random drug testing

Nurses General Nursing

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I am a CNA at a hospital. Where I work they give out random drug tests. I started working this year and got a urine and blood test done for my pre employment qualifications. I was wondering when do they usually give out those random drug tests in hospitals? Also.. if you pass the urine test, do they still do the blood test to double check for drugs in your blood system.. And do they warn you when you will have to take the test.. any info on this would be great

Specializes in Oncology/Haemetology/HIV.

Just because a med is legally prescribed and may needed to function does not mean that you can work as a nurse or in many professions while using even if your MD says it does not impair you. An example, I believe, would be commercial pilot.

Several states bar use of ANY mood modifying drug - which would include SSRIs - by nurses while working. I personally took a dose of Paxil once that affected me much more profoundly than any benzos that were used previously to treat the same disorder.

The point is that there are some drugs that you cannot work in some professions while using. And if you cannot be upfront and cleared to work in that job or with that employer because they do not permit use of that med, find the job or employer that does.

But lying or trying to skate around the issue does not work, nor is it good for you to omit your meds if you need them to properly function. This hurts you and your employer, and will seriously affect future employment when you get caught.

Im on a few prescribed medications for ADD and a mood stabilizer as well and my unit manager doesnt know. I dont need to tell her that I am either.

Maybe its different because we are unionized? Are the laws different with Unionized hospitals in the US?

I apologize however I just could not imagine being unable to work because of something that one cannot control such as ADD, depression, Bipolar, Aspergers...etc

Okay, wait...

So if my CNA tests positive for so and so, its my nursing license is at risk, as well as their CNA license? Did i hear that right? :confused:

Okay, wait...

So if my CNA tests positive for so and so, its my nursing license is at risk, as well as their CNA license? Did i hear that right? :confused:

NOPE.

Im on a few prescribed medications for ADD and a mood stabilizer as well and my unit manager doesnt know. I dont need to tell her that I am either.

Maybe its different because we are unionized? Are the laws different with Unionized hospitals in the US?

I apologize however I just could not imagine being unable to work because of something that one cannot control such as ADD, depression, Bipolar, Aspergers...etc

I don't know the policy of every hospital, but I seriously doubt being on medication for ADD, depression, or bipolar is going to be a problem in random drug testing as long as the drugs are prescribed for the patient and it can be shown that it either enhances the nurse's performance, or at minimum does NOT cause impairment. People do abuse prescription drugs which are intended to treat the above conditions. If they cannot prove the need for those medications to be in their system, then they deserve the scrutiny. As far as I know, you do not need to inform your employers of which drugs you are taking unless you get a questionable drug screen result. The tests are designed to find certain substances, not all possible prescription medications.

The hospitals are just trying to protect their patients from impaired nurses who can impact patient safety, and I don't think many of us here can really dispute that health care workers are out there who are abusing drugs, recreational as well as prescription drugs, and those are really the ones who have the most to fear from a random drug test. Anyone who can document the need for a questionable drug is most likely going to be just fine.

Specializes in Psych ICU, addictions.
To those considering how to be "clean" for a drug screen then going back to either legal meds or recreational substances:

Keep in mind that if, while at work, you are involved in an incident with a patient of any type or an injury to yourself (even needlestick, fall, etc.) the facility can and probably will demand that you take an immediate drug screen. Come up positive and you've got a world of trouble.

My facility does that. They won't press you on doing it if you don't neeed/want medical treatment after an incident, but if you need/want medical treatment or plan to file a workmen's comp claim, you need to do a UDS within 24 hours of the incident.

OP: almost every place I know of does a UDS for a random screen. If you test negative, then that's usually the end of the matter--they don't come after you for a follow-up blood test. If you test positive...well, what happens next is up to the employer.

Best of luck.

Specializes in MSP, Informatics.

scary thing when you look at all the meds that can give a false positive...

http://www.askdocweb.com/falsepositives.html

I have been an RN for 20 years... and just applied for a new job, had my first UA drug test Friday... nothing to worry about. ...until I read this thread, and googled false positive urine drug screen. Yikes! its cold and flu season...who hasn't taken some type of cold med? and I am big into holistic crap.... who knows what is in some of that voo-doo herbal stuff! cripes. Now you all have me paranoid! :sofahider

Specializes in Oncology/Haemetology/HIV.

As a general rule, if you get an initial positive, they do more thorough testing to clarify. The majority of false positives.

