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RN's w/chronic pain, using narcotics



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No. 30
Old Sep 27, 2005, 05:51 PM

Originally Posted by TweetiePieRN
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
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No. 31
from CseMgr1
Old Sep 27, 2005, 05:51 PM

Originally Posted by mattsmom81
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...
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No. 32
from sirI
Old Sep 27, 2005, 06:42 PM

Originally Posted by TweetiePieRN
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,

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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No. 33
Old Sep 27, 2005, 08:17 PM

Originally Posted by siri
Hello, TweetiePieRN,

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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No. 34
from mommymaker
Old Sep 27, 2005, 08:20 PM

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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No. 35
from sirI
Old Sep 27, 2005, 08:54 PM

Originally Posted by TweetiePieRN
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?"

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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No. 36
from SRbear
Old Sep 27, 2005, 11:25 PM
Updated Sep 28, 2005 at 12:00 AM by SRbear

When I was asked to go for a drug screen, I told them exactly what they would find. Lost my job anyway. just told them too late.
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No. 37
from SRbear
Old Sep 27, 2005, 11:53 PM

I spent 4 days last week going through withdrawal from oxycontin. I thought I would rather have pain every day then to be labeled a drug addict. Now that I think about it, I am not sure why. I have already lost my job, my self worth, my self identity, my ablility to earn a living. If not a nurse, what am I? I go to sleep and wake up in pain every day now, and think it would be ok if I never woke up. I thought that the pain was the worse thing I had to deal with, not the relief from pain.....with the labels and attitudes from nurses in general. I just need to let those who think they would never let someone who, like me, takes (took) a slow release pain med for chronic pain, take care of family members, or God forbid, drive a car, that there was not an IV I could not start, a tube I could not put anywhere, a patient I could not comfort, or a problem I could not solve as a charge nurse. I had no incident reports at work, or traffic violations outside of work. Am I angry.. yes...at myself, at hospitals, at nurses, at the docs, at the world.
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No. 38
Old Sep 28, 2005, 01:52 PM

Default People like us, and people like them
Originally Posted by SRbear
I spent 4 days last week going through withdrawal from oxycontin...brevity...Am I angry.. yes...at myself, at hospitals, at nurses, at the docs, at the world.

SRBear,

Why did you do that to yourself? I understand, believe me, I started the same thing once myself. After a couple of days I called my doc, explained, and he helped me start over, prescribing a different narc. I left the imprint of my fist in a plaster wall to remind me of how too much pride can mess with me. One of my problems was thinking that I had no pride left which drove me to trying to be a stoic. And guess what...I really can't control everything, and if my legal pain control offends the witch hunters, too bad. I don't really care about their unsolicited opinions. The Mrs. Grundys of this world may benefit from a taste of the humility that daily pain teaches us. Bastinado might be a good start.

I figured I would catch hell from someone for my prior post, and I am pleasantly suprised. I would advise anyone with a chronic problem to do what I did today, go to vocational rehab. I will be meeting with a counselor in a few days, and hopefully get some educational benefit. My aim is to turn 25 years of nursing into something that will be appreciated: Veterinary assistant. The UK has Veterinary nurses, and I can see it coming around the corner in the U.S. God grant that the BON doesn't get a hold of it.

It will be a weight off my shoulders to get behind the delusional world that health care professionals have constructed. I have no doubt that the "Robin Goodfellows" I have had the displeasure of working with are a bigger pain than the one I have now. I can see through the game now, after I've been out of the situation for a time. And to a chronic whose only mistake was keeping someone who trusted them from injuring themselves, I think that the schizoid little world of health care is the last thing we need to add to our troubles. I only regret that I wasted so much time of my life in that world. Nursing certainly pays more than Veterinary, but then so does prostitution. If a nurse is comfortable in that state of affairs, and clearly sees the game they are in, then by no means I would ever try to dissuade them. Call it sour grapes if you like, but I think in some ways my injury spares me from something worse. Sort of like the "thorn" in Paul's side.

I agree SR, I have been, and am angry, too. But it's starting to go away. I've made about $700.00 in the last 3 months, had to go on unemployment, but I appreciate my wife in the way that a woman should be appreciated. That makes both of us quite wealthy.
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No. 39
Old Sep 28, 2005, 05:14 PM

Originally Posted by grannynurse FNP student
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
Grannynurse, I agree with you on this.
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