Can any RNs tell me if this is true

[geminiskittels]

I am currently a nurse aide at a nursing home waiting to attend nursing school. The other night the RN supervisor made me go home because I am takeing vicodin (prescribed by my doctor) for my back. She said her license could be pulled because she is letting me work on a narcotic. Is this really true, also are RNs allowed to work on narcotics?? Because I know she has taking pain meds before at work. Thanks

[CrunchRN, ADN, RN]

Thanks trauma for bringing that up - there are many nurses with chronic pain issues who are on narcotics and function just fine. Think of all the nurses with back issues, fibromyalgia etc... they have to make a living still and on the proper dosage they are able to function. I would think the same would hold true for any care provider.

Now, if this is a new medication and you are not used to it then you probably cannot provide safe care right away and should not work during that time.

[ZASHAGALKA, RN]

Comments censured (edited out) by poster.

~faith,

Timothy.

[Nurse Ratched, RN]

What you're getting here are people's opinions, nothing else. All that matters is what your state board says. The dept of health (probably the division of long term care) typically oversees CNA's. Whomever your governing board in your states is can tell you under what circumstances you may work and what is considered "impaired." If you are following the requirements of your governing body, I as a nurse would have no fear that I was endangering my license by having you work with me.

When you get something in writing that clarifies this (your version of a practice act) keep it in your locker to give your charge nurse the next time she brings it up. Or give it to her supervisor sooner if you feel she is not open to this.

Your medical conditions and treatments none of your charge nurse's business if your administrator/employee health person is aware of your situation and has approved you to work. I wouldn't go out of my way to reveal personal medical info to coworkers.

[ZASHAGALKA, RN]

Let me back off here.

There are 2 issues here.

1. chronic pain managment - If your board says that's OK, fine. But if you are wearing a duragesic patch, it's probably not in your best interest to advertise, as I'm sure you well know.

I personally wouldn't characterize vicodin (the original drug in question) as a chronic pain management tool just because the high level of tylenol limits its use.

I wasn't originally trying to step on the toes of chonic pain management.

2. The original comment was about if an RN could determine to send a CNA taking vicodin home because the RN felt that it could risk the RN's license. The CNA is functioning under the License of the RN, and in my opinion, the RN has EVERY right, if not obligation, to make that determination.

I wasn't per se, speaking to anybody working under their own license. As was said, that's between you and your board.

~faith,

Timothy.

[rjflyn, ASN, RN]

This argument doesnt fly because laws have been made that state one is impaired at a certain point so one cant compare apples to oranges. How may people out there take antihitamines for example, all most all of them caution against mental impairment but I know lots of people who work, drive and do other things while taking this=- so the same should hold true for narcotic meds. The key is one needs to check with their states board for guidance.

Under this argument, an alcoholic that blows over the 'legal' limit might indeed be not only unimpaired, but would be impaired if sober and withdrawing. But this isn't what the discussion was about and I am not making a direct comparison.

Timothy.

rj

[ZASHAGALKA, RN]

This argument doesnt fly because laws have been made that state one is impaired at a certain point so one cant compare apples to oranges. How may people out there take antihitamines for example, all most all of them caution against mental impairment but I know lots of people who work, drive and do other things while taking this=- so the same should hold true for narcotic meds. The key is one needs to check with their states board for guidance. rj

But you included in the requotation of my comment that I acknowledged that this 1 comment, in a post that included several, wasn't directly on point and wasn't a direct comparison.

A better point that I made within the same post was: do you think that it's acceptable for your pilot to take vicodin mid-flight? would you want to be on that plane?

~faith,

Timothy.

[CrunchRN, ADN, RN]

Timothy,

I respect your point, but many, many people take narcotics including some using Vicodin for chronic pain. They become over time able to function normally.

Others, who are taking it short term have not made this accomadation and should not "fly the plane".

Please understand the huge differences between abilities between these 2 groups.

I do agree the RN had the right to send the CNA home as this was short term use and obviously the RN felt that safe care was compromised.

Let's hear from nurses who have chronic pain issues. I do not have any, but have worked with many fine nurses who have. Most of them were acquired on the job!

[ZASHAGALKA, RN]

I want to reiterate here that the OP was asking about taking vicodin and then working under RNs license as a CNA.

the original question was whether the RN was BS'ing the CNA by claiming that s/he (the RN) could lose their license if the CNA acted inappropriately/ ineffectually while taking the vicodin.

This is a completely different concept than whether a licensed nurse can assume that risk with their own license. And it is a risk. If at any time anybody you work with sees or hears about you taking a narc, and/or feels you ARE acting under the influence, then you can be reported to the Board.

What action the board takes is between you and the board, and that is a risk that you should only assume knowing full well what your board's response will be if you have to defend yourself.

But again, this isn't what the OP was about. The OP was about taking vicodin and working under somebody else's license. As an RN, I have the right not to delegate work to ANYBODY, in my sole judgement. Why? Because any time I delegate, I assume the risks involved.

~faith,

Timothy.

[geminiskittels]

yes, she can.

The RN is responsible for everything you do.

It's called delegation. If any task is delegated to you, the nurse is ultimately responsible.

And if the nurse knows that you are 'under the influence' of a narcotic and that, as a result, your judgement is impaired, if you make a mistake, (s)he is responsible both directly for the mistake you made, but more importantly, indirectly because she delegated a task to someone she knew to be impaired.

You, as an aide, work completely under the authority of the RN. The RN, in turn, is responible for the work you do.

If I knew you were under the influence, I'd send you home (and probably terminate you). If I knew another nurse was under the influence, I'd report it (and see to it that they were terminated). That may sound cruel, but it is the law. The Nurse Practice Act in my state and most states makes it very clear that working impaired or allowing someone to work impaired is cause for revokation of license.

Sorry,

~faith,

Timothy.

Thank you for the response but I feel like you are all making me out as a drug addict or something. My god I take 500 mgs of vicodin every 6 hrs or as needed I have tried everything else to ease the pain from other meds to physical therapy. I don't even take it all the time only IF my back hurts it. I don't take it if I don't need it and the vicodin is prescibed by my family doctor. I even asked him if I could work on it and he said as long as it dosen't make me drowsy or impair my judgement. Which it dosen't even effect me but it does take my pain away. Please don't think I am trying to lash out or start with anyone I just want you all to be clear that I am not a drug addict.

Thanks

[ZASHAGALKA, RN]

I demur to my previous position. I'll give the general topic more thought.

Looking at my NPA, it does clearly state that the litmus test isn't taking a med, but 'being impaired'

One of the definitions of critical thinking is to be able to take a position and defend it, yet being open to new positions.

I'll open myself to a new opinion as my defense of my old opinion is clearly lacking in many key respects.

~faith,

Timothy.y

[CrunchRN, ADN, RN]

Wow - Timothy - you are awesome. Very impressive for a male from the "Republic of Texas"!

[Judee Smudee, ADN, RN]

Lets face it folks, we all work with people who have medical conditions and are taking meds that may or may not impair their preformance. In most cases they just keep mum about it. This person is not saying how managment discovered this. Was there a drug screen? If there is then you would be forced to reveal you are taking a perscription medication. Other than that I would not mention it.