & P which concerns me as who cover the nursing staff if they don't?

The problem is, as always with stuff like this, They have to make up a P & P because somewhere above GOD has says so. They don't plan to enact it but with time it happens and then no one knows how it came about. To me if is a act of taking away a simple freedom, that how it started in 1937 or 38 I know most of you don't know about time before time. But let me give a small HX lesson.

A employer was planning to take over the company next door so he asked and sent out a form requesting to know certain items his staff had. They all knew what was going on, so they had no problem giving up the info.

The following year 1939 a man called Hitler had members of his party go to each persons door and take by force all guns the people had listed. WWII had began the German people were disarmed. Those that did not comply were placed in jail or/and killed

The loss of a single freedom is how the real freedoms are removed. We all think it is just a small request we don't even think about it. Many of the professionals I talk to say "just sing it and go on"

One interesting development in this is that today my wife was seen and the form has been changed. They removed the Drs and companies name but put the nurses Name right on top.

Why would you do that it you thought what you were doing is correct. It leaves the Nurse holding the bag as always

Hesstx · Nov 8, 2010

You said these problems were caused by nursing...was this a workers comp visit? Is so, that's pretty much the standard routine. If not, I'm never heard of a PCP doing that routinely, especially before the patient is seen by an RN or MD.

Not worker comp just a routine visit that I have been told has to be done Q 60 days to refill meds.

Lets see that means a pt must be seen 6 times a year just for refills rather than what use to be 4 times. that mean more $ for both the Dr. and Pharm. in Co Pays. More $? could that be the answer?

**canoehead, BSN, RN** · Nov 8, 2010

"It leaves the Nurse holding the bag as always"

That's it, I call TROLL.

Hesstx · Nov 8, 2010

"It leaves the Nurse holding the bag as always"
That's it, I call TROLL.

What is TROLL?

You can not speak out here? without name calling

Look I dont know anyone here just came here cause it was the only forum I could find that seemed to be open.

This is the problem with so many of us, and we wonder why they say we eat our young, heck we eat our young, old, sick,

if there is anything I said that is not true it would be different

linearthinker, DNP, RN · Nov 8, 2010

I don't understand most of Hesstx's rambling. If you are asking for schedule II drugs, it is perfectly reasonable for a provider to ask you to sign an agreement or decline to treat you. What is so hard to understand about that?

Hesstx · Nov 8, 2010

I don't understand most of Hesstx's rambling. If you are asking for schedule II drugs, it is perfectly reasonable for a provider to ask you to sign an agreement or decline to treat you. What is so hard to understand about that?

If by this time you have not come to understand that we should never ask/help remove the right to privacy or confidentially to any pt. You scare me know there are those out there willing to do that. We dont even ask that of a mentally ill pt.

It is not the form or agreement for the most part that I have issue with. It is giving up your rights, and what that may hold for the staff member down the line if fought and not up held

Batman25 · Nov 8, 2010

A simple soultion here is to find another doctor if this one doesn't meet your needs. Look into a new PCP and move on.

linearthinker, DNP, RN · Nov 8, 2010

If by this time you have not come to understand that we should never ask/help remove the right to privacy or confidentially to any pt. You scare me know there are those out there willing to do that. We dont even ask that of a mentally ill pt.
It is not the form or agreement for the most part that I have issue with. It is giving up your rights, and what that may hold for the staff member down the line if fought and not up held

Perhaps it is b/c I don't take any medications at all, much less sched IIs, but I don't see any violation of anyone's right to privacy here. IMO only someone with something to hide would be concerned about this benign policy. In any event, ITA w/ Batman- find a new provider.