Can a nurse come to work after taking a benzodiazepine?

[Smackdown]

If a nurse is prescribed a medication like Xanax, Klonipin, Ativan, etc for anxiety.....can they legally work as a nurse under the influence of this medication? I searched my state's boards of nursing website and could not find anything.

[MunoRN, RN]

thehipcrip said:

The point of the ADA to prevent discrimination on the basis of disability in part by *not* requiring any individual to reveal whether they are disabled or not. The courts have ruled that since there are so many drugs that are specific to certain disabilities, requiring employees to name the drugs they have been prescribed would allow the employer to deduce that an employee has a certain medical condition. In other words, having employees name the specific legal medications they are taking is the same as asking them if they have a disabling condition, which is a direct violation of the ADA, and therefore prohibited.

The right of a disabled person to not be questioned about their disability only applies prior to a conditional offer of employment, after that offer is made, but prior to completing the hiring process, (and after) the employer is free to ask about a prospective employee's limitations related to job performance. Partly due to this, drug testing is also only performed after a conditional offer is made. This is also why you won't find questions about medications on a job application, but you will find it on paperwork you fill out after a conditional offer is made.

"a. An employer may not inquire into an applicantís workersí compensation history before making a conditional offer of employment.

b. After making a conditional job offer, an employer may ask about a personís workersí compensation history in a medical inquiry or examination that is required of all applicants in the same job category. "

[MunoRN, RN]

The drug Free Workplace regulations are concerning illegal and not prescription drugs. If you are convicted from possession, manufacturing, distributing or injesting, illegal drugs, you may or may not be tested. Not prescription drugs.

Workplace drug testing typically includes benzodiazepines, opiates, amphetamines, and even SSRI's. These are all prescription drugs and yet are all tested for. The "drug free workplace" regulations place no limitations on testing for drugs that also have legitimate medical purposes.

[Chin up]

Workplace drug testing typically includes benzodiazepines, opiates, amphetamines, and even SSRI's. These are all prescription drugs and yet are all tested for. The "drug free workplace" regulations place no limitations on testing for drugs that also have legitimate medical purposes.

back to square one, but the lab labels them as a negative. And that is what is fowarded to the facility. The facility has absolutely no right to know. Period.

[MunoRN, RN]

Your facility does have the right to know what prescription medications you are taking, below is an article about an employee who sued (and lost) over being fired for taking a prescription drug (with a prescription and as prescribed.)

If Nursing was not considered a "safety sensitive" job, then it would be more debatable. But as the previous document I cited, as well as this article point out, "safety sensitive" workers "can be required to self-report the use of prescription medication if their inability or impaired ability to perform their job functions would result in a direct threat, he added." There is some controversy out there about what jobs qualify as safety sensitive, which is what the story is about; the employee in question worked in auto parts manufacturing and "safety sensitive" has been traditionally defined as jobs where an impairment poses a threat to others, not necessarily to ones self. In terms of Registered Nursing being a safety sensitive job, there's little controversy, Nursing is usually towards the top of lists that give examples of safety sensitive jobs.

The employee in question argued for her right to privacy, the ADA was also argued for. The court did not find that the drug testing and termination was wrongful or illegal, or protected by the ADA. If an Auto parts manufacturer has the right to test for, and terminate, employees based on legal prescribed medication use, then employers of Nurses and Doctors are certainly able to make self-reporting a policy.

[ZippyGBR, BSN, RN]

MunoRN said:

Your facility does have the right to know what prescription medications you are taking, below is an article about an employee who sued (and lost) over being fired for taking a prescription drug (with a prescription and as prescribed.)

If Nursing was not considered a "safety sensitive" job, then it would be more debatable. But as the previous document I cited, as well as this article point out, "safety sensitive" workers "can be required to self-report the use of prescription medication if their inability or impaired ability to perform their job functions would result in a direct threat, he added." There is some controversy out there about what jobs qualify as safety sensitive, which is what the story is about; the employee in question worked in auto parts manufacturing and "safety sensitive" has been traditionally defined as jobs where an impairment poses a threat to others, not necessarily to ones self. In terms of Registered Nursing being a safety sensitive job, there's little controversy, Nursing is usually towards the top of lists that give examples of safety sensitive jobs.

The employee in question argued for her right to privacy, the ADA was also argued for. The court did not find that the drug testing and termination was wrongful or illegal, or protected by the ADA. If an Auto parts manufacturer has the right to test for, and terminate, employees based on legal prescribed medication use, then employers of Nurses and Doctors are certainly able to make self-reporting a policy.

the fundamental issue here and the one which has earned members questionably justifable infractions win AN is the assumption seen from a number of posters

1. all Nurses taking medication are impaired

2. any nurse taking opiates ( consistantly and erroneously referred to as 'Narcotics') or 'psychoactive' medications are not fit to be a Nurse

3. that it is somehow the right of others to hound out and discriminate against Nurses who work while managing chronic or acute pain or while being 'nutters' as unfit for practice.

I'm quite sure that some of the Posters would stroke out at a clear statement made by my employer's Occupational Health Consultant Doctor (paraphrased) " In terms of impairment to practice, it is quite clear that the risk is greater should ZippyRN not take his prescribed medication, his continued use of the medication while symptomatic is most likely to improve rather than impair his work " - and that'sin relation to a medication which the panic parties would label 'psychoactive'

[Gold_SJ]

Hm well here in australia employers have no right to know what prescriptions drugs one may take.

