what happens after a positive drug screen is reported?

KelRN215, BSN, RN · Nov 14, 2012

Why do you know the results of another prospective employee's drug screen? Perhaps this person is prescribed Adderall and nothing with happen.

benlop · Nov 14, 2012

I just heard it because the doors were open. And I am not saying this other person isn't prescribed the med or that they were doing something wrong. It just made me wonder what would happen to a nurse who was using a med not prescribed to them and it was reported. I wasn't trying to bash anyone this is just something we were never taught and after hearing this it made me wonder what all would happen. Please don't take my post the wrong way.

Meriwhen, ASN, BSN, MSN, RN · Nov 14, 2012

In the case of a positive drug screen, exactly what is done depends on company policy.

If the person already disclosed what medications they are on before the test, then it'll probably be an expected positive, nothing will happen, and life goes on.

If the person hasn't disclosed the meds, they may ask that the person list all medications--OTC, herbal and prescription--taken recently, as well as have them provide valid prescription(s) as necessary. If the test checks out, nothing will happen and life goes on, or they may ask for a retest. And for the record, while having a prescription usually protects you in case of a positive test, it's not bulletproof protection.

If the patient can't provide a valid script for something they tested positive for, then what happens next is based on company policy. They could be fired, suspended, ordered into counseling, reported to the BON, have their job offer rescinded, etc.

They may retest if they suspect something was wrong with the test.

They may do a qual test to determine if it's really amphetamines or if it's another drug that is causing a false positive, such as asthma medications (which can trigger a false positive for amphetamines)

Or they may tell the applicant "so long" and not even give them a chance to explain.

Hope this helps.

benlop · Nov 14, 2012

Yes this does thank you :) does anyone know what the BON would do to the nurse if it is reported to them?

Meriwhen, ASN, BSN, MSN, RN · Nov 14, 2012

Yes this does thank you :) does anyone know what the BON would do to the nurse if it is reported to them?

You would need to ask your local BON for the most accurate answer.

benlop · Nov 14, 2012

Thank you :)

wish_me_luck, BSN, RN · Nov 14, 2012

This post rubbed me the wrong way. Quite frankly, I don't know why people are interested in what would happen to another person. It's not you (at least that's the way you present it), so don't worry about it. I read a lot of "my friend" or "another person"...if it's not you, then you have no dog in the race. I, personally, am very open about my situation, but there are many people who are private. Your curiousity is not a valid reason for someone sharing what would happen to someone else. Just my thoughts.

BONs usually take things on a case by case basis. Therefore, there is no cut and dry response. Not even for people in the same state.

PS If you really want to know something, go to "Nurses recovery"

T-Bird78 · Nov 14, 2012

Seems like a HIPAA violation for discussing positive results with the door open where other pts could hear. Anyway, the other replies pretty much summed it up; if the repeat is positive they'll verify prescription drugs and if it's not a script then it's up to the BON how to proceed.

BostonTerrierLover, BSN, RN · Nov 14, 2012

I got this one!

You are looking at a 5 year recovered nurse who was dumb enough during the peak of my addiction, to walk right in and pee a positive screen for opioids!

Like Meriwhen said, usually a prescription (like I had) would have sufficed. But, because I didn't disclose that before testing- I bombed it, and received just enough confirmation that I was in a problem bigger than me, devastated because I realized I was not just an addict- but a full blown "functional" Junkie, and embarrassed beyond what you (if it wasn't your screen) will ever understand.

They didn't call the board, though I now wish they had- I would have been immediately and "compassionately" referred to treatment, but, if there's a harder way to do something, I can usually find it.

I tried 3 days of withdrawals before going to to the ER in desperation, where I was treated like a piece of dirt, (tried to give me Ativan, which I refused- didn't need a Benzo addiction!) The MD actually said I was wasting his time- this wasn't a rehab! "What do you want me to do, write you some Hydrocodone or Dilaudid until you can get a bed?" Really? I had plenty of dope. "No, I thought people could detox in hospitals without the horrible withdrawals." "If it's been three days, you ought to feel better soon, you want something for your nerves, . . .I mean, that's all I can do for ya!" "Ok, just discharge me, I should have stayed at home." "I agree!" I must say that he came to my 3rd Year Sobriety Reception and thoroughly apologized- I later found out he was struggling with Rx addiction at that time, he's now an addictionologist, and runs a Suboxone Detox Program.

