Denied employment at agency due to ordered prescriptions

Nurses Relations

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Hello everybody. First of all I would like to say I think this website is great. I've been using it throughout RN school, and recently I decided to make an account after getting my RN License.

So, here is some back ground...

a) When I applied to RN school, I fully disclosed all medication that I was taking, which is also by order of a providers prescription. (Vicodin, on rare occasion if needed for breathrough pain, valium 5mg prn, and ambien 10mg prn insomnia)

b) In light of this information, RN school accepted me nevertheless. Throughout RN school I excelled. I maintained a 3.7 GPA, worked an average of 20 hours per week (in pharmacy), and I excelled in safe patient care, getting several recommendations from my instructors and preceptor.

The situation is this...

My final semester ended in December. I was literally sought out by the Director of the acute-care floor where I did my preceptorship to start working as soon as I had my RN License. I completed all the paperwork for hire, took the NCLEX in January & passed in 75 questions, and informed my other job, of 8 continuous years, that I would be moving on to be a newly employed RN.

a) As part of the conditions of starting, like everyone else, I had to pass the pre-employment physical, etc. Within the process of filling out this paperwork, I honestly completed it the same way that I did my paperwork for RN School.

(in other words: I was forthright about my legally prescribed medications, before I took my drug test)

The drug test showed positive for benzodiazepines,

but the test was deemed negative because I have a prescription for them.

b) The offer was withdrawn.........

c) I stated to the Doctor denying me clearance, "How is it possible that I have done approximately 500/1,000 hours of the BRN prescribed clinical hours, at this hospital, and there was never an issue when I wasn't being paid?"

The doctor responded "they probably didn't know you where on these medications".

I told him my RN program was well aware of it, and furthermore, I was one of the minority of students in my school that never got written up for making ANY minor or major errors: throughout my entire program, and I had practically almost all straight A's.

*Nevertheless, the job where I was going to be doing what I love, & make appx 35/hr, was pulled from me just a few weeks ago,

and I have been left stunned.*

If I were a threat to myself or others, i could understand the offer being pulled.

But come on, the Doctor actually just simply told me "if you were off the medications, you probably would have gotten the job".

Now I ask for your help my fellow RNs...

My question is: do you or anybody you know, who takes occasional AND LEGALLY prescribed controlled substances have a job as an RN?

If so, did you disclose this in your pre-employment physical?

Your input will be greatly appreciated...

However, I do ask for those of you who may want to say something presumptuous or rude, please keep it to yourself.

Sincerely,

RNwithHonors

(p.s., for those of you who may wonder: I NEVER have ingested ANY controlled substance at while at clinical or while working in the pharmacy in 8 years)

Specializes in Oncology/hematology.

In a perfect world, it would be nice to have nurses who were not on any meds AND who weren't impaired due to anxiety, depression, etc....

We do not live in a perfect world. Every profession is touched by these diseases. I would rather have a legally medicated nurse than one who had major issues but was afraid of a drug screening.

Specializes in Critical Care.
It's nice to hear a non judgemental nurse finally speak. What legitimally goes on between patient and doctor should not be held against the nurse as a future employee. Shame on the rest of you for being so mean.

I don't think that informing others of the fact that "what legitimately goes on between patient and doctor should not be held against the Nurse as a future employee" is not how things actually are is making any judgement, that's just what the facts are. We're not supporting or opposing an employers right limit even legally prescribed medication use, just reminding people that's how it is.

Agreed....but at which point does their concern become intrusive and biased.

Yes, what is reasonable is a good question. I do understand employers feeling a need to err on the side of caution as it seems to me there is no practical way to measure the effects of prescription drugs on employees unless the employees are obviously practicing poorly and/or are obviously impaired. Because one does not have to be obviously impaired for one's judgement to be adversely affected, I understand employers being ultra careful in regards to employee drug testing and hiring employees who take prescription medication. Then there is the separate issue that some nurses do have problems with addiction. Obviously there is a lot of potential liability for the employer. With new hires, the person is an unknown quantity. So I understand employers' caution and I believe it is necessary, ultimately for the sake of patient safety, even when it may be excessive.

From the individual nurse's point of view, the nurse who believes he/she functions perfectly safely and with good clinical judgement while taking prescription drugs, and who perceives himself/herself unfairly singled out, I don't have an answer. No-one likes to be in this position. As human beings we judge other people to a large degree from our own experience. If a hiring manager has had negative experiences with job candidates who tested positive for X drug or who admitted to taking X prescription drug then likely these experiences will influence their hiring practices.

