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.
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.
Here ya go...this is exactly what I want nurses to know. We can be wrongly judged, assumptions made about us that are incorrect and there is nothing we can do about it. I believe the paranoia that exists on this subject is related to the epidemic of impaired nurses and the public who become addicted to controlled substances. For someone who is legit, responsible, and does not cross that line is unfairly judged. Not fair. Not right. Those who have posted fear in hiring someone who takes a prescription medication, APPROPRIATELY and RESPONSIBLY might as well say that as soon as a Nurse has a health problem requiring this sort of medication that they need to abandon their career.
That comment was actually related to the responses that pointed out marijuana being a potential substance that would lead to an offer being rescinded (in the case of it being state-legal for medicinal use, but still not federally legal). And the comment re: nicotine also being a (legal, but not prescribed) substance which some hospitals will refuse to employ those who use it.
Unlike those two substances, birth control is legal on both state and federal levels AND is a prescribed medication. I can just imagine the outrage if an employer refused to hire those who used it under a physicians care. And yet, I can imagine it happening, considering news stories like hobby lobby and the cake shop who said their religious views precluded them from making a cake for a gay wedding.
What if THAT substance was a barrier to employment, like other substances apparently can be for certain jobs?
It was not intended so much hyperbole as it was hypothetical.
Pretty sure the point here was regarding bias. The fact that so many posters have admitted their bias, means that they are willingly allowing themselves to judge and reject a perfectly capable person, unfairly, for employment. If you can jump to conclusions that the person would be impaired at work, without knowing that is a fact or even likely, is wrong...just as a Catholic hospital may determine a person to be of "immoral" judgement because they take birth control pills.
Just thought of some other things....What about the nurse who 1) Comes in to work sick with a cold or whatever because they want to save their PTO? 2) What about the nurse who comes in hung-over from a night's partying who hasn't had more than 4 hours sleep? 3). What about the nurse working double shifts and then back to back 12's who is sleep deprived? Anyone think these nurses are not impaired? We tolerate these situations time after time.
Just thought of some other things....What about the nurse who 1) Comes in to work sick with a cold or whatever because they want to save their PTO? 2) What about the nurse who comes in hung-over from a night's partying who hasn't had more than 4 hours sleep? 3). What about the nurse working double shifts and then back to back 12's who is sleep deprived? Anyone think these nurses are not impaired? We tolerate these situations time after time.
I continued to work for 18 months after I was diagnosed with RSD/CRPS (a little less than half of that time in direct patient care.) I was not able to take any pain medication due to "safety sensitive position" regulations. Even during the time when I was promoted to a position to develop a new program for cancer patients and was no longer providing direct patient care, I still had to follow those regulations. I can guarantee you I was far more distracted (impaired) by my untreated pain and fall out from it (lack of sleep, nausea, etc.) than I ever was by the opioid pain medication I was finally able to take once I went on disability.
I continued to work for 18 months after I was diagnosed with RSD/CRPS (a little less than half of that time in direct patient care.) I was not able to take any pain medication due to "safety sensitive position" regulations. Even during the time when I was promoted to a position to develop a new program for cancer patients and was no longer providing direct patient care, I still had to follow those regulations. I can guarantee you I was far more distracted (impaired) by my untreated pain and fall out from it (lack of sleep, nausea, etc.) than I ever was by the opioid pain medication I was finally able to take once I went on disability.
I don't know what "RSD/CRPS", but I am sorry you are suffering. Gratefully, no longer, but at several times over the years I have had chronic pain R/t arthritis. Several surgeries and years later I am relatively comfortable. I know what it is like to suffer in pain and not be able to do anything about it. We cannot just stop working, supporting ourselves or family, and/or throw away our careers, but must be responsible and honest with ourselves about what is right and what is the responsible thing to do in relation to continuing to practice safely. In most circumstances, it is possible to balance the two. Sometimes not and that is when we must do the hard thing and have an honest "talk" with ourselves as to what the right thing to do would be. Having said that, it disgusts me to see nurses judged or wrongly denied a position R/t assumptions as opposed to facts. The "what if's" so many have stated are understood. The truth is we spend so much time, energy, and money in the health care professions on issues related to narcotics when we have other, much more frequent risks that have the potential to impair a provider's performance that we tolerate regularly.
The MRO is supposed to report the screen as negative when they receive proof of RX. It's reported as "non-negative" before then, meaning that it's not + for illicit drugs, but legal with rx ones. I always thought they weren't allowed to tell your employer anything until they got proof (or lack thereof) of RX.
That's only true if the employer has directed the MRO to report only illegally used drugs as positive, which is the most common criteria for employment drug screening, but it's not what employers are always limited to. For positions where the employer can establish a job related reason for testing for legally prescribed drugs, the employer can chose to test for drugs known to be potentially impairing and the MRO will report them as positive regardless of a valid prescription.
That's only true if the employer has directed the MRO to report only illegally used drugs as positive, which is the most common criteria for employment drug screening, but it's not what employers are always limited to. For positions where the employer can establish a job related reason for testing for legally prescribed drugs, the employer can chose to test for drugs known to be potentially impairing and the MRO will report them as positive regardless of a valid prescription.
None of the sources I've seen in this thread address testing before hire.
Testing an employee who is currently at work in a high risk position is not the same thing as making them take a random test when they are at at home on a day off. I personally think that, in the case of legally used medication, a pre-employment screen is more like the latter.
I don't think it's impossible, but I'm skeptical that an employer could legally refuse to hire you based on valid prescription drug use prior to start date AND do it without clearly outlining what their policy is beforehand. Nothing I've read here has indicated otherwise.
