Home Health LPN and no drug test???

Lacie, BSN, RN · Aug 17, 2009

It's not just home health. When I first applied to the chronic dialysis clinic I just resigned from (KRU) I couldnt beleive they didnt ask for a drug screen. When I inquired why the administrator just joked and stated "We like our employees on drugs". Then told me it was a dont ask dont tell policy.............Jeez!!!!

pagandeva2000, LPN · Aug 17, 2009

I had a similar experience with home health agencies. I try and be sure that I see the case and get as familiarized as possible before I actually accept. This is no shock, but it is also sad.

Peeker19 · Aug 17, 2009

Thanks for the responses!!!! And the lay person wonders why there are so many nurses out there diverting drugs....maybe if they screened employees for drugs before they start working there half of the problem could be solved.....just the world we live in

Chaz C. · Aug 18, 2009

Home health nurses rarely if ever give narcotics. The agencies consider their employees low risk for diversion. Not saying it's right but that's their rationale.

favflu · Aug 18, 2009

One of my friends from school just recieved her LPN license and was hired by a home health agency. She went to fill out the paperwork today and they never did a drug test. I find that strange is this normal practice for home health? They also already gave her the first patient TODAY!!!! She is a brand new LPN and they are not doing any training or anything she is to go with this woman her insulin and take her vitals!!!! What is that about? She said that this place seems strange but she cannot really put her finger on it. Is this normal???

All nurses in home care whether RNs or LPNs should have at leat 1-2 yrs of clinical experience. The rationale is that the nurse will be working alone without any supervision, and he or she has to rely on that experience to make critical decisions. Yes, the nurse will be oriented for about 4-6 weeks but that is hardly a substitute for adequate clinical training. Also, an LPN has to be under the supervision of an RN in the health field, and In some states they are not allowed to work in home care. The LPN is putting her license at risk, because she will be held fully responsible for her mistakes, no matter what.

caliotter3 · Aug 18, 2009

I have only been asked to do a drug screen twice in all the applications to home health agencies that I have made. I am certain they see this as an unnecessary expense or one that they don't care to deal with in the first place. Same goes for contacting references. Lots of times they don't bother to call the references. As for training an LPN before placing them. Well, each agency has their own outlook as far as orientation. Orientation to a specific case is provided, but one can't expect orientation to basic nursing concepts, such as checking insulin. A check off on a specific brand of meter might be done, but beyond that, the nurse going into home health is supposed to have basic competency that includes the experience gained in one to two years on the job.

diane227, LPN, RN · Aug 18, 2009

There are a lot of facilities (hospitals, clinics etc) that no longer drug screen. I did not have to drug screen for my current job in a hospital that I have had for 4 years. They do however, drug screen for cause. What is amazing however, is that she was given no orientation and no one has verified her skills. That will get them into trouble. I can't believe how stupid people are.

allnurses Guide · Aug 18, 2009

Not sure if you are talking about shift work or short visits, but here is my experience in my state. Physical exam and PPD are required, but not drug tests. Nurses give narcotics frequently in the home, and there is no count or witness. The only way diversion would be uncovered would be via a pharmacy or the patient requesting refills at an excessive pace.

Orientation was 2 hours in the office, mostly to go over how the forms need to be filled out. They will pay you for a 2 hour orientation at the home of the patient, but there is never an RN there and sometimes not even an LPN. If you are a kinown entity to them, they'll send you to orient and work at the same time.

Most of the cases have LPNs. The RN should visit every 30-60 days, but there is supposed to be someone on call if you have any issues at the home.

I was so surprised that they would take such a stunning amount of risk with this. It freaked me out. I went back twice to one home until I made absolutely sure I could handle the worst-case scenario. I suspect I was viewed as an oddity for doing that, but. . .I know enough to know what the heck COULD go wrong!! Not sure that was the case with everybody.

I'm one who thinks 1-2 years of hospital experience is invaluable, though they don't require it.