Drug Testing At Hospitals

[crazylilkelly]

Hi, I was just wondering if nurses have to take random drug tests for illegal drugs? Don't worry, I'm not a druggie nursing student I was just wondering. We had to do them all the time in the Navy. Thanks.

[EDRN-2010]

• When I company has a drug testing program, it is often handled by an independant agency (this was my job in my life before nursing)
  
• The company (hospital) when signing up with this agency will provide them with the names of ALL employees (everyone on the payroll list from the CEO, MD, RN, PCA, janitor, kitchen staff, to parking attendant) Going forward the company will fax the outside agency names of every new hire and terminated/retired employee to add or subtract from the random drug screen pool. Most independant agencies will not allow for any employee to be excluded - meaning the owner of the company can't decide he/she doesn't want to be tested.
  
• The company must have a drug policy, and this policy must be signed by all employees. (In this policy, information on when there will be testing, such as preemployement, reasonable suspicion, random, post accident, post treatment, what type of testing will be conducted like 5 panel, ten panel, split specimens, what the time frame is for getting tested when chosen, what the reprocussion is for refusal or late testing, who pays for it, basically all the information on the procedure as well as the companies policy for positive results.
  

- I am simplifying this a bit because it can be more complicated if there are employees of the company that are regulated by the federal govenment for drug testing (CDL drivers, aviation (lifestar pilots), etc) MANY companies decide to have ALL employees follow the more strict regulation but some have 2 seperate policies.

• When an employee is chosen for a random drug screen, the outside agency will fax a form with the employees info on it, HR or whomever will notify the employee and provide them with the form for the lab.
  
• If an employer suspects an employee is under the influence there are specific guidelines for sending the employee for a drug test. This is very important to follow because if the protocol is not followed the employee has just cause to sue even if they end up testing positive.
  
• Similarly, protocol must be followed for postaccident testing, preemployment testing, etc.
  

As far as the actual testing...

• Employee goes for drug screen (often providing a split sample)
  
• Most labs require the strict protocol of a special bathroom, no washing hands in the sink, all the things that employees find demeaning - this protects employees! Everyone is treated the same regardless of race, gender or age.
  
• Testing labs have extensive procedures to confirm positive tests before reporting it to the employer. Most drug testing programs use an independent physician called a Medical Review Officer (MRO) to review all test results. In the case of a positive result, the MRO will normally contact the person to determine if there is a medical explanation for the positive results. For example, eating poppy seeds before a test can result in a false positive for opiates. However, an MRO also knows that poppy seeds cannot cause certain levels of opiates, and certain additional testing can eliminate that. A RX for adderall, whatever.
  
• There can also be tests that are "negative' but show an abnormal result, such as a "low creatine level," which can indicate an applicant attempted to dilute the sample by the excessive drinking of water or some other form of alteration. That is also a result that a MRO would examine.
  
• If the positive test is confirmed, the person has the right to pay for a retesting of the sample they gave at a laboratory of their choice. Urine samples for all positive tests are retained for that purpose. Simply taking a new test is not helpful since the drugs may have left the system. There are certain threshold levels for each drug, often set high enough so that there will not be false positives for herbal supplements etc. - for example THC thresholds will be high enough so that if a person is exposed to marijuanna smoke in the air/second hand, it will not show up as positive.
  
• If a current employee tests positive, then the employer must follow the policies and procedures they have put into place. Some employers will utilize an Employee Assistance Program (EAP), which can arrange for professional assessment and treatment recommendations. All drug-testing results are maintained on a confidential basis separate from an employees' personnel file. Meaning if you have a RX for Ativan, and it is determined that you did not fail the drug test, the lab is not going to tell your employer your private medical information....the people you work with do not get this information! Just like we as medical profesionals maintain patient privacy, the drug testing agency maintains privacy.
  

Not every company out there uses an independant agency, but most do. Many companies include random drug testing because reasonable suspicion testing is subjective. One persons opinion of impaired can vary greatly from anothers. It can also be difficult to prove/justify after the fact and can have severe reprocussions when someone is wrongly accused, and often opens the door to problems. Random testing is a way many companies attempt to keep a drug-free workplace that can objectively be measured and followed through with. As professionals that are exposed to subjective and objective data on a daily basis this is something we should be able to appreciate. Just my

http://www.dol.gov/elaws/asp/drugfree/drugs/screen92.asp

[tewdles, RN]

It is funny to me that this old thread is resurrected!

I am against drug screens for the purpose of employment in nursing. I am against employers looking at my credit report. Neither of these two "tests" actually tell the employer if the victim of the testing is actually a good nurse.

I believe that if the employer suspects that a nurse is diverting, stealing, impaired, or otherwise unsafe in the workplace then by all means test quickly and unannounced. Just like you would for the surgeon or the anesthesiologist or the pilot or bus driver

[crschreib]

id like to see what happens after california, nevada, oregon and washington legalize marijuana. that nursing shortage is going to increase exponentially as my generation enters the workforce, health care being the fastest growing industry for the decade to come, will likely change their drug testing policies. at least within the states that legalize and regulate marijuana. only a matter of time until the whole united states catches on.

[gypsywind]

The Canadian's think much different than the people in the US.

Canadian Human Rights Commission Policy on Alcohol and Drug Testing

Executive Summary (2002).

In the Commission's view, drug testing is generally not acceptable, because it does not

assess the effect of drug use on performance. Available drug tests do not measure

impairment, how much was used or when it was used. They can only accurately

determine past drug exposure. Therefore, a drug test is not a reliable means of

determining whether a person is — or is not — capable of performing the essential

requirements or duties of their position. That said, alcohol testing may be acceptable in

some cases, because a properly administered breathalyser is a minimally intrusive and.

accurate measure of both consumption of alcohol and actual impairment...

