Did I deserve this?

[jaelpn]

Last week the financial/business manager instructed me and a few CNA's ("teamleaders") that with any employee incidents, they have to be urine drug screened before they can go see the doctor for workman's comp.

I work in an assisted living (I am an LPN) - So I think something qualifying as an incident (a slip and fall, trip down the stairs, resident breaking your wrist...) would justify a visit to the Dr.

So while I was doing my rounds the other day, a CNA came up to me and said, "so and so bit me on the breast, she didn't draw blood or break skin, I'll call and let her know. She never called but filled out an incident sheet and placed it in this person's mailbox. She didn't go to the doctor and was fine.

We work in the dementia/memory unit and so you expect the pinching, biting, scratching, hitting, etc as you would with any scared, dementia related resident.

So, I get called down to the office the other day and this financial/business manager handed me a sheet and said she was writing me up for not calling her and doing a urine drug screen on this employee.

Do you think I was in the wrong for not doing a drug screen on this employee? Are LPNs really responsible to perform drug screens on employees? This is the kind that you are to sit right outside the door, allow them to not wash their hands until you have the cup in your hand, etc (I think it's called chain in command?)

I have never been written up before and I was literally tearing up before I even was able to walk down the hall to my office. You work so hard to do the best that you can for the residents and then you feel like all that hard work is worth nothing when someone tries to bring you down.

[montecarlo64, ASN, BSN, LPN]

If there is a policy for drug screen with all incidents, there should also be a policy that the drug screen is provided by a trained nurse. Yes, there does need to be a special bathroom with no water, chain of command documentation, etc...Sounds like the facility needs to educate, inservice, and train the staff regarding this procedure instead of using intimidation by giving you a write up!

[norlns24]

Is there a way to appeal the write up? I would try to appeal it if at all possible. This whole situation is pretty goofy. At a company I used to work for (not health care related), write-ups became SO common. I knew of several co-workers who got written up for something stupid and petty like what you have described, and then got on the supervisors' radar and ended up getting fired over other equally stupid things that also were documented. I personally know of two co-workers who were fired for not responding to Fed Ex letters sent to their house while they were on legitimate sick leave. Yes, some people totally deserve to be fired, but other times, especially when companies are in cost-cutting mode, firings do occur for the wrong, unjustified reason. I am not trying to scare you, OP, but honestly, that whole system sounds jacked. As others have pointed out, administering a drug test sounds like a managerial duty, not an employee-to-employee duty. Has your work place changed management or has the parent company been bought out recently? This really sort of sounds like a sub-plot from "Nurse Jackie."

If you are not able to appeal this write-up, at the very least, see if you can review your file to verify how the exact wording of the entry regarding this write-up has been crafted. I am not certain how big the facility/ company you work for is, but if it is large, and someone else ends up managing you that is not aware of the details of the original situation, how the entry is worded in your file could be important. For instance, the entry might be more of a generic code versus an actual run-down of events. I'm not suggesting you become a firebrand, but you might ask if you are able to add a personal statement to be included in your file defending yourself. A well-written, very neutral and factual account of what occurred could mitigate the write-up.

Finally, at the very least, I would sit down with the manager and very openly and honestly express your concerns about this write-up, and how upset you are over it. They may view it as a clerical item, and you a number, and assume it's no big deal to you. Letting them know how upset you are and that you really take pride in your work, and care very much about your work history and your job, might give them a much better sense of you as an employee, and the level of commitment you bring to your career.

[merlee]

Explain to your employer that if they want a urine drug screen, then the employee in question needs to go to a facility that does these things. So in a situation when an employee is hurt on the job, they must leave your place and travel to the appropriate place.

Urine drug screens are collected in a special bathroom, and the chain of command is started there.

Doing it at your own facility places too much burden on coworkers.

If that is what your facility wants, there needs to be a policy and a procedure for what is expected.

Best wishes.

[jadelpn, LPN, EMT-B]

Why is HR not the one who is initiating this policy? Why would the financial person have one thing to do with declaring that people need a drug screen when getting hurt at work? Seems like it goes way beyond scope. I agree that a written policy needs to be put into place, as if it is commonplace for bites and scratches, then potentially people could have the need to be drug screened daily. I too would bring it up to your DON, as currently, unless the policy is clearly in writing, and you signed off that you understand said policy, then you should not be held accountable for this gray area....what does a resident biting a CNA have a thing to do with the CNA potentially being on drugs? IF it were a slip and fall or something of that nature, perhaps, however, the CNA's need to have a policy that they sign upon understanding that whenever they get bit, scratched and the like that all incidents of that nature need to be reported, and that all incidents reported will result in a tox screen. And a positive tox screen means what? They lose their job? They can't collect if they do? Which is putting you at a huge liability to have to then carry out. There are specific labs that do these sort of things, and you are certainly not going to leave the floor to hang in the bathroom while the CNA gives a clean and un-tampered with sample. However, when the CNA's are lined up at an expensive lab for tox screens on a practical daily basis, then perhaps the financial person will take pause. When the first CNA comes up positive and loses her job, then gets an attorney for wrongful termination, they will bring into the picture that the LPN on just handed said CNA a cup, and it was tampered with, and it is not their urine......I can see this being a huge issue. If this policy is put into place, the person needs to leave work, go to the lab the soonest they can, take the screen, then wait for the results before returning to work? They might as well just put a policy into place that requires random drug screens, as seemingly, this is the goal of the "get hurt, take a test" mentaility.

