preemployment drug testing

Nurses Recovery

Published

Is anyone familiar with the preemployment drug testing policies of major hospital systems? I know mine is a UDS, but do they typically follow SAMSHA regulations even if they are a private employer?

Specializes in Critical Care; Cardiac; Professional Development.

Why do you have two active prn prescriptions for the same thing from the same doctor?

they are from the same doctor, and they are both PRN prescriptions for the same amount of benzo

they are from the same doctor, and they are both PRN prescriptions

That's trickier.

Why on earth do you have two scripts for the same drug from the same doc in the same dose?? Did he accidentally write two scripts? Did he give you an extra that you filled early? That's big trouble there.

If he told you to D/C one and start a separate one, that could be trouble. If he stopped one kind of benzo and started you on a different benzo, with the plan of care being that you would stop the first benzo, that could be trouble. If he had you one one dose and then changed your dose in a new script with the expectation that you wouldn't double up, that also could be trouble. I cannot imagine that any doc would write for two prn benzos with the intent of them being taken concurrently.

I still think you would get hung up on the MRO with this, because any MRO would likely balk at someone using two prn scripts at the same time for the same drug, unless the MD has EXPRESSLY written in his plan of care that you could double up.

I'd much rather lose a job opportunity than risk it. Maybe it would be okay...but if there is a 10% chance you wouldn't be okay, is that a chance you would be willing to take?

You do not want to face the Board of Nursing over this, trust me.

Specializes in Critical Care; Cardiac; Professional Development.

Right, but why would your doctor do that, unless they were unaware that you still have an active prescription? From your post it sounds like same drug, same dose, same time etc. Is one of those expired? What are the dates on them?

I have had a PRN for a benzo for over a year, and the doctor wrote me the exact same script a few days ago, but the other script had not expired yet, and he did not tell me to d/c the other script. I'm confused as to what I have done wrong, as I have followed the legal and prescription instructions.

the prior script with 2 refills was prescribed 12/17, and he issued a NEW script with same dosage and instructions last week

Specializes in Critical Care; Cardiac; Professional Development.

Obviously he did not think the first one was still in effect. If you are not sure you need to call and ask. If you feel you did nothing wrong you would NOT be panicked about this. Seriously.

Respectfully, I have GAD, PTSD, and panic disorder so I "panic" about anything. I am just trying to ensure that I have done nothing wrong. I was not told to d/c anything, and he prescribed another 3 month script of benzos.

I have had a PRN for a benzo for over a year, and the doctor wrote me the exact same script a few days ago, but the other script had not expired yet, and he did not tell me to d/c the other script. I'm confused as to what I have done wrong, as I have followed the legal and prescription instructions.

Okay, there is your trouble right there. If a script is over a year old, it is universally invalid by law. If it is a controlled substance script, it is lawfully invalid after six months. Even if you did not have a current script, if you were only taking the prescribed dose of a script over a year old, you would be in trouble with the MRO for using a script that is considered legally invalid due to the date.

Is it fair? Who knows. Many, many people don't know this. You think that because you filled it and you paid for it, and its sitting in your cupboard, you can take it when you see fit. Appropriate or not, the Board of Nursing does not follow that standard, I can tell you.

I know this because in another life I was a pharmacy tech, and also because I was informed of this fact when I entered my monitoring program. But that is how it is, fair or not. Knowing this, I can confidently (but not definitively) say that if your level pops high, you will likely get in one form of trouble or another.

You doubled your prescribed dose with a now-invalid script without MD approval. That will get you burned.

Actually, my MD resubscribes me every three months. So any pill I took was not invalid, and he issued a new prescription last week for the exact same med and dosage. So every pill I took was within prescription range and was PRN.

Respectfully, I have GAD, PTSD, and panic disorder so I "panic" about anything. I am just trying to ensure that I have done nothing wrong. I was not told to d/c anything, and he prescribed another 3 month script of benzos.

Ah, I just noticed you said it's not expired.

Regardless, your doctor did not write for you to take 2 mg, he wrote for you to take 1 mg. It doesn't matter how many bottles are in the house, if you are taking more than 1 mg, you are abusing the prescription and not taking it as prescribed.

I have spoken to about 9 different MD's today, and they all say that UDS only shows presence of a drug not level of impairment or recent usage bc everyone metabolizes drugs at their own rate. Blood draws are the only way to determine a therapeutic level as UDSs are very unreliable. If you wouldn't mind could you please share more of your own story so I can understand?

+ Add a Comment