Canadian trucking and bus companies wishing to do business in the U.S. may be

required to develop drug- and alcohol-testing programs to comply with U.S. regulations

(See Appendix). Nevertheless, these programs must respect Canadian human rights

law.

Canadian human rights law takes a different approach to the U.S. on the issue drug

testing — not because protecting the rights of those who abuse drugs or alcohol is

considered more important than public safety, but because drug testing has not been

shown to be effective in reducing drug use, work accidents or work performance

problems.

In my opinion it seems that Canada does not buy into the lobbyist from the insurance agencies who are out to make a lot of money drug testing. Also University of Michigan did a research study on drug testing and found similar results. Last I heard, a few years back now, they do not do new hire drug testing or random testing either.

For more information about the Canadian Human Rights Commission Policy

on Alcohol and Drug Testing Executive Summary (2002).

http://www.chrc-ccdp.ca/pdf/poldrgalceng.pdf

[lvn-rn]

Its my OPINION ONLY that drug testing is necessary for pre employment, however, what they are testing for is what is up for debate..and of course the long standing argument is about maryjane, weed, ganga, chronic, what ever you want to call it. What a person does on there own personal off time is that persons business. Some people drink, some people smoke, while some people do both. Now lets look at this from a "medical" standpoint..nurses..how many of you can HONESTLY say you treated a pt for marijuana releated illness? Car crash victim cuz they were high on mj? No, maybe crack or heroine or even ALCOHOL, but not weed. Have you ever treated someone with multi system organ failure due to weed smoke? Or how about chirrosis of the liver due to marijuana? Or how about a marijuana induced attack? See where I am going with this..I think of weed just like alcohol but with less consequences. If you are drinking and driving, you get cited and maybe arrested right? Well same thing should apply for weed. If you decide to get off work and go home and have a beer and crash, u know that u have to work the next am so u would NOT get up and have a beer before u go to work. Same thing applies to weed. If someone chooses to go home, take a hit or two before bed and then have to get up for work, I am pretty sure they wont be taking 1-2 hits before they go to work..see where I am going here with this? Just like alcohol has to be used responsibly and in moderation..so does marijuana. I know some execptionally smart nurses who have alcohol problems..and i know some exceptionally smart nurses who dont drink a drop but take a toke every so often..if i had to choose, I would chose the nurse that tokes.

[lvn-rn]

I too take my job seriously...I would never ever come to work under the influence of anything except happiness! But because of something I may have done the night, week, month, etc before be discovered on a urine screen, shouldnt be held against me.

[sunnycalifRN]

In the 11 yrs that I've been working at this hospital (as both RT and RN), I've been drug tested twice!! It's totally random . . . many co-workers have never been tested . . . too bad my luck doesn't apply to the lottery!!

[AsatruRN]

Happy2Beme said:

I don't do any illegal drugs and drink zero alcohol. But I think drug testing is an invasion of privacy and also really stupid, because it doesn't really prove a whole lot.

I would much rather work with nurses who smoke MJ occasionally than alcohol abusers who think it's OK to "party" till they puke, then come in to work with a big hangover.

Talk about impaired:uhoh21:

And how bout those addicted to nicotine that everytime you turn around, (usually when one of their patient's need them), they're gone to smoke a ciggy:angryfire

I wish I could quadruple kudos this one because of the points proven. Especially the part about the cigarettes...and nurses disappearing to leave YOU to handle their crap.

A patient's trust CERTAINLY can be betrayed with legal substances. Sneaking off to get a coffee or a bite to eat and then your patient codes. Is that nurse impaired? He or she is having a craving for a substance which happens to be legal. Having said that there is such a thing as responsible drug use. Especially MJ. Come on - the chemical compounds are fat soluable. Detectable in the body long after the effects have worn off. The only reason it's illegal is because of DuPont. They ran what amounts to propaganda ads in the early 1900s because they saw that hemp was/is a major competitor to their carpet fibers.

Maybe I've got a soft spot because my parents, aunts, uncles - grew up in the 1960s and they're smoked a whole lot of ganja. AND GUESS WHAT THEY ARE RESPONSIBLE PEOPLE. Totally not monsters. People need to actually question what goes on in legislature. I'm not in a position to quote but a few pages back it was mentioned that we don't question our rights being taken away when it doesn't directly apply to us. If we can examine what happened in a certain European country in the 1930s and 1940s NO NAMES we could learn something.

Kind of an extreme example I am aware.

[kaiasunshine]

Hey this is a really old topic but an interesting one! I just googled the laws in Canada regarding drug testing in the workplace, out of curiosity, and came up with this link- http://www.parl.gc.ca/Content/LOP/ResearchPublications/prb0751-e.htm#acanadian

"In 2002, the Canadian Human Rights Commission's 1988 Policy on Alcohol and Drug Testing was revised to reflect recent jurisprudence.

The policy now states that the following types of testing are not acceptable: (1) pre-employment drug or alcohol testing, (2) random drug testing, and (3) random alcohol testing of employees who are in safety-sensitive positions.

When an employer can demonstrate the existence of BFOR, the following types of testing may be included in a workplace drug and alcohol testing program: (1) random alcohol testing of employees in safety-sensitive positions; (2) drug or alcohol testing for reasonable cause or after an accident; (3) periodic or random testing after disclosure of a current drug or alcohol dependency or abuse problem, if such testing is tailored to individual circumstances and forms part of a broader program of monitoring and support; and (4) mandatory disclosure of present or past drug or alcohol dependency or abuse for employees holding safety-sensitive positions, within certain limits and in concert with accommodation measures."

[mandy7702]

I was just wondering if your drug tested and have a prescription but it is 4 months old I forgot to have my doctor renew it maybe they are good for 6 months I don't know can someone help me Thanks