Another dilute urine for IPN

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Specializes in Mental health, Critical Care, Nurse Educator du.

I have been batteling with "peeing perfect" for the last 11 months. Either I don't make enough urine for the sample, or when I do, its too dilute. I'm not trying to hide anything, but IPN is treating me as if I am. My question is, isn't there a test that they can run which will actually show the presence of adulterants? I don't mean the normal SVT (which looks at specific gravity, creatinine and ph), but a test that would show if you tried using a masking agent or something to obscure the results. I have no other way to prove to them that I am not intentionally trying to influence my results. I have already had to do a repeat evaluation and have had the whole big toxicology work up, had numerous repeat urines and I have come up clean. I ended up having another dilute urine last week, and now I'm terrified of what will happen next. The last urine they ordered had some other add on test to it, so I am hoping that was a way to detect dilution or adulterants so that I can be cleared of this and return to work.  Has anyone faced a similar situation?  

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I don't think proving that it isn't altered is the issue-dilute would kind of mean that you didn't alter the sample and are trying to flush your system out. If you're using your first morning urine, etc and it is still dilute, I'd go to the Dr and see if there is something going on with you that might explain it, as that isn't normal. 

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Specializes in Addiction Medicine, ER, and Psychiatry.

I agree with @TIMFY. Please go to the doctor and see if something is wrong. I can only speak from my own experience. I went through a year of dilute urine with no defense, hair and blood came back negative. Each dilute urine created a violation of my contract - 11 in all I believe. I was facing near suspension of my nursing license and termination of my contract... and I was sober! I went to my MD who sent me to a nephrologist.

It turns out the Lithium I am taking for Bipolar Disorder had caused me to go into Diabetes Insipidus (which explained a whole other set of symptoms). I got a lawyer at that point because I had to truly fight to stay in the program. I ultimately won, but not without a year-long fight to the death and three years added to my program. But had I not gone to my primary, I would never have known what was causing my dilute urine (I thought it was the post long-run hydrating?).

I also realized beyond a reasonable doubt that the BON will dissect any reason you present until they get to the answer they desire. My lawyer is a gem. He is expensive, but I would do whatever I could to keep him. I wish I hired him many years ago. 

I am on year 7 of a 5 year contract and I have been sober the whole time. I have 18 months to go. Yes, there will be a book or a podcast or something when my case file is finally sealed.

Good luck!

 

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Specializes in Mental health, Critical Care, Nurse Educator du.

Wow! This is tragic! I have issues around anxiety everytime I have to do a urine. I've had numerous times when I didn't drink enough and my sample was insufficient. Sitting at Labcorp for another 3-4 hours to give another sample isn't an option when I'm already taking time off work to take the test. I currently cannot work because of all of this, and its resulted in me losing a job. It's been almost 4 weeks since my evaluation was done, and I still don't have an answer from IPN. In the meantime they keep selecting me for Peths, and other urine tests that I have no idea what they are for, but they cost more than my usual $55 test. I'm going broke and can't work. I'm 54 and my 27 year career in nursing has been destroyed by a couple of poor choices in the past.  I am honestly very close to giving up this fight for my license.  I wish I could be seen for who I am and not what I might be. 

Thank you for your share on this. It makes a difference knowing I'm not alone.

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Don’t give up and let them win!!  You can do this! Yes it’s expensive and a big pain in the butt!  You worked hard to get your nursing license; don’t throw it all away. There were times I wanted to do the same. I know that you’re going through!  Stay strong and try to remain positive. It’s hard but you got this!?

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Specializes in Mental health, Critical Care, Nurse Educator du.

Thank you so much!! Means a lot to me. 

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I am going through the same thing! What did IPN finally do?

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Specializes in Psych, Addictions, SOL (Student of Life).
On 12/26/2021 at 11:37 AM, TIMFY said:

I don't think proving that it isn't altered is the issue-dilute would kind of mean that you didn't alter the sample and are trying to flush your system out. If you're using your first morning urine, etc and it is still dilute, I'd go to the Dr and see if there is something going on with you that might explain it, as that isn't normal. 

As a working nurse it's not always practical to use first urine in the AM. As the collection might need to be observed or the collection center no open that early. I had this problem and was advised by my physician to space my fluid intake out through the day and eat plenty of protein on test days.  Also try not to drink anything or go the bathroom for at least two hours before you test so your your urine is concentrated when you give your sample. If this doesn't work get your physician to do a 24 hour urine collection test.  This will show the BON that you are looking for an answer to the problem.

Hppy

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On 12/27/2021 at 1:31 PM, Quickstepper said:

Wow! This is tragic! I have issues around anxiety everytime I have to do a urine. I've had numerous times when I didn't drink enough and my sample was insufficient. Sitting at Labcorp for another 3-4 hours to give another sample isn't an option when I'm already taking time off work to take the test. I currently cannot work because of all of this, and its resulted in me losing a job. It's been almost 4 weeks since my evaluation was done, and I still don't have an answer from IPN. In the meantime they keep selecting me for Peths, and other urine tests that I have no idea what they are for, but they cost more than my usual $55 test. I'm going broke and can't work. I'm 54 and my 27 year career in nursing has been destroyed by a couple of poor choices in the past.  I am honestly very close to giving up this fight for my license.  I wish I could be seen for who I am and not what I might be. 

Thank you for your share on this. It makes a difference knowing I'm not alone.

You are NOT alone sad thing is if you give up then that's a win for them and a loose for nurses. It is BS and expensive  but KEEP pushing on. When it's over and you still have your license  share with other nurses your experience. I always do so the younger nurses know this can happen and happen fast. The system  is flawed and needs repair. All of us who have gone through this will someday fight the whole darn thing and win to change it for future  nurses.  I know I sound crazy, but that's what it takes ....I'm up for the fight after I retire of course because the cra cra IPN and BON will tear me to pieces LOL. Keep you head up !!

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Specializes in Mental health, Critical Care, Nurse Educator du.

I'm all in with you. It seems that there should be another forum to discuss monitoring programs (IPN). I don't necessarily trust that this public forum isn't monitored by big brother. I also feel like we really need our own support group where we are independent and can support eachother, help those just entering ( not our facilitated groups obviously because everything you say there goes right to your case manager). Thoughts? Ideas? 

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I agree ... will have to do some research. You would think that something like that would be in place . But I will be looking and letting everyone know what I find out. 

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I agree! I would love to be a happy art of advocating!

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