RN's w/chronic pain, using narcotics

Specialties Pain

Published

I am currently, and have been, for 3 years, taking oxycontin for chronic pain. My question is, Is is legal for a nurse to work while taking pain meds? I am unable to work, or hardly move unless I get some relief from the pain. A nurse friend told me it is against the nurse practice act for a nurse to care for patients while under the influence of narcotics. Looks like I will have to stop working if this is the case. I have been a nurse for 27 years...what else could I do? What else would I want to do? answer to that last question is easy..I don't want to do anything else. Thanks for your time, and any help or suggestions.

Do you want someone under the use of narcotics driving a car.

Do you want a nurse using narcotics to control pain to take care of your family members

To be truthfull for myself I have to answer....No

I do feel sorry for your problems though. There are areas that you can go into not involving patient care though, that you can do. Insurance comapnies love haveing nurses for audits and such. So do Shysters.

If I take a Vicodin, my pain is well controlled, I can smile and think straight. I don't get dizzy or fuzzy but that's just me. Right now my pain is controlled on Tramadol and Mobic, but this will likely change in time and I'd like to think I could still get a nursing job if I need an occasional Vicodin.

Would I work in critical care???Probably not...I'd go for something less stressful. My problem is with the BON essentially saying we can't be nurses anymore because we have chronic severe pain (and most of it is FROM nursing) and I am afraid that no employer would want us because of the stigma. Just doesn't seem right. We can't get SSD in many cases, and we can't get a job either. Doesn't seem fair. :(

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Specializes in Clinical Research, Outpt Women's Health.

I would have no problem having a nurse whose meds are stabilized, and is able to funtion care for me or my family. If the pain management doc say's they are safe I think it should be allowed. I would be thrilled if my family member had an experienced, sensible nurse like Mattsmom caring for them. It is so ironic that nurses who are hurt doing their duties are then literally dumped by everyone without so much as a thanks for your years of service. I think it stinks, and once again I think other nurses who should be educating the public and those in power on these issues. There is a HUGE difference between a nurse on chronic pain amagement and one taking PRN meds or treatment for an acute problem. No, I do not have pain issues, but I can see what would happen if I did have them and I do not like it.

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I am an RN and have chronic back pain for a number of years. I never really thought about the "issues" involved. I have always told my DON about my back problems and what I took, in advance. When drug testing, no problems. They just check levels to make sure I do not abuse my meds. I went to a siminar in my state related to nurses and drugs. The speaker was from BON. She said to tell your boss, in advance if possible. Other then that, keep it to yourself. This may vary from state to state but I have had no problems so far.

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Do you want someone under the use of narcotics driving a car.

Do you want a nurse using narcotics to control pain to take care of your family members

To be truthfull for myself I have to answer....No

I do feel sorry for your problems though. There are areas that you can go into not involving patient care though, that you can do. Insurance comapnies love haveing nurses for audits and such. So do Shysters.

Do you want a doc performing surgery on you while in severe pain, needing to sit down,perhaps lie down for a few minutes to regain focus? I'd prefer to have my surgery done by a surgeon who is comfortable and not hastening the procedure to get it over with. Of course in the ideal world, health care providers ignore and overcome the pain with their stoic character.

Believe me, I'm there, and the pain is getting worse. I don't volunteer info to anyone, I am not cloudy due to narcs, relif of pain helps me to focus on what I should be doing. Believe me, no one is going to give you a gold star or blue ribbon for living in constant inescapable pain. You will simply realize that when the end of your life comes, you had never lived, to paraphrase Thoreau.

Or you may end up putting a bullet in your own head when you have no more reserve to live with it.

So my message is that when quality of life is poor at best you have nothing to lose by lying, cheating, falsifying or whatever it takes to get by those employers or agencies who would exclude you from the human race. And being in a position of having nothing to lose is quite liberating if you think about it. It takes a great load off if you accept that you can't improve your lot. (I am not talking about stealing drugs or forging scripts or anything of the sort. I am talking about prescriptions administered by competent physicians.)

What are the "good people" in a position to do about it if they catch you using a prescription at work? Make you more miserable than you already are?

Don't just stand and take it. Be a troublemaker if needs be, and choose your battles wisely.

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I checked the NYS NPA. It is not addressed in their NPA. And I doubt it is ib any other one. W@hat is, is the term moral wrong doing. Employers can set their own rules however.

Grannynurse

Obtained this info from the California BRN:

"2762. Drug-related transgressions

In addition to other acts constituting unprofessional conduct within the meaning of this chapter it is unprofessional conduct for a person licensed under this chapter to do any of the following:

(b) Use any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code, or any dangerous drug or dangerous device as defined in Section 4022, or alcoholic beverages, to an extent or in a manner dangerous or injurious to himself or herself, any other person, or the public or to the extent that such use impairs his or her ability to conduct with safety to the public the practice authorized by his or her license."

Judging from the wording of this, nurses may still practice if they are on narcotics. It is only if the narcotic impairs them. I have used Vicodin for pain...I get pain relief, but do not have any effects of being impaired or feeling "high".

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If an individual has a valid prescription for a controlled substance and does not declare this, it is in violation. There is nothing to fight.

