California nurses and medical marijuana

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Specializes in Army Medic.

We had an interesting topic in discussion today about how the State Board Of Nursing is pro medical marijuana.

For many people suffering from chronic pain it's a great alternative to narcotics - which in my opinion hold a much higher risk for destruction of life style through addiction.

What I could not answer, nor anybody else in the class - since none of us are Nurses - is will a RN lose their license for receiving a Medical Marijuana License legally in the state of California (or any other state where it is legal) and testing positive on a urine screen?

What are your thoughts on this? Should Medical Marijuana continue to be an alternative choice for those suffering from chronic pain? Should Nurses who suffer from chronic pain - with legitimate medical conditions - be allowed to use Medical Marijuana? Can Nurses who have Medical Marijuana card continue their practice without fear of bias judgment by their place of work due to the Federal vs. State laws on the drug?

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Specializes in Emergency, CCU, SNF.

My guess would be, it's like any other prescribed drug and drug screens....if you have a script, well, okay.

However....and I may get some flak for this, but I don't think it's a good idea to mix nursing and marijuana. I don't think it should be used prior to working your shift. I do believe it's a wonderful alternative to many of the meds out there, it can help improve appetite, it can help ease pain and anxiety for some...but I can see the dangers of it being used on the job.

So many jobs and safety can be affected....bus drivers, truck drivers, police officers.....let alone, health care professionals. I think it's a good idea to have some policies to have in place. And there are so many drugs that people have legitimate reasons for, it can turn into a giant-sized mess if you set rules for one drug and not another.

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Specializes in Army Medic.

Oh I totally agree on never using before or during a work shift - I would think that applies to any narcotic!

Which is a dilemma I will ultimately face when I obtain my RN - due to chronic pain disorders I do take narcotic medications, and it comes down to a question of whether I feel my competency is high enough to do my job - or if the pain will affect my performance. How do you answer a question like that? If anyone knows, I'm all ears - because I haven't figured it out.

My own personal opinion on Marijuana is that it should be federally legalized as a prescription medication - with the same strict laws of adherence that all narcotic medications hold.

I was just curious what actual nurses in the field think about it - or if their hospitals actually hold a policy based around this specific issue.

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Specializes in Ante-Intra-Postpartum, Post Gyne.

IMO, yes, I think it should be totally fine for an RN to have and use a medical marijuana card as long as she/ is not under the influence, just as any other mind altering substance such an Norco, Percocet, Vicodin, ect. In the state of California one with a PRESCRIPTION for marijuana should have the same rights and restrictions as anyone that has a PRESCRIPTION of a narcotic such as Norco, Pecrcocet, Vicodin, ect.

The one thing a person would need to be careful for is Work-man's-comp since Marijuana shows up in a urine test long after it has stopped its affects; so one could not labrotisticly prove they were not under the influence on the job.

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Specializes in Critical Care.

I'm totally down with medical Mary J. I think for the people who need it (i.e chemo/CA patients, chronic pain pts etc) I think it is great for them. As far as nurses go. If they have a script for it then it should hold the legal weight of any other narc script that we would get from a doctor. I think most of the people, RNs n MDs I mean, who are pro-medical marijuana are the ones who have tried it at some point in their life.

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Specializes in Army Medic.

So I'm guessing nobody actually knows if it's treated differently from say taking percocet for chronic pain if you hold an RN license?

Are nurses who could possibly use it as an alternative to more addictive and destructive narcotic pain medications avoiding it for fear of loss of their license? Is there a stigma around it in hospitals?

I hope the core of the question I'm getting at is clear. Are there any documented procedures or pieces of policy information based around the use of a narcotic that is condoned by the state, but not federally?

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If they condoned it then that would be a major hurdle to getting it fed legalized. Im all for it.

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Specializes in Critical Care, Education.

I'm a bit confused - pardon my 'non California-ness'. If you are using medical marijuana - do you smoke it, eat it or what? Since hospitals are now non-smoking, how does that work from a practical standpoint.

Let's try to think of this from the patient's & employer's perspective. How would you feel if something bad happened to you or a loved one and you (or your lawyer) discovers that the nurse (who was involved) tested positive for a narcotic???? Hmm? How do you think a jury would feel? Any employer with a halfway competent risk management department would refuse to hire or maintain clinical staff who are consuming narcotics - no matter how 'legitimate' the reason. It's just too risky.

The user is NEVER able to objectively assess his/her own capability. People under the influence never realize how buzzed they are - cause their brain is too impaired to make this judgement. Maybe if there was a device they had to use periodically to check cognition or hand/eye coordination or something - just to make sure.... nah, I still don't think its right to subject unsuspecting patients to potentially impaired care providers. It's hard enough to deliver safe care under normal (understaffed, over-worked, stressed out) conditions.

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to me, there's a huge difference betw taking a vicodin vs smoking marijuana.

i have taken one vicodin before work, w/o me getting a 'buzz'.

it only targeted the pain.

however, there is no way i could smoke before working...

you always get high off of marijuana, and cognitive abilities are impaired.

so while i have no problem with medical marijuana, i would take issue with those who toke before work.

any med that alters your perception, is dangerous to be using at work.

leslie

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Specializes in Psychiatry, ICU, ER.

I'm not entirely sure WHY whenever marijuana is mentioned, a certain segment of the population cries "patient safety." News flash: alcohol is legal and we're not all coming to work impaired. Stop using "patient safety" as a way to object to something that YOU don't like.

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Specializes in Army Medic.
I'm a bit confused - pardon my 'non California-ness'. If you are using medical marijuana - do you smoke it, eat it or what? Since hospitals are now non-smoking, how does that work from a practical standpoint.

Let's try to think of this from the patient's & employer's perspective. How would you feel if something bad happened to you or a loved one and you (or your lawyer) discovers that the nurse (who was involved) tested positive for a narcotic???? Hmm? How do you think a jury would feel? Any employer with a halfway competent risk management department would refuse to hire or maintain clinical staff who are consuming narcotics - no matter how 'legitimate' the reason. It's just too risky.

The user is NEVER able to objectively assess his/her own capability. People under the influence never realize how buzzed they are - cause their brain is too impaired to make this judgement. Maybe if there was a device they had to use periodically to check cognition or hand/eye coordination or something - just to make sure.... nah, I still don't think its right to subject unsuspecting patients to potentially impaired care providers. It's hard enough to deliver safe care under normal (understaffed, over-worked, stressed out) conditions.

I don't personally use marijuana - but it is available in all sorts of forms. Marinol (I may be wrong on the name) pills are actually a prescription drug of concentrated THC, you can bake it into foods, etc. It does not have to be smoked.

My question is not should nurses use narcotics on the job, though you raise a new point. If a nurse tested positive for prescribed marijuana after a mistake - versus testing positive for prescribed percocet after making a mistake do you think it would be handled differently?

My question centers around if whether RN's are allowed to use medical marijuana for their own purposes as an alternative to narcotic pain killers in states where medical marijuana is legal.

Taking a vicodin and taking a hit from a joint are an equally stupid thing to do during a shift - obviously. People who say you don't function properly when high on marijuana versus vicodin say it because there have been no studies to show potency equivalency between the two drugs. (i.e. 1 mg of xanax is equal to 6 mg of ativan).

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I just watched a story on the news a couple of days ago concerning something similar. According to the news, this issue was challenged in court in a few States. The court ruled that someone can be fired for testing positive for marijuana even if it was medically prescribed. That is all I remember from the story, sorry. I'll talk to my wife when she gets back, maybe she will remember more. If she does, I'll let you know and try to provide a link.

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