I recently received an offer for a position at a major hospital in Houston and had to go through all the pre-hire stuff, including a drug screen. I am currently prescribed a prescription that shows up on all the drug screens I've ever done. I always have had anxiety that this will cause me to lose a position in some way.
I'm panicking after what happened today.
-Last Wednesday (6/22) I went into the hospital's employee health clinic for my drug screen. I expressed my concern that I had prescriptions that will affect the results. I was reassured if I had it written down in my history everything would be fine.
-This morning (6/27) I missed a call from the hospital's HR department and then 2 hours later missed call from a 1-800 number. Since the 1-800 number left me a message instructing me to call, I gave them a call first. It was the MRO asking for verification of my prescription. They informed me I had 72 hours to submit proof. I submitted the proof immediately.
-In the next couple of hours I called my recruiter (assuming it had nothing to do with the drug screen) and asked if she had been trying to contact me this morning. She said yes that she was calling to inform me that I had positive drug screen (Note- before the MRO attempted to contacted me). I explained that the results were due to a prescription drug. She seemed confused: "What do you mean a prescription?" She seemed extremely judgemental, and disgusted with me. I didn't disclose the name of the prescription because as I was told by the hospital: My health information only goes to the employee health clinic. I expressed this situation panicked me. She replied "It panics us too." It was extremely hurtful. She obviously thought I was lying. She told me to contact her if I got that sorted out.
-I called the hospital's employee health clinic immediately after my call with my recruiter to inquire about the drug screen results. They were reluctant to help me, because apparently whoever normally deals with this "leaves at 3:30." I insisted; I told her HR had contacted me and that I was under the impression that this information would not be released to HR and was worried about losing my position. She then said "Oh we did just receive verification. I'll update your profile to show a true negative and let HR know. Someone from HR will be in touch with you."
-I waited 15 minutes then tried to call my recruiter back twice with no answer. I sent her an email to confirm she received the information and to confirm my start date. No answer yet. I'm afraid she has contacted my unit and nurse manager about the situation.
I did not think that HR was suppose to be aware of a positive result of a drug test until it was verified? Especially since this hospital has its own employee health clinic, and HR does not deal directly with drug screens. Agh. Could they take away my position? (I was going to have my offer rescinded before the MRO even had contacted me!) How is this normally supposed to work? Can anyone shed light on this situation? I am really upset that this happened, and hope it gets sorted out.
[Not happy at the idea of my boss hearing I had a positive drug screen, then hearing "Oh never mind, she is taking the drugs legally."]
Note again:This is a MAJOR hospital system that excels in employee satisfaction, one that I would not pin having this kind of confusion with.
No, they can't. The purpose of a drug screen is to identify people who are using substances illegally, period, and it was wrong (possibly illegal, but I can't say with 100% certainty) to disclose drug results before they were verified.
The hospital CAN have a policy that you cannot work under the influence of a controlled substance, but they CANNOT refuse to hire you for taking something you were prescribed while not at work.
OP, they've done you wrong, but it isn't rude of Pangea to point out that your anxiety and panic (I'm not trying to label you - just using your words) can affect your perceptions of the situation. Employee health isn't who you work with on the unit. The nurse recruiter isn't who you work with on the unit. HR isn't who you work with on the unit. But it will not help to harass people for not getting things fixed quickly enough. You said you wouldn't wait until the next day because the employee who deals with these things was gone for the day? (hard to tell, you said they leave at 3:30 but didn't say when you called) Then you called the recruiter twice in a row then e-mailed? Your fear and frustration are legitimate because they clearly crossed a line, but if your immediate response is panic, you are only increasing their concern that something is wrong, and feeding into any prejudice they may have. If your goal is to keep the job offer, put on a good face for them - even though they don't deserve it - and give them a day, not 15 minutes, to get things fixed.
If something like this happens again, you may want to simply say to HR (or whoever calls you besides the testing company) that you do not use any drugs illegally and you will contact the testing company to discuss results. Then the testing company will mark you as negative, and all the employer will know is that there was some sort of error.
You may also want to contact the testing company to file a complaint. Whoever returned the results to your employer without giving time to verify prescriptions is the one who started this mess.
My post did not address the legality of disclosing the drug screen results prior to verification. Per federal law and the employer's P&P that may very well have been the wrong thing to do.
But I stand by my assertion that a prescription is not a blanket "OK" for any substance that is detected on a drug screen. There are medications that have the potential to impair a worker, regardless of legitimate medical use, and under those conditions, an employer does not have to hire the individual for that safety-sensitive job. To do so would invite an incident (and avoidable liability) compromising worker and/or client safety and force the employer to address it retroactively by removing the worker from a position s/he never should have been assigned.