Regardless of whether it CAN be legally done, it clearly did not apply to OP's situation, as the drug screen was incorrectly reported as positive, then fixed.
I don't know what "RSD/CRPS", but I am sorry you are suffering. Gratefully, no longer, but at several times over the years I have had chronic pain R/t arthritis. Several surgeries and years later I am relatively comfortable. I know what it is like to suffer in pain and not be able to do anything about it. We cannot just stop working, supporting ourselves or family, and/or throw away our careers, but must be responsible and honest with ourselves about what is right and what is the responsible thing to do in relation to continuing to practice safely. In most circumstances, it is possible to balance the two. Sometimes not and that is when we must do the hard thing and have an honest "talk" with ourselves as to what the right thing to do would be. Having said that, it disgusts me to see nurses judged or wrongly denied a position R/t assumptions as opposed to facts. The "what if's" so many have stated are understood. The truth is we spend so much time, energy, and money in the health care professions on issues related to narcotics when we have other, much more frequent risks that have the potential to impair a provider's performance that we tolerate regularly.
Well said!
RSD (reflex sympathetic dystrophy) aka CRPS (complex regional pain syndrome) is a neuro-inflammatory disease that causes severe burning pain, swelling, color & temperature changes, muscle spasms, etc. to the affected area(s). I also had never heard of it until I was diagnosed with it. There is no cure and until recently, no treatment I tried was effective. But like you said, it's not like I could just stop working and throw away my career. Only eventually that's exactly what I had to do--after 18 months of suffering and my doctors telling me I needed to go on disability to treat my pain, I ended up in the ER in a severe crisis. After three particularly difficult 12 hour shifts in a row, I was admitted to the hospital with uncontrolled pain, tachycardia & SVT, bone marrow depression, and gastroparesis (all complications of the RSD/CRPS and untreated pain.) After some serious heart-to-heart discussions with my pain management doctor, cardiologist, hematologist, neurologist and my family I realized I could not continue to work. I never returned.
Anyway, I didn't mean to hijack this thread. But it struck a nerve in me. There should have been/should be other options available.
So bizarre. I just started a new job. When I went for my screening I was asked to bring any prescriptions that could show up in the drug screen. I don't take anything, but I assume they would want to know ahead of time.
RSD (reflex sympathetic dystrophy) aka CRPS (complex regional pain syndrome) is a neuro-inflammatory disease that causes severe burning pain, swelling, color & temperature changes, muscle spasms, etc. to the affected area(s). I also had never heard of it until I was diagnosed with it. There is no cure and until recently, no treatment I tried was effective. But like you said, it's not like I could just stop working and throw away my career. Only eventually that's exactly what I had to do--after 18 months of suffering and my doctors telling me I needed to go on disability to treat my pain, I ended up in the ER in a severe crisis. After three particularly difficult 12 hour shifts in a row, I was admitted to the hospital with uncontrolled pain, tachycardia & SVT, bone marrow depression, and gastroparesis (all complications of the RSD/CRPS and untreated pain.) After some serious heart-to-heart discussions with my pain management doctor, cardiologist, hematologist, neurologist and my family I realized I could not continue to work. I never returned.
Anyway, I didn't mean to hijack this thread. But it struck a nerve in me. There should have been/should be other options available.
I don't feel you hijacked this..you gave a great example of what relates to the thread. My heart goes out to you. I can only imagine what it is like to live in your shoes. Giving up your career being one of the most difficult things a person faces on top of living with your disease. Wish I could hug you right now.
Just thought of some other things....What about the nurse who 1) Comes in to work sick with a cold or whatever because they want to save their PTO? 2) What about the nurse who comes in hung-over from a night's partying who hasn't had more than 4 hours sleep? 3). What about the nurse working double shifts and then back to back 12's who is sleep deprived? Anyone think these nurses are not impaired? We tolerate
time after time.
Well, shame on us. This isn't the 80's anymore. People will continue to use poor judgement until they're confronted by their peers. We've all needed guidance in the past from others to point us in the right direction.directi
None of the sources I've seen in this thread address testing before hire.
Testing an employee who is currently at work in a high risk position is not the same thing as making them take a random test when they are at at home on a day off. I personally think that, in the case of legally used medication, a pre-employment screen is more like the latter.
I don't think it's impossible, but I'm skeptical that an employer could legally refuse to hire you based on valid prescription drug use prior to start date AND do it without clearly outlining what their policy is beforehand. Nothing I've read here has indicated otherwise.
Regardless of whether it CAN be legally done, it clearly did not apply to OP's situation, as the drug screen was incorrectly reported as positive, then fixed.
There's generally not really any such thing as drug testing "before hire", drug testing as part of a hiring process is typically done after a "conditional offer of employment" is made, so it technically occurs after hire.
At the conditional offer of employment, employees are typically given information such as job description and HR policies. There have been numerous references to the fact that employers can screen for legally prescribed drug use in employees for certain positions. If that is the case the normal protection that an employer cannot be informed an employee tested positive for legally prescribed medication no longer applies and the result can be returned as positive prior to confirming a valid prescription.
BeenThere2012, ASN, RN
863 Posts
Here ya go...this is exactly what I want nurses to know. We can be wrongly judged, assumptions made about us that are incorrect and there is nothing we can do about it. I believe the paranoia that exists on this subject is related to the epidemic of impaired nurses and the public who become addicted to controlled substances. For someone who is legit, responsible, and does not cross that line is unfairly judged. Not fair. Not right. Those who have posted fear in hiring someone who takes a prescription medication, APPROPRIATELY and RESPONSIBLY might as well say that as soon as a Nurse has a health problem requiring this sort of medication that they need to abandon their career.