So, hopeless, and feeling like I had super-influenza- and sure I would probably end-it-all that night, I went in to my State Board of Nursing that next day sweaty, shaky, and exhausted. I was expecting to tell them I was an Opioid Addict, tell them what happened, and give them my license. I was expecting them to berate me, humiliate me further(if possible), and tell me my nursing career was over because of my poor choices and sickening lifestyle- I remember thinking (I was only 23-4 years into Nursing), They might have me arrested for the possibility I diverted (I never did thank God!) I was an ER coordinator without Pyxis Access in prior job. I was way wrong.

I walked in to see a sweet young African American Girl at a reception desk who said "Baby, are you lost?" I told her no ma'am, I need to speak with a Board of Nursing Rep- "I have a personal emergency."

She lit up with a glow-"Are you here with a chemical dependency problem baby?" I felt my heart slow down, I thought I was dreaming. "Your in the right place, You want a little help?" "Yes ma'am, but I came to report myself." "Let's get you to Ms. Xxxxxx.

They preceded to save my life, my dreams, and my career. But, even if they'd tore up my license and danced around them while they burned, I would still only be here because of them! They found me a bed at a Detox Center, a Rehab bed following that for a 90 day stay, and they introduced me to the Recovery Nurse Program. I never thought before that I would consider employees of my State Board "My Angels!"

Now fast forward 6 years later and I am an NP who consults regularly with the same nurses at the Board, along with 3 counselors, and 3 MDs/2 DOs to help others entering those doors petrified with fear, and feeling miserable, hopeless, and bracing for the same thing I was. I am still in shock of the way they treated me like their brother had walked in and said he was "in trouble."

I think Nurses are Awesome, and from the one there when I was born, to the Board Nurses that saved my life, I am in great debt to some awesome substance abuse Nurses! That's pretty much what happened to me. The test saved my life and BSN- maybe/hopefully (if the persons is abusing them), you witnessed a huge "turn-around" in their life.

wish_me_luck, BSN, RN · Nov 14, 2012

Beautiful, Boston.

I am sorry to have been short earlier, but sometimes, I do feel like I am in the this clear case/cage in front of everyone and they just come and want to gawk or in that bad wreck that everyone wants to look at. They can't help nor do they have any issue of their own, but they just want to know. I went through a lot of emotional pain and self medicated with alcohol, then starting having issues with it. I decided to be open about it to help others, esp other nurses, going through a similar situation (it is scary not knowing what to expect). Not to be an informative for curious people.

I have to second Boston's opinion. I did self report via being honest on my application to the BON. I am 3 months into HPMP. I did go through irritability with having to do HPMP, but I realized, especially now, that they may have saved me from self destruction.

I feel like I am this dog that can't leave well enough alone and the alcohol is a bird or cat that I so badly want to chase after, but I can't because of the BON/HPMP keeping me on this short leash. Eventually, I'll get to the point of not needing the leash (after my 5 year contract.) With my appts and meetings, self control is learned somewhere during this. That's about 3-6 months in, when they give you a little more leash and let you go find employment. But, they are still there after the contract-- that if you step out of line (or chase after that cat or bird) back on contract (the leash) you go. If you do it over and over, then you become too unsafe for the public, and it's game over. To the pound and euthanized (meaning, your license is revoked).

That's the best way I can put it.

But, Boston, that is a beautiful story!! Kudos to you for realizing you had a problem. :up:

kakamegamama · Nov 14, 2012

BostonTerrierLoverRN--thank you so much for sharing your story. Congratulations on your years of sobriety! May you have many, many more. You give hope to others, and that's what nursing is (or should be) all about. Blessings!