The ADA may come into play in the instance of a worker with a legitimate prescription for a medication with the potential to impair safe job performance. If the worker claims a disability covered by ADA, then additional steps would need to be taken to protect employment rights, but even that is not a "given" that the employee must be hired for a position with significant safety concerns.
Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
This subject was discussed here when a few states legalized marijuana... just because it was legal to use it in that state didn't mean that a facility had to hire you if you tested positive.
Kinda like systems that are nicotine-free... they can say, "We don't hire people who use tobacco products." They can also say, "We don't hire people who use narcotics."
This subject was discussed here when a few states legalized marijuana... just because it was legal to use it in that state didn't mean that a facility had to hire you if you tested positive.
Kinda like systems that are nicotine-free... they can say, "We don't hire people who use tobacco products." They can also say, "We don't hire people who use narcotics."
This issue is of an entirely different nature than marijuana use (unless it is marijuana, which I doubt, because the OP sending in her RX documentation got the positive result corrected). Marijuana use is a federal crime. Prescription drug use is not. Nicotine is banned because it increases the risk of health problems (which could drive up insurance costs to the employer) and leads to nurses ducking out for breaks at inappropriate times, smoking on the grounds in while identifiable as an employee (and coming back in with burn holes in their scrubs...), and nicotine does not have medicinal use.
No one here has said the hospital doesn't hire people who use x drugs. They've said the drug screen was, in effect, negative, because the OP was using a prescribed medication legally.
If someone wants to educate me (sources?? I did a quick Google search and didn't turn up anything definitive), I'd love to learn more, but so far I've only seen it as a moral philosophy - not a legally protected one - that employers can refuse to hire people who use legally prescribed medications (which are not illegal on any level, state or federal) because they are concerned it would impair performance. Nothing OP has said indicates that's what is happening here at all. The drug testing company screwed up, then employee health screwed up, then HR screwed up. If this were a banned medication, OP would have been told about it before testing. Their drug screen was negative.
I hadn't heard of safety-sensitive positions having different regulations. It makes sense in a way, but only if the drug test happens while you're on the job. It doesn't make sense that the employer could call it a positive drug test when you took a prescribed med at home days or weeks before you started work with them, and the occupational health nurse who posted seemed to be saying the same thing.
Being under the influence AT work is a different story, but I just don't see hour a pre-employment screen could work that way. There's certainly a lot I don't know, but I don't see how employers could get away without informing applicants that legally used drugs can come back as positive.
Hmm.
Workers in general are covered by ADA which is why employers can't test for legally prescribed medications in general. Where it can be established that use of prescribed medications could affect the safety of workers or others then that overrides the ADA, those positions are legally designated as "safety sensitive" which has consistently included direct care nursing. Not all employers chose to test for prescribed medications in these workers and instead apply the general standard to all employees. I don't think I've ever worked a nursing job where I didn't have to report and could be tested for prescribed medications, these were union places with very good lawyers on retainer so that's something they would have disputed if there was a legal basis to do so.
As an example:
In some instances, like with employees in safety-sensitive positions or in a post-accident situation, employers may have some latitude to inquire into, or even test for, prescription medications used by the employee.
Specializes in orthopedic/trauma, Informatics, diabetes.
I am on a presciption med that shows up and for something that I needed a drug screen, the person that called me definitely acted as if they had "caught" me doing something wrong. took the wind oout of her sails when I provided the documentation required. I have had to do 3 for school (ADN, BSN, MSN) and 2 for jobs. All come back positive for my med and all 5 times it not been a problem.
Employee health should have never spoken to anyone but you until you all was straightened out. Some PP mentioned a lawsuit.....
Workers in general are covered by ADA which is why employers can't test for legally prescribed medications in general. Where it can be established that use of prescribed medications could affect the safety of workers or others then that overrides the ADA, those positions are legally designated as "safety sensitive" which has consistently included direct care nursing. Not all employers chose to test for prescribed medications in these workers and instead apply the general standard to all employees. I don't think I've ever worked a nursing job where I didn't have to report and could be tested for prescribed medications, these were union places with very good lawyers on retainer so that's something they would have disputed if there was a legal basis to do so.
That does not address pre-employment screens. No place I've ever worked has told me they would not hire me if I tested positive for legally prescribed medications, and it seems absurd to me that if it were their practice, that potential hires wouldn't be clearly notified in advance. It's an interesting discussion, to be sure, but I don't think there's any chance it applies to OP.
