How do US nurses feel about the testing/disclosures they must do?

allnurses Guide · Nov 7, 2015

I believe that much of what's done if put to the test would be considered violations of the 14th amendment as it is understood by most people. Still under the Amendment a person is only entitled to privacy when they have a reasonable expectation of it. Pre-employment testing is considered voluntary (but isn't really if you want the job) and testing after an accident or suspected impairment at work is a given. Still I agree that my mental health history is no one's business if I'm not at risk for shooting up a movie theater or axe murdering my family. Still the BONs get away with it under the guise of protecting the layman from evil, dangerous impaired nurses. I believe we all put up with it because we just want to work and drug testing and mental health issues have become an engrained part of our culture. If I were independently wealthy I would organize a million nurse March on Washington and address these issues along with safe staffing etc...Bla Bla Bla - let's hope I win the lottery soon.

hppy

K+MgSO4, BSN · Nov 7, 2015

In all honesty what are chances of admitting that you are planning on going to rob a bank etc. For my jobs in ireland and Australia I have been asked to provide my immunizations record which always require titres for me because England's schedule differed to Ireland and I had things at odd times and crossing countries my record looks odd.

I have had to prove that I can safely lift a 10Kg box from the ground which I rhink is the most stupid thing as the box is evenly distributed in weight and doesn't bit or require PPE to be worn.

My annual registration requires filling in an online questionnaire asking about criminal charges but never have I had to pee into a cup, worry about someone analyzing my hair for drug and smoking history (neither) or anything.

MunoRN, RN · Nov 7, 2015

I think it's reasonable for both BONs and employers to take measure to protect patients from avoidable harm, and one could certainly argue that they don't always set a good example (safe workloads for instance), but the general goal seems reasonable.

Employers can't actually require disclosure "If you are taking a medication that does not impair you whatsoever", but they can require disclosure of medications that have been well proven to cause impairment such as opiates and benzos.

elkpark · Nov 7, 2015

Licensure (in any of the licensed professions/occupations, not just nursing) is a privilege, and the point of licensing is that we have a greater responsibility to the general public than the average Joe on the street, responsibility that we undertake voluntarily by pursuing licensure. We voluntarily agree to give up some of the privacy we would enjoy as general members of the public in order to protect public safety.

Also, having worked as a hospital regulator for my state and CMS in the past, I can assure you that all these types of regulations are reactive, not proactive -- that is, they came about because awful things happened (more than once; more like a pattern over time) and the state legislatures sat up after awful things happened (e.g., situations involving impaired nurses) and said, "Golly! We've got to make sure that doesn't happen again!" And then they create a new regulation to ensure that whatever bad things happened don't happen anymore. That's why there's pre-employment and random drug testing. That's why there are pre-employment physicals to rule out communicable diseases.

Personally, I feel these are reasonable accommodations for pubic safety and safe practice, and a small price to pay for the privilege of licensure. I know that I have nothing to hide, and I don't want to be working with impaired colleagues.

AceOfHearts<3 · Nov 7, 2015

I honestly have no issue with it. Why wouldn't they do a drug test? Many companies, even not related to healthcare do them. My father just started a new job (tech industry) within the last year and his company required one. I expect anyone in healthcare to have one and I don't mind random screenings- I just think about the care I would want my loved ones to receive and I certainly wouldn't want someone taking drugs giving them care (and if the threat of a random screen stops that or catches it, then I'm all for it).

I also have nothing to hide. I don't do drugs. I don't smoke. I only drink alcohol on social occasions 1-2 times a month (sometimes a bit more, sometimes less). I'm in good health and on a couple of maintenance meds for allergies. I'm starting a new job and I was asked about my health, but I wasn't actually physically examined. We went over my vaccination record and I then had blood drawn to check for titers and had a drug/nicotine test. My new place is nicotine free and I don't have issues with that either. Personally I think it's nice not being around people that smell like ashtrays.

NOADLS · Nov 7, 2015

'Murica!

I personally love the drug testing done on us for pre-employment screens. As someone who is clean and will never use any illicit substance, or prescribed substance (yes, that means I will not be compliant with a prescription), I can be comfortable knowing that other legitimate candidates for a job will be weeded out while I will make it through because I make good life decisions.

NurseStorm, BSN, RN · Nov 7, 2015

Thank you for your replies! K+MgSO4, we also have to show vaccination records and disclose criminal charges which I feel is very reasonable. MunoRN, the issue with benzos and opiates is that for people with anxiety disorders or with chronic pain conditions, these meds at proper doses will NOT impair you. I have been on a low dose benzo in the past and it did not impair me at all, in fact made me function much better as it removed the edge from the anxiety I was experiencing which was actually causing memory loss. (This was in nursing school, I have been off it for years now). I know people with chronic pain that have to occasionally take some narcotics and it does not impair them at all. I am obviously not talking about IV or opiate abuse..

