What would you suggest?

Charles S. Smith, RN, MS · Jul 7, 2001

Originally posted by BrandyBSN
What would you suggest for the following problem?:

While sitting in her student orientation, a friend of mine was told by two of her fellow new nursing students that they are regular marijuana smokers. She fears that this may cause them to "not be on top of their game", and possibly lead to patient harm. She is also concerned about having one of them assigned to her as a lab patient. her school does not require drug testing for students, and she really doesnt know what her best move would be. I am not sure what to tell her, as she is in a different program from me. Any input would be greatly appreciated!

Thanks!
Brandy

Unless I am very out of touch here, marijuana is still quite illegal here in the states. It does not matter how much or how frequently the person uses an illegal drug. The question is what is the ethical thing to do here? Is it ethical for the student to know something that could jeopardize patient safety and health and not report it?

It only takes one drug screen for employment to ruin a whole career in nursing that is just getting off the ground. I question the values of the individuals who think that illegal action constitutes the moral fiber upon which nursing should be grounded.

regards

chas

-jt · Jul 7, 2001

she has NO facts. All she has is what someone said & they could have been trying to impress or joke or whatever. Just because "Mary" SAID she uses drugs doesnt mean she actually does & she can deny it later. So it doesnt matter what "Mary" said. What if she was putting on an act as a joke, really doesnt do drugs & the student gets the whole school administration after her for doing drugs - based on a comment she passed & no actual proof? Could "Mary" sue the student & the school for defammation?

The student cant accuse - especially not based on just what was said. She shouldnt run to the instructor with "Mary told me she does drugs!!" All the student can report are her observations & concerns. She can take the instructor aside & say she is worried about this individual & has concerns over having her as a lab partner because of behaviour that she has witnessed & then describe - She can then tell the instructor there was mention made of marijuana use but she doesnt know if this is a fact or was said in jest. However she is concerned because of the changes she sees in the person's behaviour & would prefer another lab partner. This way she isnt accusing, she is expressing her concern & explaining her reason for asking for a different assignment...... which hopefully will get assistance for the other student.

She can tell of her concers & what she sees & let the instructors take it from there.

Rita Marie · Jul 7, 2001

I'd turn those rusty butt students in, in a New York minute.

Just because they don't get "caught," their indulging in smoking dope is still illegal. People who believe that things are ok as long as they don't get caught are not the type that we need in nursing. Where are these students morals?

What will be next? Swiping pain meds from patients?

Oh, please. "If they aren't doing it regularly"--that is a load. Some of the posts have been less than appropriate and sound more like they are in the defense of these two.

How about--would you want them working on the peds unit your baby is admitted to? There aren't any clinicals going on when they are at work--does that mean we shouldn't care that they smoked several hours before work?

We are to be advocates for the patients, we are to see that they are as safe while on our watch. Do you really want the pilot of the plane you are on to be using? Well, I don't want my nurses to be using either.

Well, I guess better close off. I think that I made my point. And I know I am echoing what several have already said.

Good luck to your friend. :rolleyes:

CEN35 · Jul 7, 2001

bottom line....it's not legal............ anybody can use all the rationale they want......like, the instructor has to be present for any procedures.........blah blah blah. if it were me? i would say listen......i know what you told me.....your my lab partner......if you want to get through this quit now. then i would tell them.....if i even think your judgement or senses are impaired because of that, i will turn you in immediately. just my thoughts and opinion...........like it.....or not. love the usa! me

actually......upon further thinking...........let them know also.....if they get busted, before, during or after nursing school......they could very well be done! what a way to waste your money.....then to go to school for a few years...........and pay out for tuition, books and so on......then not get anything out of it! lmao!

RNed · Jul 7, 2001

Do nothing !! If we acted on everything overheard, we would spend 100% of our time in other peoples lives. What you have overheard is not fact.

My last patient said, "he was going to kick my butt". A nurse suggested a medication error would solve the problem. "My wife is going to kill me when I get home." We say and do many things without thinking. Legally, I should turn each in.

Were you listening at the beginning of the conversation. Has elements of the conversation been misinterpeted? Without hard defined facts, I believe action could end up being the so called, "Can of Worms".

If in fact, drug use, alcohol use, etc. inhibits the ability to function, those who do it will pay the price. I am not saying not to followup on behaviors and issues which can be documented and observed by others. Absolutely impaired nurses and students need to be removed. What I am saying is that what has been shared does not constitute you making a case in the defense of nursing.

You are going to hear absolutely everything during your career as a nurse and you will see things never presented in nursing books and see things done absolutely outside medical and nursing practice. You can not protect the world or fight every injustice overheard or seen.

There is a saying, "pick your fights". This is not one of them. If you turn them in don't say, " they are using drugs! You don't know that ! What you know is they made these statements. That is all you know !

You will label them and you will label yourself. Confidentially, does not exist here. I absolutely do not believe confidentially will be maintained. All these things need to be put in perspective.

Just my thoughts !

PhantomRN · Jul 7, 2001

finally a voice of reason. i feel the same way, how can you turn someone in without having any facts? people say things all the time just to get 'a rise' out of someone else. maybe they are getting a rise out of you, who knows. you at least need to wait until you see odd behavior from them, before you turn them in. just because someone says they do something does not mean that they really do.

Charles S. Smith, RN, MS · Jul 7, 2001

Originally posted by Charles S. Smith, RN, MS

Unless I am very out of touch here, marijuana is still quite illegal here in the states. It does not matter how much or how frequently the person uses an illegal drug. The question is what is the ethical thing to do here? Is it ethical for the student to know something that could jeopardize patient safety and health and not report it?

It only takes one drug screen for employment to ruin a whole career in nursing that is just getting off the ground. I question the values of the individuals who think that illegal action constitutes the moral fiber upon which nursing should be grounded.

regards
chas

The advice to your friend who is the student in this situation is to be blunt with her fellow students and tell them that what they are doing, if true, is illegal and she wants no part of it. She might also inform them that every board of nursing has specific prohibitions against substance abuse. Your friend has the ethical obligation to speak up to the parties involved and not a third party until warranted.

As an aside, public drunkeness...getting wasted in public...is also an offense that can be sanctioned negatively by any board of nursing in this country. It speaks to moral turpitude and in some states one can lose the privilege to practice nursing.

just an fyi

chas

Sharon · Jul 9, 2001

If you are not going to turn the information over to someone who is trained to investigate, you should remember that many boards do consider not reporting the information to be a violation of the Nurse Practice Act.

I have a brother who just spent five years on a drug interdiction task force in which they not only prosecuted the nurses using but the also the nurses who were aware and did not report it. Most of the nurses, who did not report the information, just lost their license.

If you intend to be the one who determines the validity of the statement and determining what needs to be further investigated and what doesn't. I recommend you check all of your insurance policies (malpractice, license defense and home owners/rental) to see if you are covered.

Ironically, One of my first tasks this morning is to provide counseling services to a large group of staff who were injured in two separate events as a result of another staffer violating the Workplace Violence Policy (also an OSHA violation). The first was not reporting the treats of "I'm going to kick your butt." The second was a threat to kill the wife in which she was killed. Who knows maybe if the treats were reported, as outlined in our policies, there would be no injuries or deaths?