For jobs that aren't considered "safety sensitive", a drug test that is positive for drug but a valid prescription exists will be resulted as negative. Direct care nursing however is classified as a "safety sensitive" position, which means employers can test for certain drugs and be notified of a positive result with or without a valid prescription. So regardless of whether or not your employer chooses to actually prohibit certain medications even with a prescription, there is no requirement that prescribed medication use be kept secret from them which is the purpose of allowing a prospective employee sufficient time to present a valid prescription to an MRO. The test can be resulted as positive immediately, and then later clarified to be either with or without a valid prescription.
As somebody else wrote - nursing is a safety sensitive job. And some medications can be excluded. I understand that there is bias and prejudice - but to be honest, if I was hiring, I would rather take the person with the negative drug screen. It is not a guarantee and many people function fine on medication but it is concerning for many reasons.
I am not an expert on drug screening policies and procedures, but it is possible that the applicant was positive for a substance that would have been deemed unacceptable regardless of prescription.
An employer can disallow medications that might potentially impair an individual in a highly sensitive position regardless of prescription.
I've never heard of this "safety sensitive" rule where they can refuse to hire you based on any certain (federally legal) prescription that is found in your drug screen (which you may not even take regularly scheduled prior to a shift).
Does anyone have examples of what kinds of substances would be on a list like that? Or where I could find more info?
This subject was discussed here when a few states legalized marijuana... just because it was legal to use it in that state didn't mean that a facility had to hire you if you tested positive.
Kinda like systems that are nicotine-free... they can say, "We don't hire people who use tobacco products." They can also say, "We don't hire people who use narcotics."
This issue is of an entirely different nature than marijuana use (unless it is marijuana, which I doubt, because the OP sending in her RX documentation got the positive result corrected). Marijuana use is a federal crime. Prescription drug use is not. Nicotine is banned because it increases the risk of health problems (which could drive up insurance costs to the employer) and leads to nurses ducking out for breaks at inappropriate times, smoking on the grounds in while identifiable as an employee (and coming back in with burn holes in their scrubs...), and nicotine does not have medicinal use.
Can you imagine if a Catholic hospital had a policy that they would not hire anyone who used prescription birth control pills?
All of the back and forth in this thread is why the company would just hire someone else. Not worth the drama. And no it isn't personal.
Exactly why HR has NO right to know if a potential hire's drug screen is positive for a prescribed medication. I have also been in this situation when I was taking xanax a few years back. I submitted proof of my rx to the testing center the same day that I gave a sample, because I was super worried about it. My result was reported as negative to my employer.
There is no rx that should bar a person from a "safety sensitive" job. Just because someone has an rx for a potentially impairing med like benzos, stimulants or narcotics, that does not mean they are coming to work impaired, and it is discriminatory to assume as much. People who are on long term methadone maintanence are certainly not getting high from their rx, a nurse with ADD may be impaired WITHOUT her meds, and someone like me who has used benzos off and on for acute anxiety issues should not be assumed to be popping xanax before work.
I don't think Employee Health should have contacted HR. I've reread this and can somebody show me the quote where her offer was rescinded? I'm not seeing that.
I take a substance that shows up. I disclosed it though before the test. I disclosed every med I had taken in the previous 30 days and I had two teeth pulled as well. I was assured my medical record would stay private from the beginning. And I'm guessing it did as I had no issues.
OP, were you assured your record stayed private? By Employee Health?
I don't think Employee Health should have contacted HR. I've reread this and can somebody show me the quote where her offer was rescinded? I'm not seeing that.
Here it is:
I have spoken with this recruiter many times and she was speaking to me differently than our previous conversations. However, regardless of how I perceived it, she called to tell me my offer was being rescinded because of my drug screen results. I had to discuss my private medical information, which was not appropriate. ]
Jolie, BSN
6,375 Posts
My post did not address the legality of disclosing the drug screen results prior to verification. Per federal law and the employer's P&P that may very well have been the wrong thing to do.
But I stand by my assertion that a prescription is not a blanket "OK" for any substance that is detected on a drug screen. There are medications that have the potential to impair a worker, regardless of legitimate medical use, and under those conditions, an employer does not have to hire the individual for that safety-sensitive job. To do so would invite an incident (and avoidable liability) compromising worker and/or client safety and force the employer to address it retroactively by removing the worker from a position s/he never should have been assigned.
The ADA may come into play in the instance of a worker with a legitimate prescription for a medication with the potential to impair safe job performance. If the worker claims a disability covered by ADA, then additional steps would need to be taken to protect employment rights, but even that is not a "given" that the employee must be hired for a position with significant safety concerns.