The best excuses for positive drug screens

[rnaturcervix]

I have recently had a lot of positive UDS pts, and the excuses I hear as to why they are positive simply blow my mind! Anyone have any good stories? I'll start with my favorites.....

+ marijuana: I was trapped in a car with 10 other people smoking and the windows were broken

+methamphetamine: I don't use it, I just cook it, and usually not at my own house

+cocaine: I was asleep, and my boyfriend blew it up my nose. The 2 gay men that live next to me put cocaine in their air vents, and it must have got into my apartment.

**my all-time favorite: well, of course my wife is positive for cocaine, you have no idea how many cokes she drinks everyday**

Anyone else??? :)

[klone, MSN, RN]

Klone, what is the big deal if you have nothing to hide. You came in with an abruptio placenta. You know drugs could be a reason... the baby is stressed... there are a lot of unanswered questions... if it's negative GREAT. But we're trying to save your life and your babies life... besides you're unconscious REMEMBER? It was an emergency C section. We don't have a whole lot of time to wait for you to wake up, explain it all... we need answers and we need them asap. Got it?

How is the care you give to me going to be ANY different if I abrupted because I did a line of coke earlier?

Explain one thing you would do differently with my care, please.

[canigraduate]

I wish the hotheads would shut up. I like the stories. If you want to start a peeing war, start your own thread.

My favorite is the guy who told me he must have gotten his positive result from petting a neighborhood dog that supposedly lived with the local drug dealer.

[FLAlleycat]

I think someday I would like to be a CNM, but I know I'd have to get L&D experience, and I think I might attack some doctor, or beat the crap out of a fellow nurse when I see her sabotage a breastfeeder (don't deny it happens).......and get fired long before I could ever reach my goal.

One nice thing about being a CNM, you don't HAVE to work in the hospital (and I agree, many are broken). Perhaps you could start your own practice (very successful where I live) at birthing center or "specialize" in home births.

[birthingbabiesrn]

It saddens me to see that so many nurses here do not have a basic understanding of what addiction is and have no compassion for it.

It also saddens me they don't realize that unauthorized testing leads to mistrust between a patient and provider. That women will avoid prenatal care altogether because they use and are afraid of being arrested. That not every woman has access to a midwife.

One cannot wake up one day and stop their addictions--this very rarely happens or works. Women do frequently wake up pregnant. Not everyone has good access to birth control.

Educate yourselves for your patients' sake. It will also make you feel more at peace about working with your patiens.

[klone, MSN, RN]

It also saddens me they don't realize that unauthorized testing leads to mistrust between a patient and provider. That women will avoid prenatal care altogether because they use and are afraid of being arrested. .

That is the EXACT reason why both ACOG and AAP are against universal drug testing of pregnant women, and testing without consent.

[Christy1019, ASN, RN]

It saddens me to see that so many nurses here do not have a basic understanding of what addiction is and have no compassion for it.

It also saddens me they don't realize that unauthorized testing leads to mistrust between a patient and provider. That women will avoid prenatal care altogether because they use and are afraid of being arrested. That not every woman has access to a midwife.

One cannot wake up one day and stop their addictions--this very rarely happens or works. Women do frequently wake up pregnant. Not everyone has good access to birth control.

Educate yourselves for your patients' sake. It will also make you feel more at peace about working with your patiens.

I agree with the issue if mistrust between pt and physician, but if the baby is born with low birth weight and/or other symptoms of narcotic withdrawal, is the hospital allowed to do a drug screening on the infant without parent's consent? If not, what do they do if the parent says no?

[Elvish, BSN, DNP, RN, NP]

I agree with the issue if mistrust between pt and physician, but if the baby is born with low birth weight and/or other symptoms of narcotic withdrawal, is the hospital allowed to do a drug screening on the infant without parent's consent? If not, what do they do if the parent says no?

I have never had a parent refuse infant testing when I explain exactly what can happen during withdrawal from certain types of drugs. I don't hide things from parents or lie to them about it. Many of these parents have dealt with the healthcare system - specifically the perinatal healthcare system - and know what we're doing anyway.

I do explain that we'd like to test the urine for any drugs that baby may have in her system in order to be able to treat her if she begins to show withdrawal sx. So many of these mothers have been through withdrawal at least once themselves and know what it feels like, they don't wish for their babies to go through it untreated. I've found it's best to just be honest, no beating around the bush and no value judgments.

[klone, MSN, RN]

I agree with the issue if mistrust between pt and physician, but if the baby is born with low birth weight and/or other symptoms of narcotic withdrawal, is the hospital allowed to do a drug screening on the infant without parent's consent? If not, what do they do if the parent says no?

Yes, hospitals can do a drug screen on an infant without a parent's permission. All that is needed is a pediatrician's order.

[duskyjewel]

Yes, hospitals can do a drug screen on an infant without a parent's permission. All that is needed is a pediatrician's order.

Which is exactly why you don't need to force the issue with the mothers. The infant is a separate person with his own rights and needs for medical care, which can be addressed as needed after birth.

Do I wish all mothers cared enough that this would never be an issue? Of course, but that's not the world we live in. The issue of mothers of all stripes being treated as incubators with no human rights of their own, though, is both big enough and omnipresent enough that no one should seek to make it worse.

[morte, LPN, LVN]

even that is wrong, permission of guardian should be required, or court order.

Yes, hospitals can do a drug screen on an infant without a parent's permission. All that is needed is a pediatrician's order.

[AnnaT1129]

I once had a patient tell me he was allergic to narcan.... guessing he must have had it before!

[debsgreys]

A UDS is done on every patient that is admitted. Oh yea I have heard many excused. Positive for cocaine, I think I used the straw that was up my boyfriends nose (gross )