Did Satan vomit on my doorstep??? Since I got canned last month (thank you for your kind support on my behalf for sticking up for patient safety and unfair labor law violations...see "I got Canned!) I have attempted to join an new registry. This has been going on for over a week. After spending 4.5 hours taking wriiten exams and compliance evaluations which could not EQUAL sitting for my boards, I am providing blood, urine, happy factor, access to my personal life and am now informed by an MD that my urine came back positive for benzodiazapine. Cricky balls! If everything I've been thru over the past few weeks doesn't merit a little valium, I don't know what would! I do have a scrip for ativan and did succomb to it's evils a few fort nights ago, provided a copy of the RX to the agency, but the MD is not satisfied. He states that the by product that came back positive was from a sedative like ambien, valium, traxene, etc. NOW, I have an old scrip for ambien on file with my MD but I have not taken any. What would you do ?
Specializes in Critical Care, Emergency, Education, Informatics.
To the best of my knowledge, taking meds that you don't have a script for is illegal. You have to be willing to pay the consequences. Having spent the past 25 years working for Uncle Sam and part of it running a drug testing program, there are a few simple rules.
1. Don't take anythign that isn't yours
2. Don't take anything that " may" in anyway affect your performance.
3. Don't work if you have taken anything. (this assumes you have sick time)
4. Make sure you ahve a copy of the script for anything you are taking.
5. Ask questions. Know what your hospital or agency tests for and how they test it. Finding this stuff out after the test is the wrong time.
6. Be honest. If your honest, and they still want to can you, most states have an impared nurse program, that will help you from the BON. Remember the BON isnt' there to help you, they are there to protect the taxpayers of the state you live in.
7. Don't take anything that you don't have a script for.
8. Make sure that you don't give them a behavior patern that plays into abuse scenarios.
9. Don't take anything you don't have a script for. (get the point?)
10. It's not that Doc's don't get called on the carpet as much as nurses, it's that they are better at voluneterring for corrective action first. i.e. impared provider programs, etc.
As a nurse manager, I've been involved in more provider, with a drug problem than nurses.
Now I"m a a chronic pain patient (jumped out of to many perfectly good airplanes while working for Uncle Sam) I've peed in the bottle at least 6 times and each time I had all my eggs in a basket and didn't have any trouble at all.
The safest bet is to not take anything but of course that is not reality. I have had prn valium that has never showed up in drug test. But maybe because such a small amount, 5 to 10 mg over a 20 day period. Doctors don't get subject to drug testing the way nurses do. Also they are treated differently if they get drunk driving on their record. Nurses may lose their license by the BON if drunk driving on record. Nurses are treated this way because it is traditionally female dominant field so that means less money, prestige, and power. We will be treated this way as long as we put up with it.
Specializes in LTC, ER, ICU, Psych, Med-surg...etc....
At my facility you must have a valid, current prescription for any medications. For example, if you broke your leg three months ago and had a scrip for percocet and didn't use it all and developed back pain or a bad headache or something and took a percocet, then were drug tested because someone spit on your shoe or something, you would be positive and fail the test because you did not take the drug for what it was prescribed for, unless you can get your doc to write another script saying that it was okay to take percocet for whatever it was that ailed you. I can understand some of the rationale behind this, but you as well as I know that a "drug addict" is not going to have a three month old prescription for percocet and still have pills left! Give me a break!
So, again, do not take anything that is not prescribed for your "current ailment".
I had back problems and was given vicodin...that was 6 months ago. I still have vicodin left. I had to ask my doc to write a note okaying me to take it again recently because the pain returned (just old age and overuse muscles)...this was to protect me in case someone spit on my shoe or I was randomly selected. If we are tested and declare that we are on some prescription meds we have to show the bottle and get a copy of the original prescription from the pharmacy where the med was filled.... Makes me very nervous...what have we become?
Specializes in ER, ICU, Nursing Education, LTC, and HHC.
Since lorazepam is a benzo how could they differentiate it in a drug screen? ambien is another class of drug imidzopyridines. I assume all their metabolites come up the same.
As for old prescription use, I have read that it is considered to be inappropriate, if not illegal.Check your board of nursing laws.
It may be inappropriate, but It is not illegal to have extra pills left over from a prescription. Most of these meds are pain meds, sleep meds, etc.. and they are usually not taken in such a manner to use them all up..having leftovers is common. Though it may not be to smart to use them after a year old, (thinking shelf life of the effect) though many people have them around and do use them. I used to do all the drug testing in our facility, (I have since accepted a better job elsewhere) any person who would test positive, is not in violation if they can produce a script or a pill bottle that clearly has their name on it, with no limitations on the date.
If you do not have anything to hide, be up front ... much better than finding on discovery.. if you borrowed a med from someone, then you probably have a problem... you could reveal this, maybe honesty will carry more weight.. either way, no script, big problem.
Specializes in ER, ICU, Nursing Education, LTC, and HHC.
It is protocol some places that ANY on-the-job incident (something that would cause you to have to go to the ER, even if it is spit in the eye) is followed-up by a drug screen.
another post that caught my attention:
In the facility I previously worked, (left to accept a better job elsewhere) I had to do the testing for not only new employees but any and all incident reports filled out.. An incident report was automatic drug screen.. yes it did decrease the number of incident reports completed, but from a management perspective it saved alot on worker's comp.. that is why it is done that way. If a test were positive the employee would not be covered on work comp, and would be fired.
It also made the cost of the qwork comp premiums less money for the building to be "drug free workplace" etc, etc.. as so, policies in place saved then alot of $$$.
