Can a nurse come to work after taking a benzodiazepine?

MunoRN, RN · May 3, 2011

They can't ask these questions prior to an offer, but they can then not hire you (after the offer) based on a medical screening process which can include medical conditions, medications, etc.

Just because you've received a conditional offer does not mean you've been hired. While there are protections for those with disabilities, investigating what those disabilities are is not prohibited prior to completing the hiring process, and even then they are only required to make "reasonable accommodations" to those with disabilities, which does not include every medical condition only true disabilities, which usually does not include anxiety.

medpro32 · May 3, 2011

They can't ask these questions prior to an offer, but they can then not hire you (after the offer) based on a medical screening process which can include medical conditions, medications, etc.
Just because you've received a conditional offer does not mean you've been hired. While there are protections for those with disabilities, investigating what those disabilities are is not prohibited prior to completing the hiring process, and even then they are only required to make "reasonable accommodations" to those with disabilities, which does not include every medical condition only true disabilities, which usually does not include anxiety.

Anxiety is covered by the ADA if it meets the criteria of a disabilty. Situational anxiety may not fit, but PTSD, panic attacks, agoraphobia and others do, if the level of impairment is great enough.

MunoRN, RN · May 3, 2011

Anxiety is covered by the ADA if it meets the criteria of a disabilty. Situational anxiety may not fit, but PTSD, panic attacks, agoraphobia and others do, if the level of impairment is great enough.

Which is why I said "usually does not include anxiety". Homebound agoraphobia is sometimes considered a disability, although even then an employer is free to ask you about this aspect of your medical history (after making a conditional offer) and not hire you based on it if the accommodations that would be required aren't considered "reasonable".

tyvin, BSN, RN · May 3, 2011

The testers can't reveal what you were positive on if a Rx is found to clear you. They are obligated to send a result of negative back to the employer if you have Rxs. It's called HIPPA and it protects even us and if they disclose to the employer what you're on with a legal Rx you have definite grounds for a suit.

BTW; I, in fact, know a nurse that the lab blabbed what legal stuff he was on and he took them to the cleaners; the lab I mean. Though it's not for sure whether they would have hired him or not the lab made a mistake that resulted in the possibility that the employer discriminate based on the results they received. You know for sure where I live the labs aren't going to make that mistake again.

As for nurses being held to a standard of higher accountability I say the urine and background are enough.

skittlebear · May 3, 2011

Sometimes anxiety symptoms can be much, much worse and hinder ones judgement as well. Some NEED anxiety medications to be able to function. As one poster suggested, it depends on the person and the medication. I am not against it as long as the nurse can perform and make sound judgements.

medpro32 · May 3, 2011

The are different employment laws that vary state to state. Before deciding NOT to disclose.......talk it over with an employment lawyer in the state you are going to be employed. It is NOT illegal to ask but it is illegal to discriminate. When you fill out the "Employee Physical" history that are required by most employers to be sure you are "physically fit" for the position. In most offer letters it is stated....."upon completion and passing of the pre-employment physical". If you lie....and are later outed for whatever reason......you have given them reason to fire you but also reason to refuse workmans comp in the event of a needle stick (they require drug testing in the case of a work related 'accident') because you lied and were impaired.......
I agree testing positive and being under the influence are completely different as just because you take the drug doesn't mean you can't function.......that is why earlier I said it was a convoluted subject and difficult to know what to do.......seek legal advice.....but DON"T LIE

ADA, Title VII, EEOC violations etc, are all federal law and state law may not contradict them. You don't really need to be too concerned about variations from state to state. You are either protected by a just cause employment contract of a union or you can be pretty much fired at will for no reason at all.

The issue about the pre employment physical/fitness to perform the job is different when talking about the medial use of benzos. It one thing to get a job as a nurse, then tell them you cant even lift 5lbs when the job description requires you to lift 35-40, be able to stand, bend kneel etc.

The use of benzos does not mean your ability to meet the job requirments is affected at all. The only question is does the benzo use lead to a condition of impairment in the individual.

MunoRN, RN · May 3, 2011

The testers can't reveal what you were positive on if a Rx is found to clear you. They are obligated to send a result of negative back to the employer if you have Rxs. It's called HIPPA and it protects even us and if they disclose to the employer what you're on with a legal Rx you have definite grounds for a suit.
BTW; I, in fact, know a nurse that the lab blabbed what legal stuff he was on and he took them to the cleaners; the lab I mean. Though it's not for sure whether they would have hired him or not the lab made a mistake that resulted in the possibility that the employer discriminate based on the results they received. You know for sure where I live the labs aren't going to make that mistake again.
As for nurses being held to a standard of higher accountability I say the urine and background are enough.

Labs usually don't care what you have prescriptions for, they are only obligated to perform the test and report the results, it's up to your employer to validate positive results with a prescription, changing the result to negative would be falsifying the results. Even when you have a prescription, an employer can choose not complete the hiring process based on your drug screen.