And it is not easy to show positive even if you have had meds. As a traveler, I basically was getting tested up to every 3 months. The policy was if it was positive then you provided documentation, but not before. I had several screens done within 24 hrs of conscious sedation, involving large doses of both narcotics and sedatives, and never came positive for them. I did show positive once for some codeine/phenergan cough syrup for a cold, which I had documentation for.

The tests have gotten better-less issues with positives from poppy seed bagels and such. It isn't that easy to test positive these days

Poor OP opened a can of worms with that question...hope valid reason behind it...#IJS!

the op's question in itself, is reason enough for random drug screens.:twocents:

leslie

Specializes in Critical Care.
In the first place I kind of thought I made it clear I was refering to drugs that are tested for in a drug screen. Second even if it is not tested for in a drug screen is still no reason to hide it. Any potentially mind-altering/debilitating drugs should be reported to those that are responsible for your actions. Privacy is a not an issue here. People have the right to privacy, but not when it potentially threatens another person. Someone with a fatal STD has the right not to tell anyone about the disease, until they decide to have sex that may or may not transmit the disease to another person. They are required to divulge this information because it MAY harm someone.

I want to be clear that I do not think anyone with a problem should just be written off, but those that may have to suffer consequences should be allowed to make a choice as to whether or not they want to take that chance.

No we should not have to ask our CNAs everyday if they are on prescription drugs, we simply should have CNAs that have enough ethics to tell us when they are on a drug that can potential to harm our patients. A person that lies and cheats on a drug screen is not a person that has these standards. As nurses we should also be aware of signs of mind-altering/debilitating drug use.

"Any potentially mind-altering/debilitating drugs" can include almost every drug. Metoprolol can cause hallucinations and memory loss, should they be required to inform that they are on metoprolol? And if they are can I refuse to work with them? SSRI's? (Yes, even pilots can fly while on SSRI's). What about drugs that effect people differently based on their underlying condition such as ADD meds? Many night shifters take ambien, which is possibly the most potentially mind altering legal drug their is, should that be banned for healthcare workers? (I'd agree it should be banned altogether to be honest). Caffeine is mind altering, beneficially for some, maybe not so beneficially for others, no more coffee? Privacy is in issue, in that it needs to be weighed in terms of likelihood of risk. I can't justify removing someone's right to their medical privacy based on the remote chance that their metoprolol will cause hallucinations.

Without overt reasons to believe that someone will be able to do their job safely (which doesn't include metoprolol use, or smoking pot 2 weeks ago for that matter), the most accurate way to measure a person's ability to do their job safely is...their ability to do their job safely; unless signs of impairment are seen or can be reasonably expected based on medication use it's none of my business.

I don't know the policy of every hospital, but I seriously doubt being on medication for ADD, depression, or bipolar is going to be a problem in random drug testing as long as the drugs are prescribed for the patient and it can be shown that it either enhances the nurse's performance, or at minimum does NOT cause impairment. People do abuse prescription drugs which are intended to treat the above conditions. If they cannot prove the need for those medications to be in their system, then they deserve the scrutiny. As far as I know, you do not need to inform your employers of which drugs you are taking unless you get a questionable drug screen result. The tests are designed to find certain substances, not all possible prescription medications.

The hospitals are just trying to protect their patients from impaired nurses who can impact patient safety, and I don't think many of us here can really dispute that health care workers are out there who are abusing drugs, recreational as well as prescription drugs, and those are really the ones who have the most to fear from a random drug test. Anyone who can document the need for a questionable drug is most likely going to be just fine.

Okay maybe I misread. I thought someone said in an earlier post that even those on prescribed medications should not be working in the health field due to S/E that a medication may cause.

I agree that patient safety comes first, however, correct me if Im wrong, but from my understanding, many drugs that are abused by health care workers are alcohol and narcotics (stolen from ones facitlity) which is why we have 2 nurses count and sign off (RN's and LPNs), and why the med rooms and med carts are all under lock and key.

From what I have gathered as well, if one does have a drug problem (which includes alcohol) they are not fired, but rather sent for treatment. If they refuse treatment then they may be fired. However maybe this is just the laws here, and again maybe just under our union.

I definetly dont know how the US or other Provinces work, though Im sure other Provinces work the same throughout Canada.

From my understanding those that abuse prescription medications are the elderly as they are the ones who go from doctor to doctor getting many prescriptions and then have them filled at varying pharmacies, then end up taking medications that are very likely to interact with each other, or take OTC's or Herbals which may interact with their medications.

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