Well kids....I appreciate the feedback here and have to say that I do think to some extent a drug screen does violate some aspect of privacy but what occurs to me is that I tested positive for a drug class that I did have a scrip for, not street drugs, pot or alcohol, which I would say would be a cause for concern. In reading through some of your posts and the meds you have been taking it makes me feel lucky that I have remained unscathed as far as back injuries, migraines etc. Hopefully I got out of that butcher shop of a hospital just in time...I am told they have an alarming increase in work related injuries from nurses having to do primary all alone. Will this place ever realize the importance of having our support staff there to provide a positive patient outcome?
I had to do the testing for not only new employees but any and all incident reports filled out.. An incident report was automatic drug screen.. yes it did decrease the number of incident reports completed, but from a management perspective it saved alot on worker's comp.. that is why it is done that way. If a test were positive the employee would not be covered on work comp, and would be fired.
It also made the cost of the qwork comp premiums less money for the building to be "drug free workplace" etc, etc.. as so, policies in place saved then alot of $$$.
You are right. The hospital would want to do this to save $$$. When you say that your old job screened for drugs with incident reports, do you just mean when an employee is injured? I ask because where I work, an incident report includes anything, such as administering the wrong strength of Tylenol. At your old job, do you think there were many employees that suffered injuries and really should have reported them (say, a needle stick for example), but didn't only because the employee was scared something might show up on a drug screen, costing them their job? Or if your incident reports included everything (like ours), do you think that Nurses who made mistakes, don't want to report them, for the same fear? I ask this because whenever a nurse makes a mistake where I work, there is always some sort of inservice to hopefully prevent the same mistake from happening again...but this only works if mistakes are reported.
Specializes in ER, ICU, Nursing Education, LTC, and HHC.
You are right. The hospital would want to do this to save $$$. When you say that your old job screened for drugs with incident reports, do you just mean when an employee is injured? I ask because where I work, an incident report includes anything, such as administering the wrong strength of Tylenol. At your old job, do you think there were many employees that suffered injuries and really should have reported them (say, a needle stick for example), but didn't only because the employee was scared something might show up on a drug screen, costing them their job? Or if your incident reports included everything (like ours), do you think that Nurses who made mistakes, don't want to report them, for the same fear? I ask this because whenever a nurse makes a mistake where I work, there is always some sort of inservice to hopefully prevent the same mistake from happening again...but this only works if mistakes are reported.
Yes just on the job injuries not patient related incident reports.
and yes, I am sure some did not fill them out for fear of a positive drug screen. I say that just knowing the crowd at large and who they hang out with, etc. Cannot say that anything major was avoided in an incident report such as a needle stick, or anything real significant like that.
and yes again, always inservices upon inservices for all potential problems and incidents.
This whole thing is just so strange to me - we don't have routine drug testing at all.
It may be inappropriate, but It is not illegal to have extra pills left over from a prescription. Most of these meds are pain meds, sleep meds, etc.. and they are usually not taken in such a manner to use them all up..having leftovers is common. Though it may not be to smart to use them after a year old, (thinking shelf life of the effect) though many people have them around and do use them.
I was wondering about this. I get migraines, somewhere between two and five times a year (no clear trigger) - I take Panadeine Forte, Cafergot, metochlopramide, prochlorperazine, and put myself to bed for a day or so. Twenty Panadeine Forte to the packet - I used to get a new script when the packet expired (never made it through a whole box within the expiration date), until I read an article on medscape:http://www.medscape.com/viewarticle/460159?src=search
The US Army tested their expired medications for efficacy, and discovered that time does little to affect the potency of the medications they tested - 90% of the meds they tested were good 15 years after the posted expiration date.
The article cautions that for drugs where dosage is vital, taking meds well past their expiration isn't advisable, and that there are time sensitive meds (like insulin, glycerine trinitrate, and liquid antibiotics) that should be discarded after they expire.
but I no longer worry about replacing my antimigrainoids every five minutes!
Lortab is very much like Vicodin: hydrocodone. If you have a prescription and are taking the medication for a legitimate reason there should not be a problem. Borrowing someone else's meds is a problem.
At what point does a Rx for a PRN type drug as Ambien become too old for it to be taken appropriately/legally?
No kidding! My husband, a police officer who works rotating shifts, has an rx for restoril prn that he only uses when he's working graveyard shift. Depending on how much of a problem he's having & how often he has to do graveyard, he can make one rx of #30 last a year.
CraigB-RN, MSN, RN
1,224 Posts
To the best of my knowledge, taking meds that you don't have a script for is illegal. You have to be willing to pay the consequences. Having spent the past 25 years working for Uncle Sam and part of it running a drug testing program, there are a few simple rules.
1. Don't take anythign that isn't yours
2. Don't take anything that " may" in anyway affect your performance.
3. Don't work if you have taken anything. (this assumes you have sick time)
4. Make sure you ahve a copy of the script for anything you are taking.
5. Ask questions. Know what your hospital or agency tests for and how they test it. Finding this stuff out after the test is the wrong time.
6. Be honest. If your honest, and they still want to can you, most states have an impared nurse program, that will help you from the BON. Remember the BON isnt' there to help you, they are there to protect the taxpayers of the state you live in.
7. Don't take anything that you don't have a script for.
8. Make sure that you don't give them a behavior patern that plays into abuse scenarios.
9. Don't take anything you don't have a script for. (get the point?)
10. It's not that Doc's don't get called on the carpet as much as nurses, it's that they are better at voluneterring for corrective action first. i.e. impared provider programs, etc.
As a nurse manager, I've been involved in more provider, with a drug problem than nurses.
Now I"m a a chronic pain patient (jumped out of to many perfectly good airplanes while working for Uncle Sam) I've peed in the bottle at least 6 times and each time I had all my eggs in a basket and didn't have any trouble at all.