Drug testing a RN while a patient in the er

gonzo1, ASN, RN · Mar 28, 2012

All I can say is wow. I don't know how you kept your cool. I would have been really ****** off. I am clueless as to whether this is legal or justified. Sounds like harrassment to me.

Esme12, ASN, BSN, RN · Mar 28, 2012

Yes they can test you. First you had an incident at work....making it a possible workmans comp. Depending on your policies an at work incidents require drug testing. You also asked to speak to a psychiatrist and that in any ED I have worked, that gets you a drug screen as a part of the medical screening exam. You admitted to taking a substance that should show up in the urine and it didn't........nothing personal to you, remember the ED deals with the general public and some chronic drug abusers who will do anything to not be outed. It is the standard then, in my experience, to have a witnessed UDA (urine for drugs of abuse) so they know best how to treat you or the possible precipitating cause.

I hope you are feeling better.....:hug:

Altra, BSN, RN · Mar 28, 2012

I agree with Esme12 - any incident or accident at work (in many industries, not just hospital-based health care) will likely trigger a UDS. And a UDS, breathalyzer or serum ETOH, and often some basic labs (CBC & BMP) are standard when seeking emergency psychiatric treatment.

muesli · Mar 28, 2012

Wait - they made you do an employer drug screen? The only way I could see this being legal (but I'm not a lawyer) is if because you went to the ED during work and it might be covered under workman's comp? I think you are safe because they came back negative, but it might be worth contacting your employee assistance program. They might be able to hook you up with a lawyer who could advise you on legality. I would recommend looking up a good recent article on Medscape about HIPAA law.

netglow, ASN, RN · Mar 28, 2012

Lesson learned here. Never get your care at your place of work (unless you cut off a limb and are bleeding to death). Suck what ever it is up and go offsite for care. It's like Lord of the Rings, Draw notice to yourself and they gotcha!

lori4367 · Mar 28, 2012

Lol I didn't have a choice. I work in the er and we have no other in network facility (and it was midnight). Looking back, they had me sign in so that they could keep me there to test me. I stupidly thought they cared and wanted me to talk to someone. I had already been a patient for 2 hours when they came in to do a drug test for work. I completely understand why they did it. I just was told by a friend that once I was a patient, I was no longer an employee on the clock. furthermore, HR had my information that I gave during my triage. But that's a different matter completely.

Horseshoe, BSN, RN · Mar 28, 2012

Lol I didn't have a choice. I work in the er and we have no other in network facility (and it was midnight). Looking back, they had me sign in so that they could keep me there to test me. I stupidly thought they cared and wanted me to talk to someone. I had already been a patient for 2 hours when they came in to do a drug test for work. I completely understand why they did it. I just was told by a friend that once I was a patient, I was no longer an employee on the clock. furthermore, HR had my information that I gave during my triage. But that's a different matter completely.

If you had hurt your back at work, clocked out, and went to the ER, you would still be drug screened. They really do have to do this, and yes, worker's comp always plays into this. So this was really no different. I don't know why it took 3 screens, though.

caliotter3 · Mar 28, 2012

I believe they were covered due to the nature of you checking in while at work. I am glad there were no negative repercussions but I would be careful from now on. Remember that this incident will be a matter of memory as long as there are supervising personnel there that know about it. Should you have a crisis type situation in the future, you might want to consider leaving the work place and checking in elsewhere to try to maintain better privacy for your concerns. Speaking from personal experience, it does not make a pleasant workplace atmosphere when others at work know about your medical or other private concerns.

Meriwhen, ASN, BSN, MSN, RN · Mar 28, 2012

AFAIK, what they did with the drug testing was legal, which they could since you did have the precipitating event--the breakdown--at work and it could fall under Workman's Comp. And it's lucky that you cooperated with the drug tests: if you refused the drug tests, most facilities treat that as a dirty (positive) test and you may have been fired...or at least denied the comp.

Also, as far as psychiatric treatment goes, one of the first things on our to-do list is to get drug testing from the patient in order to determine whether the psychiatric problems are due to substance use. So even if you went to an Entirely Different ER for this and no one knew you from a rock on the ground, you'd still be tested.

I agree with everyone though: next crisis, try to find another facility to go to.

Best of luck with dealing with everything.

netglow, ASN, RN · Mar 28, 2012

Ish. You work in the same er. Well, that's even groovier.

rjflyn, ASN, RN · Mar 28, 2012

What the OP describes would be something that would fall under my facilities fitness for duty policy. She describe abnormal behavior that if I as a supervisor would have observed I would have most likely needed a UDS- of with the policy requires to be observed. That said like a prior commenter has noted pts coming to the ED with mental heath complaints get a drug screen, though in my experience these are never collected observed. There reasoning for the negative could be as simple as the med not being take frequently enough to keep a level to be detected- it happens. That said the only drug screens commonly observed are federal ones for truck drivers post accident.