An RN friend being set up at her job, are even threatening her license; need advice

klone, MSN, RN · Apr 12, 2010

A psychiatric nurse told me that Ambien definitely comes up as a benzo on a urine drug screen.

I'm pretty sure your nurse friend is incorrect. Ambien is NOT a benzo, and as such, would not come up on a standard UDS (although there are special panels that can test for it). Also, it has a very short half-life, which means that unless she took an Ambien 3 hours before the UDS, it wouldn't show up anyway (half-life is about 2 hours, which means it will be pretty much undetectable after 10-12 hours, so most people would not have any left in their system the morning after taking it the night before).

morte, LPN, LVN · Apr 12, 2010

No, it doesn't definitely or always come up on a UDS. Also, it has a very short half-life, which means that unless she took an Ambien 3 hours before the UDS, it wouldn't show up anyway (half-life is about 2 hours, which means it will be pretty much undetectable after 10-12 hours, so most people would not have any left in their system the morning after taking it the night before).

the person in question took Ambien CR....perhaps this would make a difference?

klone, MSN, RN · Apr 12, 2010

the person in question took Ambien CR....perhaps this would make a difference?

The half-life of Ambien CR is just a bit longer - more like 3 hours instead of 2. And nope, Ambien CR is still not a benzo, and would not show up as a benzo on a standard UDS.

Trauma Columnist · Apr 12, 2010

Please be careful with details here. The internet is not so anonymous as one would like to think.

Though I appreciate that you want to help your friend, would she want all this splashed all over the internet?

I agree that her employer knows way too much info about her personal life. Employment is just that; employment. Its not a social occasion and they don't need to know all the deails.

Katie5 · Apr 12, 2010

I'm sorry for your RN friend but why would she want to lay her head down in full view of others employees and visitors alike at the nursing station. The break room would have been a better bet.

BabyLady, BSN, RN · Apr 12, 2010

I have a friend who is an RN who just got out of a psychiatric hospital. She has problems sleeping and today was supposed to work and did try to go to work although she was very groggy. She tried to call in and was told she would lose her job if she didn't come in. So she went in and said she felt very dizzy and laid her head down on the nurses' station for about 10 seconds...however, another employee saw her and told everyone she was sleeping. The nursing manager shows up and gives her a drug screen, she passes, but they place her on suspension anyway and are threatening to call her BON and get her license revoked. Doesn't she have any rights at all in this matter? I want to help her in any way I can...
Please advise!
Blessings, Michelle

I think they are blowing smoke up her butt.

She passed the drug test...that is physicial proof she wasn't impaired.

They don't have a leg to stand on and I would be very, very vocal if I was her that if they tried to file false charges against her with the BON that her last name will be on the front door of the hospital when she is done.

An attorney would have a field day with that one.

Jolie, BSN · Apr 12, 2010

I think they are blowing smoke up her butt.
She passed the drug test...that is physicial proof she wasn't impaired.
They don't have a leg to stand on and I would be very, very vocal if I was her that if they tried to file false charges against her with the BON that her last name will be on the front door of the hospital when she is done.
An attorney would have a field day with that one.

It's evidence that she wasn't impaired by drugs. It doesn't speak to her fitness to work in any other aspect, such as health, fatigue, etc.

cherrybreeze, ADN, RN · Apr 12, 2010

A psychiatric nurse told me that Ambien definitely comes up as a benzo on a urine drug screen. I know it is a sedative/hypnotic, but other people have told me that too. When I said she passed her drug screen, I meant she didn't have any other meds on there besides her Ambien. She was negative for illicit drugs and alcohol. I haven't talked to her today but will keep everyone posted on the outcome.
Thanks for all the advice...
Blessings, Michelle

This makes things very different than your original post, when you just said she "passed her drug screen." Passing it by having something prescribed on board makes things a lot more iffy, and they can sway that any way they want to.

I still agree with the other poster that said, it's not a benzo, therefore it's not going to come up as one. The short half life info is also true.

BabyLady, BSN, RN · Apr 12, 2010

It's evidence that she wasn't impaired by drugs. It doesn't speak to her fitness to work in any other aspect, such as health, fatigue, etc.

If every nurse that went to work that was fatigued is reportable to the BON, then anyone working tons of overtime or the night shift is at risk.

No medical mistake was made...what kind of complaint is the hospital going to make, "Oh yeah, Sue Smith laid her head down on a desk" or "She seemed tired".

It will take alot more than that to make a case with the Board.

You cannot make a complaint based on assumption, you have to PROVE it.

cherrybreeze, ADN, RN · Apr 12, 2010

If every nurse that went to work that was fatigued is reportable to the BON, then anyone working tons of overtime or the night shift is at risk.
No medical mistake was made...what kind of complaint is the hospital going to make, "Oh yeah, Sue Smith laid her head down on a desk" or "She seemed tired".
It will take alot more than that to make a case with the Board.
You cannot make a complaint based on assumption, you have to PROVE it.

It wasn't that her drug screen was negative, though...it sounds like it was positive for benzos, and considered "negative" since they're prescribed (and I still disagree with Ambien registering as a benzo, but that's beside the point). She still had meds on board, and if they are using that to draw a line then to her evident fatigue, it's not such a baseless complaint any more.

The biggest point, though, IMO, is that OP wasn't there, either. Her friend told her that she "put her head down on the desk and closed her eyes for 10 seconds." We don't know, and the OP doesn't know, the shape she was in that day. You have to be awfully tired in order to do that (I can't imagine doing it, period), and that level of tiredness may have been evident in more than just that one act. I hardly think that she seemed perfectly awake, acting normal, etc, and then by doing that (putting her head down), everyone had a fit. If you're that tired, it's gonna show, whether you want it to, or think it does, or not.

klone, MSN, RN · Apr 12, 2010

If Ambien registered on a UDS, then she took it close enough to her shift that she *was* impaired while at work.

Meriwhen, ASN, BSN, MSN, RN · Apr 13, 2010

If every nurse that went to work that was fatigued is reportable to the BON, then anyone working tons of overtime or the night shift is at risk.

There's a difference between being tired but able to function safely, and being so exhausted that you're not capable of fuctioning safely. I'm sure you can understand the difference: after all, you did just start your own thread about how you didn't feel safe to work because you were so sleep deprived...well, the same could be said for the OP's friend--if she didn't feel safe coming into work due to being dizzy and tired, then she should have stood firm about calling out and cited patient safety.

And the BON's priority is patient safety. If the BON feels the behavior of the OP's friend is a valid safety concern, they're not going to drop the matter just because her UDS was negative...though in this case, it apparently wasn't.

Sorry to put you and your thread on the spot, but it did make my point perfectly about how fatigue can impair a nurse's performance to the point that she/he may not be safe to practice. And a tip: melatonin and earplugs helped me when I first adjusted to nights--after a while I didn't need them anymore and could sleep anywhere anytime.