I agree, we are all imperfect, and all professions are full of imperfect people. The professions though, where peoples lives are at stake, such as medicine, nursing, airline pilots etc. require the bar to be set higher precisely because of the high level of responsibility.

Specializes in Med Surg.

Jesus Pete. I don't care - I don't care - I don't care. A nurse is a human being and has a right to be on whichever medications she/he and her physician/hcp see fit. Period.

Whatever a nurse is taking should not impair his or her ability at work.

That said, I DO NOT BELIEVE that a benzo or some ambien taken the night before is going to cause the type of impairment which some of you claim. Sorry, I just don't. So then I have to wonder if YOU really believe that or if this is some other type of bias.

I take epo. Can't really make enough blood without it. Anti-hypertensives too. Because I want to AVOID having a stroke someday, I've always kept my blood pressure well under control. I exercise and eat well. Some things really ARE just genetic. But since when are patients, even nurses, supposed to be blamed for being ill? Or worse, blaimed for actually MANAGING their health? Isn't that what we want them to do? Or do we suddenly not believe in medicine/pharmacology when it comes to nurses?

Specializes in Med Surg.
Yes, what is reasonable is a good question. I do understand employers feeling a need to err on the side of caution as it seems to me there is no practical way to measure the effects of prescription drugs on employees unless the employees are obviously practicing poorly and/or are obviously impaired.

Weird. Practicing poorly or being obviously impaired seems like a pretty good way to measure in my book.

Specializes in Emergency Room, Trauma ICU.

I am absolutely behind the hospital for recinding their offer of employment based on either the physical or drug screen. Just imagine OP that something happens at work, you fall or get hurt in some way or a patient complains about your performance, and you have to have a drug screen and it comes back positive. Do you know how horrible that makes the hospital look? Especially if a patient was injured?

And to everyone saying that people have the right to take medications prescribed to them by their doctor, that is true, but not everyone has the right to work as a nurse. Just because you have worked hard and are smart, doesn't mean you get your dream. Sometime physical limitations win out over dreams.

I am sorry to hear that you were denied employment. I think you should look further into what happened to you and possibly consult a lawyer--i know there are always certain situations that can warrant an employer to deny employment, but the law states that if you have a prescription and a provider's note stating you are able to safely work then you cannot be denied employement or have a job offer withdrawn or the business has committed a violation of the disability act. I have read other people's comments and I disagree with almost everyone. I think it is easy to judge when one obviously has no personal experience of needing a prescribed medication; comparing a prescription medication to alcohol is just ignorant. People who abuse prescription medications or those who are not taking them for the appropriate reason are a threat to taking care of people in a nursing setting; however, someone who is taking the medication responsibly and no one would even know they are taking anything by talking to them is a completely different situation. It sounds like you are taking your prescription responsibly and it is unfortunate you were treated the way you were and I truly hope you seek legal advice in this matter. If you went in for an interview slurring your words and acting "impaired with cloudy judgement'' it would be understandable to not offer you the position, but what you describe is plain discrimination. If everything you wrote it true about your performance as an RN then I would rather have you be my nurse than someone who is not taking any medications but has horrible bedside manner and barely passed boards. Don't give up and fight for your right to be treated like every other fortunate nurse that has no health issues requiring prescription medications.

SionainnRN---Licensed RN's who have active licenses without ever being investigated or suspended have just as much of a right to work practicing nursing as you do. It is truly ignorant and unfair that so many people think that a person who has a medical condition that is out of their control should not be able to work if they require a prescription. If someone on a prescription fell and had a drug test, they would not test positive if they have a prescription so get your facts straight. I think it would be more of a liability if someone quit taking their needed medications to get hired and then something bad happened that could have been prevented if they had their needed medications. I agree that people who act impaired or have cloudy judgement should not be hired to take care of sick patients, but nurses who take their prescriptions responsibly and no one would have even guessed they were taking prescriptions because they behave as any other person not taking a prescription should not be treated differently. Prescribed medications CAN affect one's judgement and cause side effects such as drowsiness, but as nurses we should all know that they do not affect EVERY person that way. I have been prescribed an opiate for 10 years because I have a bladder disease that has no cure and is only managed by controlling my symptoms, which is constant pain. I never take more than what is prescribed to me and I never take more than I need to--I take enough to control the constant pain I have to the point where it is bearable so that I can function like any other person and I am an excellent nurse. I did not ask for my chronic condition and I do what I have to so that I can work and take care of my patients and be a good mother. No one should have any negative opinions about me unless I harm a patient because I was "impaired" which I have not ever been and not ever done. If you met me and interviewed me for a position you would not believe that I took prescription medications and I pride myself in that I only take what I absolutely have to and that it doesn't impair me in any way--I understand the ignorance in most people because I have seen many people who abuse their prescriptions and/or are not taking it for the right reasons and this is unfortunate, but people like me and the nurse who started this discussion should not be labeled the same just because we require a prescription for conditions that we did not cause or ask for and wish we did not have.

