am i understanding this correctly?

Nurses Recovery

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Specializes in NICU, ER, OR.

ok, so nurse A takes vicodin for chronic back pain, xanax for anxiety, prozac for depression, and ambien to sleep. she is not "impaired" at work, has been on them for years, has a rx for all of them, never ever diverted. am i understanding correctly from reading some of the posts here that this nurses needs to be reported to the bon and in a recovery program? just for taking the meds prescribed to her? :confused:

Specializes in Telemetry, Case Management.

I am not a 'nurse in recovery', but I wouldn't think this nurse who is properly using prescribed meds is doing anything wrong nor should she be reported.

Specializes in OR, ER, Oncology, CPC.

I don't think anyone has ever said she should be reported. Every case or situation is different.

It appears, from posts on this site over time, that different states have different positions on this -- some BONs don't care about Rx meds as long as they're being used appropriately. Other BONs take the position that any schedule drugs, even when legally and appropriately Rx'd and used, are impairing and unacceptable.

my personal opinion is that nurses are people too and are not immune to health problems requiring prescription medication. she is under the care of medical doctor and is taking her medication appropriately, as long as she is not under the influence of these medications at work then i would venture to say she is safe to practice.

....

check with your state bon guidelines.

Specializes in Impaired Nurse Advocate, CRNA, ER,.

Nobody should be reported unless there's a reason to report them.

We'll take the "hypothetical" nurse in your scenario as an example. If that person shows up to work and is exhibiting behaviors that are concerning...slurred speech, forgetting to perform procedures, making unusual medication errors, nodding off during report, disappearing from the unit, etc., there's a problem.

Is it an unusual circumstance? Is this happening more than once? Is the nurse exhibiting signs of impairment? If yes, then the employer policies kick in. If the Nurse Practice Act requires a licensee to be reported when there is action taken because there are signs of impairment, then they are reported.

I know of a nurse who was tested for cause (nodding off during report and several medication errors). When she came to the office for her initial consultation it was clearly evident she was under the influence. Her speech was slurred and she had a difficult time following our discussions or answering questions. When I reviewed the drug screen from the day she was confronted, she had Vicodin and Robaxin in her system. She also had valid prescriptions for these medications. She wasn't chemically dependent or abusing her medications. But she WAS impaired. Showing up for work impaired is never OK.

Many boards are beginning to receive increasing numbers of complaints with similar circumstances. Just because a professional has a valid prescription doesn't mean they are allowed to practice under the influence. I wouldn't want a pilot flying my plane while taking Percocet or Xanax or Robaxin. If the nurse has a condition requiring the use of opioids, benzodiazepines, etc. during scheduled work time they need to take time off until they no longer need those medications while working.

Jack

Specializes in Women's Health.

I can't function if I take 600 mg of motrin

I agree, even if you have a RX, you may not be able to function.

I'd be asleep with all that on board.

Specializes in LTC, MDS, Education.

A nurse should NEVER EVER even mention any meds she is prescribed at her place of employment. There are too many mean-spirited and two-faced people who are backstabbers looking to start trouble and rumors. Sad but true.:smokin:

I agree with everything Jack said. I know I wouldn't want my pilot on all those meds. Just because they are all prescribed doesn't mean the nurse isn't high. There are many unethical/uneducated doctors out there. Where I live they with give anyone anything, there are all sorts of 'pain clinics' that hand out pills and IV medications and patches like candy.

So yeah, is it legal? Yep. Is it smart, ethical? Perhaps no. So it's legal, that's good. But sometimes good isn't near enough. The best is what's right, and that's having a clear mind to the best of our ability.

Specializes in ICU, psych, corrections.

I have a client who has prescriptions for about 600 vicodin in just over 3 weeks. Just because something is prescribed, doesn't make it right. I had prescriptions for my Norco and in the beginning, when I was taking it as prescribed, I didn't think I was impaired at work, either. Reflecting back, I know that thinking was erroneous. I WAS impaired but didn't realize it at the time. The amazing thing is I'm in less pain now that I'm off all that crap than when I was taking it....never thought that was possible :rolleyes: But I'm grateful because I can do my job as a completely UNimpaired nurse with a clear head. I can get a lot of things prescribed for but that doesn't justify taking them.

I understand nurses are people, too, who have pain, depression, anxiety disorders, and difficulty sleeping. But we also have a higher level of responsibility when it comes to our jobs than most and I can't rationalize (the way I used to) why it's okay to take some of the medications used to treat any of that and then jaunt off to work. I use talk therapy, journaling, sleep hygiene (and melatonin), meditation, prayer, meetings, and a myriad of other solutions where before, I would just pop a few pills. And you know what? I'm in less pain, sleep better, happier, and am able to deal with my (rare) panic attacks than I ever have been. Sobriety is a gift and one I am grateful for every single day. So while I never diverted from work and until the last year, was taking them as prescribed, I was definitely using them as a crutch. But that's me and I can only speak for myself. I know how I feel today versus how I felt 10 year ago BEFORE I ever started taking medications for any reason. It's like night and day. Life's pretty damn good these days....even in the midst of losing our home, having friends commit suicide, my mom passing away, and dealing with custody issues. I can deal with life - sober. 952 days :yeah:

p.s. You don't have to take pills, use drugs, or drink to be impaired....you can go to work without sleep, work depressed, or have psychiatric issues and you will still be considered impaired and in violation of the Nurse Practice Act (in my state, at least). That is one thing I have learned in this journey. I now take care of myself and don't go to work if I'm sleep deprived....lol. My boss just loves me!! teehee

A nurse should NEVER EVER even mention any meds she is prescribed at her place of employment. There are too many mean-spirited and two-faced people who are backstabbers looking to start trouble and rumors. Sad but true.:smokin:

I agree. I once mentioned a relapse that happened when I was not working (on leave) and a person who saw this on the internet decided I should be reported. This allegation, which does not in fact constitute a violation of my Nurse Practice Act, will follow me for the next few years...regardless of their veracity. Be very careful what you say on the internet. Not everyone is here to support you. Some are surfing for reasons to turn nuses in.

Just a fair warning from one who learned too late.

Specializes in ICU, psych, corrections.
I agree. I once mentioned a relapse that happened when I was not working (on leave) and a person who saw this on the internet decided I should be reported. This allegation, which does not in fact constitute a violation of my Nurse Practice Act, will follow me for the next few years...regardless of their veracity. Be very careful what you say on the internet. Not everyone is here to support you. Some are surfing for reasons to turn nuses in.

I will second that....although it didn't cause a problem with my nursing license, posting my story here back in 2008 (shortly after I signed my monitoring contract and had gotten out of rehab) caused my husband to lose custody of his kids temporarily (after I had been sober about 2 1/2 months). His ex didn't know I even had a problem with drugs/alcohol, went to rehab, etc. I posted my story here in hopes it would help another fellow nurse and about a month later, the kid were removed from our house by an ex parte motion. We couldn't figure how the hell she knew everything until we saw the paperwork from her attorney and I saw my post printed out from here! Then we were trying to figure out how she found me here because I never use my real name or identifying details. Then it dawned on me....back in 2003, I had posted and used my email address (NEVER do that!!! LOL). She must have done a search for my email address and that post from 2003 popped up, then she clicked through to my profile and read through all the posts I had made. Bingo!

It turned out fine for us in the end and the judge handed the kids right back over to us, stating that I was obviously in compliance with my BON's monitoring agreement and he was satisified the ~6months of sobriety I had, in addition to all the monitoring I was undergoing. 2 years later and it's still brought up by her that I'm a drug addict but it's all good....because I'm a drug addict in recovery = )

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