[cbsncmom]

"How many people are going to want to NOT report an incident because they may test positive? "

Makes me wonder if this is their way of keeping worker comp claims down. Might be worth a call to the state labor board for clarification. The rules are pretty straight forward about reporting any and all injuries.......

I have a management background. Every management job I have had required an employee to have a drug screen administered if they got hurt on the job. It is the companies way of keeping worker comp claims down. You were absolutely right. However, we NEVER administered the drug screen. We sent them with a "chain of custody" letter to the hospital lab to have done. I think it is terrible that they are making employee do this.

[JZ_RN]

The employee didn't get worker's comp, or go to the doctor, nor was blood drawn so it's not an infection risk (just gross) so no, I wouldn't do a drug screen. The employee didn't do anything to warrant a drug screen and you don't deserve to be written up.

[butterfliesrus]

if there is no policy regarding this requirement then you should not have the responsibility. Frankly, I do not think any co-worker should have that responsibility because there could be legal ramifications, chain of custody of the specimen and other issues.

Pretty sure that if you are "trained" to be the urine-collecting nurse who is in charge of deciding whether or not the co-worker is going to get compensation for an incident, then you are liable for not doing the collection, whether or not they sought medical attention. Policies like that are decided by the facility; its not state-mandated or federal. Basically, you were cheated for incomplete or inaccurate "training" and you should talk to the administration regarding further "training" in regards to how that policy works. It's super vague and really shouldn't be a policy. I agree that you shouldn't have that responsibility at all since you are a co-worker. Unless you are getting paid for that responsibility, you shouldn't be in charge of it. Can you revoke that responsibility? I would.

Sorry that happened to you, but legally if you went through the training or signed something saying you would collect urine specimens from your co-workers if they had an incidient, then you are liable whether or not they sought medical treatment. Reason why is that whether or not she sought treatment isn't justification for not doing the urine test. She could have decided not to get medical treatment so she woulnd't fail the urine-test required for worker's comp. Protect yourself, is my advice.

[xoemmylouox, ASN, RN]

So then, it's everyone's responsibility to drug test everyone else?

A patient bit me and I mention it to a colleague, and it's fine if I'm subjected to a drug, even if I take no further action? That is pretty weird. Is the assumption that it's pretty likely that if a person gets hurt on the job, it's probably because he's high? It sounds like a good way for employers to not need to worry about unsafe working conditions.

Maybe people should be forced to submit to a drug test when checking out at the grocery store. After all, the quality of the food they buy has serious health implications for them and their family.

Don't worry about the false positive from that poppy seed bagel you just ate. It will be sorted out after you're fired for cause.

You misunderstood me.. I don't think everyone should be tested.. NEVER said that.. so stop over reacting. My issue was when the OP posted that "How many people are going to want to NOT report an incident because they may test positive?".. My actual point still stands.. If someone gets hurt at work, gets drug tested, and fails.. That is THEIR issue.. The least of my concern. My concern is that this person who was under the influence could be working under MY license.. That is a problem.

[Wet Noodle]

It's absurd to test for drugs rather than addiction. A person who comes to work after having had four hours of sleep over the past three days is likely not in any better condition than someone who's had a few shots of tequila or a couple of bong hits, and is probably in worse shape that a chronic (but moderate) opiate abuser. That is what research shows.

I'll bet a lot more accidents are caused by exhaustion of health providers than by stoned health providers.

We obsess over the easy answers. It's like searching for your lost keys under the street light.

Is the point of giving a drug test to a worker after he's bitten by a patient to ensure that patients aren't tempted to bite healthcare workers and draw blood as a means of getting high? What exactly is the point?

And then of course there is the issue of how the testing is handled at the OP's facility.

The medical error reporting system is confidential. The reason why should by obvious.

[dudette10, MSN, RN]

I have a management background. Every management job I have had required an employee to have a drug screen administered if they got hurt on the job. It is the companies way of keeping worker comp claims down. You were absolutely right. However, we NEVER administered the drug screen. We sent them with a "chain of custody" letter to the hospital lab to have done. I think it is terrible that they are making employee do this.

Agree about sending them out for a drug screen to a facility that does this on a regular basis, usually as pre-employment screens.

I can just see when someone comes up positive, the person claims that the untrained co-worker nurse didn't do the screen correctly, and that nurse is the one who is then in trouble.

It's possible that the facility which has a co-worker do it is trying to save even more money by not contracting with a lab to do it nor having to cover the employee that has to leave for the screen. It's all about money.