Specializes in Emergency Room, Trauma ICU.
SionainnRN---Licensed RN's who have active licenses without ever being investigated or suspended have just as much of a right to work practicing nursing as you do. It is truly ignorant and unfair that so many people think that a person who has a medical condition that is out of their control should not be able to work if they require a prescription. If someone on a prescription fell and had a drug test they would not test positive if they have a prescription so get your facts straight. I think it would be more of a liability if someone quit taking their needed medications to get hired and then something bad happened that could have been prevented if they had their needed medications. I agree that people who act impaired or have cloudy judgement should not be hired to take care of sick patients, but nurses who take their prescriptions responsibly and no one would have even guessed they were taking prescriptions because they behave as any other person not taking a prescription should not be treated differently. Prescribed medications CAN affect one's judgement and cause side effects such as drowsiness, but as nurses we should all know that they do not affect EVERY person that way. I have been prescribed an opiate for 10 years because I have a bladder disease that has no cure and is only managed by controlling my symptoms, which is constant pain. I never take more than what is prescribed to me and I never take more than I need to--I take enough to control the constant pain I have to the point where it is bearable so that I can function like any other person and I am an excellent nurse. I did not ask for my chronic condition and I do what I have to so that I can work and take care of my patients and be a good mother. No one should have any negative opinions about me unless I harm a patient because I was "impaired" which I have not ever been and not ever done. If you met me and interviewed me for a position you would not believe that I took prescription medications and I pride myself in that I only take what I absolutely have to and that it doesn't impair me in any way--I understand the ignorance in most people because I have seen many people who abuse their prescriptions and/or are not taking it for the right reasons and this is unfortunate, but people like me and the nurse who started this discussion should not be labeled the same just because we require a prescription for conditions that we did not cause or ask for and wish we did not have.[/quote']

I'm sorry you feel that way but I stand by what I said last year. Just because you are prescribed a medication doesn't mean you can work as a nurse on it. If I get prescribed Vicodin and drive on it and get pulled over, guess what? I'll probably get a DUI. Doesn't matter that I have a prescription. Same with work. There are many jobs, some in nursing, that you can do with a narc prescription but I don't think hospital nursing is one of them.

I think the difference is acute vs chronic use. If someone is on a stable dose, it is way different than acute/episodic dosing.

I'm sorry you feel that way but I stand by what I said last year. Just because you are prescribed a medication doesn't mean you can work as a nurse on it. If I get prescribed Vicodin and drive on it and get pulled over, guess what? I'll probably get a DUI. Doesn't matter that I have a prescription. Same with work. There are many jobs, some in nursing, that you can do with a narc prescription but I don't think hospital nursing is one of them.

It may be a hospital policy for them. Some places say it has be used only minimal ,8 hours prior to shift to ensure it clears your system. You may want to seek legal counsel

People are so narrow-minded when it comes to certain topics... I suffer from anxiety and panic attacks. I have an Rx for Xanax 0.5, which I usually only take for sleep. But this one day i on my shift, my anxiety was at an all time high, was in the midst of a panic attack, which i usually just try to power through. But this day i decided to take my xanax. And it was incredible what happened. The veil was lifted, i was back to normal and not just functioning, but thriving. I could think again, and saw things clearly. It was truly amazing. It wasn't until i removed the anxiety that i was able to see just how debilitating it was on my judgment, social skills, and every aspect of the job.

ANXIETY IMPAIRS JUDGEMENT. That is a proven fact. Research is plentiful. Go find me the research behind the "belief" that 0.5 xanax would impair judgement on a person who is used to the dose, and takes it for the management of anxiety. Yes if i popped 4 of them, then there would b a problem.

People who don't know what anxiety is like and have never taken a low dose of xanax therapeutically are ignorant on the subject, and really can't say that it would impair ones judgement. So when i read the opinions of the auto-naysayers who are throwing out judgments bc of their "value" that drugs are bad, i respectfully ignore them!

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