Wondering....so if a nurse is a closet alcoholic, do they also need to declare their addiction to alcohol? Isn't alcholism a disease? Couldn't this be considered discrimination against someone with a mental disorder (alcohol abuse)? Just curious about this. Also, Siri...are all 50 states Board of Nursing the same with regards to rules and regulations?

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Obtained this info from the California BRN:

"2762. Drug-related transgressions

In addition to other acts constituting unprofessional conduct within the meaning of this chapter it is unprofessional conduct for a person licensed under this chapter to do any of the following:

(b) Use any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code, or any dangerous drug or dangerous device as defined in Section 4022, or alcoholic beverages, to an extent or in a manner dangerous or injurious to himself or herself, any other person, or the public or to the extent that such use impairs his or her ability to conduct with safety to the public the practice authorized by his or her license."

Judging from the wording of this, nurses may still practice if they are on narcotics. It is only if the narcotic impairs them. I have used Vicodin for pain...I get pain relief, but do not have any effects of being impaired or feeling "high".

Tweetie, I realize the NPAs vary from state to state. I also ocassionally use narcotics. When I haven't used them for a long period of time, I suffer some of the side effects. However, after using them on a continued bases, I don't. I also do not drive when taking a narcotic. In some instances, I believe it is BON over reacting and fear of being accused of the same things BOM are. No one knows if a chronic pain suffer is taking a narcotic unless she/he shares the information. And to be honest, it is no one elses business, unless they are showing signs of impairment.

Grannynurse :balloons:

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Specializes in Case Management, Home Health, UM.
i'm so sorry. i would love to see this challenged in the courts through ada. i don

t think the bne can make laws against federal laws, and it seems to me this has been done here. if a nurse is not impaired and can do the job i cannot understand this..it seems to me discrimination towards a nurse in chronic pain who needs narcs to function, with an assumption they are 'impaired'. :(

siri...sorry...i didn't know you were a legal nurse consultant...is there no hope that this can be fough, or will nurses in chronic pain be forever undermedicated to keep a job???

you just stated the same thing that my employer said, when i submitted for a drug screen: "as long as the prescribed medication does not impair our ability to perform our job..."

i have been taking hydrocodone for the past two years under the supervision of a pain management specialist for treatment of a bulging disc, as i have been informed by my two orthopedic specialists that there are no other treatment options for me. if i thought i could survive the application process for getting on ssi without losing everything i own, i'd stop taking it today and stay at home. but since i can't, i have to stay functional in order to keep drawing a paycheck. the day that i become impaired, is the day i quit. until that day comes, i have to keep on working... :o

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Specializes in Education, FP, LNC, Forensics, ED, OB.
Wondering....so if a nurse is a closet alcoholic, do they also need to declare their addiction to alcohol? Isn't alcholism a disease? Couldn't this be considered discrimination against someone with a mental disorder (alcohol abuse)? Just curious about this. Also, Siri...are all 50 states Board of Nursing the same with regards to rules and regulations?

Hello, TweetiePieRN,:balloons:

Alcoholism is another issue entirely in that you do not need a prescription in order to drink. If the individual is drinking on the job, yes, they most probably and should be terminated on the spot.

Mental disorders in conjunction with alcohol abuse is a whole other issue in and of itself.

Now, prescription drugs ..... I must repeat what I said earlier.........IF you have a prescription for the medication and do NOT declare that you are taking said med, you more than likely will be terminated when the drug is found during drug testing.

All BON have their own regs. Most view this as being in violation (failure to disclose).

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Hello, TweetiePieRN,:balloons:

Alcoholism is another issue entirely in that you do not need a prescription in order to drink. If the individual is drinking on the job, yes, they most probably and should be terminated on the spot.

Mental disorders in conjunction with alcohol abuse is a whole other issue in and of itself.

Now, prescription drugs ..... I must repeat what I said earlier.........IF you have a prescription for the medication and do NOT declare that you are taking said med, you more than likely will be terminated when the drug is found during drug testing.

All BON have their own regs. Most view this as being in violation (failure to disclose).

OK, that makes sense! I thought that you meant on any given day if you are taking vicodin (prescribed) that you could get in trouble! I see! That makes total sense if it is found in the drug screen and you didn't disclose! Thanks! :)

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All I can tell you is that I have worked in the past for a pain management clinic, where we treated working RNs with scripts for many narcotics. The doctor was a stickler for legal stuff, and I don't believe he would prescribe to RNs knowing they were working if it were illegal. Hope this helps.

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Specializes in Education, FP, LNC, Forensics, ED, OB.
OK, that makes sense! I thought that you meant on any given day if you are taking vicodin (prescribed) that you could get in trouble! I see! That makes total sense if it is found in the drug screen and you didn't disclose! Thanks! :)

I am glad I made sense, TweetiePieRN. You know trying to type on these forums about certain issues and not actually making eye-eye contact, it is hard to make myself clear. Sometimes after I post, I look at what I typed and think, "Now if I can't figure out what I have said, how in the world can I expect them to?":lol2:

I think with all this what concerns me the most is the individual who will keep the fact they are on pain meds a secret. Not disclose this information for fear of losing their jobs. This is just not a good idea and will more than likely lead to a disastrous ending.

My stance on this (and I have/do work with my BON ) is: (1) you have a legal, current prescription (2) you take the medication as directed (3) you use full disclosure (4) you have a physical examination to verify the need for this medication while performing your duties ........ a nurse should be allowed to take their medication and work.

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