HIPPA doesn't protect you. Part of a pre-employment drug screen is a Release of Information form which allows the lab to send the results to your employer. The lab is not liable for providing accurate test results to your employer so long as you have signed an ROI.

medpro32 · May 3, 2011

Yeah, thats a sticky situation. If anything at all goes wrong, whether related to being under the influence of the medication or not, they will likely consider you to have been practicing under the influence of a medication and go aftr your license. If someone is so anxious about their work place that they have to self medicate, perhaps they should consider finding a new work environment or career!

That attitude belittles individuals who have legitimate anxiety related issues. I doubt the O.P. was "so anxious" about their job that they had to "self-medicate" (another derogatory term, unless someone else is injecting it into you, almost all medication you or I take is "self". It's not as if we are talking about getting boozed up in an attempt to control anxiety. Benzodiazepines are very legitimate, predictable medications that are used responsibly by millions of people.

Gold_SJ · May 3, 2011

It's perfectly fine if under Medical orders and it shall not impact nursing care. Many don't realise to go to work without taking the dosage is more dangerous. Any prescribed medication for anxiety/bipolar/schizophrenia ect. Is to be taken as required as if in a high anxious state it brings you back to normal. Hearing voices and medication = diminished and ease of concentration. Ect ect. At all times a person should take the medication as the doctor is telling you to.

A person just needs to know if their doctor states they are able to have them and function normally at work if so, there is no problems whatsoever. If of course it put you to sleep...well obviously you're not functioning (aaaand I'd be inquiring over your dosage) and you would have to call in sick that day, work alongside your medical practitioner/psychiatrist you'll have it worked out pretty quick ^.~

All the best!

Chin up · May 3, 2011

Labs usually don't care what you have prescriptions for, they are only obligated to perform the test and report the results, it's up to your employer to validate positive results with a prescription, changing the result to negative would be falsifying the results. Even when you have a prescription, an employer can choose not complete the hiring process based on your drug screen.
HIPPA doesn't protect you. Part of a pre-employment drug screen is a Release of Information form which allows the lab to send the results to your employer. The lab is not liable for providing accurate test results to your employer so long as you have signed an ROI.

HIPAA does protect you. Yes, you sign a ROI form, and yes the lab sends the results to your employer. But, and where you keep getting hung up, the lab, upon finding a banned substance will do a second test to rule out a false positive. They will then notify you and ask for the prescriber. If you have a legit script, they will read it as a negative. Your employer has no right to know, or ask what medications you are taking. If you choose to tell them, well then, good luck. Like stated on a previous post, it is a federal program and supersedes state law. Peace!

Chin up · May 3, 2011

Ps- the whole point of drug testing is to eliminate illegal drug users and ETOH abuse. They are looking for abuse. Not the random percocet you take for a broken leg, or Xanax used for anxiety disorders. Nurses are given prescriptions when needed for all types of narcotics knowingly by their doctors. Some have taken these medications for many years and some may take them for the rest of their lives. Just because you take a narcotic or anti-anxiety drug, does not mean you are impaired. Different meds have different effects on different people. Benadryl impairs me and I won't take it ever. So does vicodin, but a percocet does not. Maybe they would if I Abused them, but taking anything in excess, or by wrong route is against the law.

Years ago in the hospital, we did not count Xanax, halcion, Ativan, Darvocet, etc. We had a bowl full of these drugs and administered them when needed. We did not have an issue with theft at that time. Maybe a tubex of demerol, here and there would cause a full scale door locking, no one move until we find them, but that was rare. Peace!

MunoRN, RN · May 3, 2011

Chin up said:

HIPAA does protect you. Yes, you sign a ROI form, and yes the lab sends the results to your employer. But, and where you keep getting hung up, the lab, upon finding a banned substance will do a second test to rule out a false positive. They will then notify you and ask for the prescriber. If you have a legit script, they will read it as a negative. Your employer has no right to know, or ask what medications you are taking. If you choose to tell them, well then, good luck. Like stated on a previous post, it is a federal program and supersedes state law. Peace!

HIPAA only protects you from unjustified access to your medical records without your consent, an ROI is your consent. HIPAA does not protect you from being asked about your medical history. HIPAA is available online, if you know where that is stated I'd be interested to see it.

Where I work we also sign an ongoing ROI for both random drug testing and an agreement to notify HR if we are prescribed any "Potentially performance altering" medications, which is defined as any medication that contains warnings in the FDA approved labelling regarding "impairment". Employers do have the right to ask what medications you are taking, prescribed or otherwise. I have worked at 3 hospitals in 2 different states, all of which required us to notify HR if we were any medications that could potentially affect our work performance. One of these hospitals provided us with a list that included everything from benadryl to opiates. This is from a different state, but it pretty well describes the boundaries for employers.

In particular: "A controlled substance's use as part of a prescribed medical treatment is not grounds for disciplinary action, although it is paramount for the appointed authority in the facility to know the use is occurring.

Failure to disclose prescription drug use once a policy is in place which is discovered as part of a random or for-cause drug screen can and should be cause for disciplinary action."