My mother is a Register Nurse and works majority of the time in OT and drug testing. While out testing train drivers and trade workers at the powerhouse/smelter etc etc. If she gets a positive result the employer only gets told that a positive has come back, not what it is for. The worker is removed from the workplace, as then it is sent away to the lab and tested and found 'exactly' what drug it is. If the worker has a prescription for this and presents it. Then the employer is contacted and told that it was a false positive and not an illegal substance and the employee goes straight back to work.

The employer has no right to know what it came back positive as, nor what the prescription is.

I guess it may work out differently in other countries. But this is how it works in Australia.

I just don't see how if medically a person is told they are fit for duty then why it could possibly be the employers business whatsoever, unless they were suddenly unwell or not meeting up to standards in the work environment. Even then they certainly have no right to know your medical history or drug prescriptions, that's very big brother really.

[MunoRN, RN]

the fundamental issue here and the one which has earned members questionably justifable infractions win AN is the assumption seen from a number of posters

1. all Nurses taking medication are impaired

2. any nurse taking opiates ( consistantly and erroneously referred to as 'Narcotics') or 'psychoactive' medications are not fit to be a Nurse

3. that it is somehow the right of others to hound out and discriminate against Nurses who work while managing chronic or acute pain or while being 'nutters' as unfit for practice.

I'm quite sure that some of the Posters would stroke out at a clear statement made by my employer's Occupational Health Consultant Doctor (paraphrased) " In terms of impairment to practice, it is quite clear that the risk is greater should ZippyRN not take his prescribed medication, his continued use of the medication while symptomatic is most likely to improve rather than impair his work " - and that'sin relation to a medication which the panic parties would label 'psychoactive'

Personally I'm a fan of personal rights, I'm not advocating for an employer's right to be aware of or control your life beyond a reasonable extent, just pointing out how things are in the US. I think impairment should be judged based on actual impairment. Once you start banning everything that can potentially contribute to impairment then you're dealing with having to eliminate a long list of items that can't reasonably be totally eliminated such as being physically/emotionally tired, being hungry, personal life distractions, etc. The workers in the article were not tested because of concerns of impairment, and some had worked there for over 20 years without any problems, some even had doctor's notes attesting that they were safe to work, but with our system it's up to the employer as long as the rules are stated clearly and it's justified as "job relatedness and consistent with business necessity", which has been loosely defined. It would be helpful to see more numbers on how medications can affect safety rather just assuming every person who takes potentially impairing drugs is less safe compared to other workers or less safe compared with the same worker not taking the drug. It would be nice if someone could invent an 'impair-o-meter' and just use that.

In the US, "Narcotic" has taken on various definitions, now being more of a legal term than a medical term. You'll often hear it referred to as any highly controlled drug, although the DEA defines it only as opiates and cocaine derivatives.

[Esme12, ASN, BSN, RN]

Chin up said:

you are right, it is not their business and they cannot ask you. Google drug free workplace for more info.

I wish everyone to realize. Different employers perform different tests. Most hospitals use their own labs to perform drug screens so trust me they know the answer......so don't lie. Federal Law does supersede State Law in most cases. Employee at will states can actually do pretty much what they want. You can sue, but hospitals are pretty smart and almost impossible to prove wrong doing.....just like the Government and any big business. You can report them to the EEOC.....be prepared to WAIT, REALLY WAIT, and WAIT......Most "lawsuits" are out of pocket expensive.......very expensive especially if you lose. We didn't count certain narcs a long time ago....that's why we DO count them now.....

Please read this website.....ADA,preemployment physicals ect.

Thank you Hipcrip.........those of us who have experienced discrimination at the hands of hospitals are intimately familiar with the realization there is still very little protection for the "little" guy. The last time I asked for accommodation I was "laid off" with a nice severance package.......The reality is the hospitals CAN ask you what meds you take and they CAN perform medical exams, it is not advisable to lie...that can fire/not hire you for that.....Remember on you application...."Do you certify these statements are true to the best of your knowledge???"

Before you decide to take the med or not take the med or lie that you have meds........talk to a lawyer

[Reclusive1]

I have Agoraphobia with Panic Disorder, Anxiety Disorder and Schizoaffective Disorder. I have intermittent FMLA and had to call off today using my FMLA due to depression and anxiety...when I called off my DON said "Well, we really could have used you today" I can take an Ativan and go in...but I am afraid that it will make me feel loopy...I usually take it at night but if I had to go in I would have to take one...btw..I am a CNA...would it be safe for me to work under the influence of Ativan?

[WereBadger]

You need to talk to your prescriber about how your medications affect you. Some employers do have specific rules about classes of medications which may not be taken immediately preceding or while on shift, but I can understand the murky waters of not wanting to disclose medical conditions to your supervisor. Does your workplace have a confidential HR line that you could call about this to confirm policy, once you've spoken to your prescriber?

[emtpbill, ASN, RN, EMT-P]

I have Agoraphobia with Panic Disorder, Anxiety Disorder and Schizoaffective Disorder. I have intermittent FMLA and had to call off today using my FMLA due to depression and anxiety...when I called off my DON said "Well, we really could have used you today" I can take an Ativan and go in...but I am afraid that it will make me feel loopy...I usually take it at night but if I had to go in I would have to take one...btw..I am a CNA...would it be safe for me to work under the influence of Ativan?

Would you want someone taking care of you or your loved one who took Ativan and felt loopy?

[NOADLS]

Just because you can doesn't mean that you should.

Even if the drugs are legally prescribed, you become an easy target when someone you work with figures out that you're on drugs. This includes your manager.

If you think about it, taking a benzo whether or not you are in possession of it legally doesn't change the effects of the drug. If you have to ask, you probably shouldn't be taking it. Maybe seek an alternate prescription?