Elkpark, while I do agree licensure is a privilege and we have a greater responsibility.. I do not agree that I give up my privacy in order to be licensed. If anyone is appearing impaired or not appropriate, or any suspicion ETC, that is different, in which case of course tests should be done. But I don't feel everyone should be guilty until proven innocent. I guess that is where the countries differ in approach. I would be very interested to see studies to see if nurses are safer in the US vs. Canada, and I suspect that is not that case, but if anyone has found any research re: this please share!

- I do understand that awful things happen and agree we should work to prevent this but I don't think this is necessarily the answer. I guess it's like the phrase used in law (paraphrased) "it's better to let 10 guilty men free then to falsely imprison 1 innocent man"... It seems from reading these forums there are many nurses in these punitive monitoring programs when completely unneeded (history of depression or bipolar disorder with no substance abuse but yet has to do frequent urine tests and go to aa/na?) and you wonder how many innocent people are tangled into these programs compared with people who actually need to be in them (impaired on the job, diverting, etc). Don't get me wrong, I am extremely against any impairment on the job and do not agree with it whatsoever. I do not agree history of mental illness with no impairment of job should be grouped with these behaviours nor that you should be in a "monitoring program" unless it is of an assistive and non punitive nature, i.e., providing free counselling and support to the employee to ensure they remain mentally healthy.

AceOfHearts- Vaccine records and titres I don't feel are invasive as this is directly relevant to the job and patient protection (whereas your antidepressant, asthma meds, fertility meds, ETC are not). I also understand the no smoking as second/third hand smoke is damaging to patients (although I haven't heard of any hospitals around here banning it, just banning smoking on hospital grounds. Other areas of Canada could be different, I haven't looked into that). I also would not want my loved ones nor myself cared by for someone under the influence, however is the "threat of a random drug screen" actually stopping anyone? Are the rates of impaired nurses in the US much lower? From what I understood reading posts here usually its a pre employment screening and then mostly under suspicion. So I doubt if someone passes the initial test they are too worried after that about being tested. They probably think they will not appear impaired, and then by the time they get to that level that they are using at work, I doubt the thought of a test is going to stop them. They are probably too far into the addiction by then. But I don't know, thats just my opinion after working with some patients with addiction, I haven't actually worked with anyone who was addicted or diverting.

NOADLS- lol :cheeky:

CryssyD · Nov 11, 2015

This situation reminds me a lot of anti-terror screening at the airport. Someone tries to light his shoes up, we all have to take off our shoes, even though I haven't heard of one single shoebomber found by this measure. There's a rumor of some British terrorist cell planning to use liquid explosive, so we all have to throw out our bottles of water or soda and can't bring anything bigger than travel-sized shampoo in our carry-on; again, no evidence of ever having found any liquid explosive. The underwear bomber can't blow up his shorts, but we have to submit to full-body scans because he was an idiot. They're always playing catch-up, but never catching anybody at anything--like, ever.

Same thing with all this invasion of privacy. All to protect the public--where's the evidence that pre-employment screening has prevented patient harm? Knowing what medications, if any, I take, doesn't make anyone safer--it just invades my privacy. It may sound good, but how effective is it, really? It's the same as the airport--it's all about looking like you're doing all you can, even if there is no objective evidence that you are doing anything of the sort.

By the way, drug testing is a huge (like, monstrous huge) industry in this country--and extremely profitable. You cannot convince me that the drug testing industry isn't heavily into lobbying for even more testing of anyone and everyone they can think of. They may talk about public safety, but it's dollar signs they see dancing in front of their eyes.

Really sad that we put up with it. Just more self-sacrificing by people--nurses--who sacrifice plenty already.

quiltynurse56, LPN, LVN · Nov 11, 2015

I think it comes down to safety. At this point in time I have had background checks done. What they are looking for her is if there have been any issues regarding abuse. Would you want someone who is a known abuser to be taking care of you or your loved one? I have had this done for both jobs.

I have had physical capability tests for both employers. This is to determine if you can safely do the job and should you get hurt, they have a baseline to go by.

I have had the drug screen for one of my jobs. This would be to make sure that you are safe also. You wouldn't want to have someone taking care of you or your loved one who is impaired do you? If you are taking a medication by prescription, you have your physician show why you are taking it. This is all done through the drug testing company. Your job only knows if your test was positive or negative.

My son, a software engineer has had to submit to drug testing for a job.

Horseshoe, BSN, RN · Nov 11, 2015

I have had drug screens done but never had to have "an examination" and have never been asked to provide a list of my medications. I am allegedly subject to random screening, but have never been asked to do so. I was required to submit to a drug screen when I was injured during one of my shifts. I have never been tested for nicotine, though I've never smoked. I know some facilities are screening for nicotine, but I've never worked for one that does.

I PERSONALLY have not been subject to many privacy invasions.

mmc51264, BSN, MSN, RN · Nov 11, 2015

or prescribed substance

Why would you not want to take a medication that will help you heal? The body cannot heal if it is in a state of constant crisis. Cortisol levels rise and healing is impaired. There is nothing at all wrong with taking prescribed medications to help the body heal. you make it sound like taking a narcotic is something shameful.