I was accused of being impaired at work

[Lorie Brown RN, MN, JD]

I have had severe daily migraines since I was 7 and took my lawfully prescribed migraine medicine Fioricet for 20 years in the middle of the night before work, which lasts about 3-4 hours. I was taken by security and took a drug test and passed fully minus the Fioricet which I proved my script.

My director still is accusing me of being impaired. I was not- and occasionally my migraines can make me look impaired. I was probably acting defensive very anxious/shocked I was being accused, but initially, his accusations were based on my eyes-they water and get bloodshot when I have a migraine and I had burned the first time (and last time) tanning artificially the night before.

I didn’t get to tell my story. I was sent home, drug test passed with MRO follow up for safety concern for a high level of Fioricet, occupational health followed up and my PCP wrote to not take the medication at work (which I don’t anyway) and cleared. I have been out of work for 3 weeks now still.

Now they are meeting the quality for patient services and safety Dr. RN. And I am still home.

Is an accusation of being impaired alone reportable to the board of nursing? Even after a drug test is taken and I am legally prescribed a medication?

Is this something they will fire me over and then report to the BON? What can I expect? What are my rights?

Thank you

Dear Wrongly Accused

I am sorry this is happening. I too am a migraine sufferer. Anyone can report you to the Board for any reason. So, yes, you can be reported for appearing impaired at work.

As far as the Fioricet is concerned, the Board is concerned with nurses taking controlled substances for a prolonged period of time. The reason why they are controlled is because they are habit-forming. The Board has no way of knowing if you took your medicine at work or not. You may want to talk to your physician about ways to control and treat your migraines without using controlled substances.

As far as employment is concerned, most states are employment at will and they can fire you for any reason. If you are reported to the BON, you should receive a call or a letter. Make sure your address is correct so you will receive the mail because you will only have a certain number of days to respond.

I hope you were able to keep your job and nothing comes of this.

Lorie

[caliotter3]

What does "looking impaired" consist of, I ask? Some of us have a RBF that could conceivably be construed to be that "impaired" look every single day we show up for work.

[Persephone Paige, ADN]

On 6/3/2019 at 5:52 PM, Zaphina said:

The key here is she “APPEARED” impaired. She was not impaired ....her symptoms of her migraine made her look “IMPAIRED” WHICH SHE was not. Symptoms made her look that way...the side effects of having your head crushed by an imaginary bowling ball, and torched with a hot poker in your temple, with an intense light shining in your eye (s) at the same time, ..all while feeling like you might vomit all over the person asking you —are you on drugs-. She took her prescription and sat down to get better.. and someone who apparently has absolutely no pain or discomfort at all... made an erroneous decision to say she was impaired. That is the KEY PEOPLE... and no I am not bitter.... I am someone that suffers with chronic pain in many forms... clearly tired of those that do not know.. telling those of us that do know.. which way to go and what to do when we get there! As the elderly say, do not not speak on something you do not know anything about, you are only showing everyone what an a... you are. The donkey is in the barn.

What I don't think you understand is that the powers that be don't discriminate between appeared impaired and was impaired. If she appeared impaired to the person who reported her and she tests positive for a narcotic, for all intents and purposes, she's impaired. If the drug test supports the report, they have no way to retroactively do a field sobriety test, they will ere on the side of safety. Forget compassion, you are dealing with a corporate world. They look at the bottom line. The amount a patient/patient family could sue for outweighs the puny noise makings of a nurse with a history of migraines.

When you start thinking like the wolf of Wall Street, then you'll understand where we factor in to this.... we don't.

[LC0929, ASN, RN, EMT-B]

I agree wholeheartedly! Here’s the thing, WE can change things.....I’m speaking for myself and only my colleagues that have similar conversations with me, but I’d bet a months pay that thousands of us feel like we walk on eggshells on a daily basis. There is no reason for this....the BON is made up of people...nurses....just like US....they even include “public” members to “assure” that EVERYONE is represented....it seems reasonable enough that with our numbers, even if we were to only include those nurses who have been falsely accused of something, that statistically we could command change....I’m 53, so even if there was a demand like this made, I may not see anything significant in my lifetime, however, the young nurses would....if we all continue to sit back and allow this abuse to continue, it will do just that....we, as nurses, are somewhat of our own “population”.....we have the numbers...we also have something so amazing that many never will....because of our relentless pursuit of knowledge and the ability to APPLY that knowledge, even under the worst possible conditions and the ability to FIGHT for a patient’s life, when everything is hopeless,!WE have been given the ability to SAVE LIVES....that is an amazing gift that NO ONE, not even the board, can take away....and that’s precisely what scares them....I’m off track, sorry, but essentially we don’t have to accept their bull****.....WE are Nursing....not the paper pushers....it’s US that make things happen....

[HigginsdogRN]

On ‎6‎/‎4‎/‎2019 at 11:04 PM, caliotter3 said:

What does "looking impaired" consist of, I ask? Some of us have a RBF that could conceivably be construed to be that "impaired" look every single day we show up for work.

Exactly. I have Ocular Rosacea and migraine with aura. My eyes get really dry and red at work under the horrible florescent lighting. I am not impaired but constantly fear the possibility of suspicion.

[Persephone Paige, ADN]

This is going to be another unpopular comment, but we're not allowed to be impaired physically, either. We are not allowed to be impaired from chemotherapy, we are not allowed to be impaired from Bipolar or Anxiety, we are not allowed to be impaired from narcotics.

Nurses not in a monitoring contract have no clue what is actually meant by "impaired." If someone with MS comes to work in a 'flare' they can be pulled from the floor for being 'impaired' and referred.

We have rights, we can't (or shouldn't) be fired. But, the rights of the patient supersede our right to work if a disability is interfering or has the potential to interfere with patient care and safety. Then, get ready to have to prove you are safe after being referred.

Monitoring programs include physical, mental and chemical impairment.

[subee, MSN, CRNA]

On 6/4/2019 at 10:12 PM, LC0929 said:

Well, alright then....consider this for a quick minute....how many of us have worked with colleagues who were extremely obese and/or close to retirement, and possibly not the first one on the scene of an emergent situation, due to their physical condition? One could argue that they also work “impaired” if they are having a rough day....my point is this....there are enough nurses who have worked and continue to work, GENUINELY impaired....the nurses that are truly addicts.....the ones who, for instance, use a syringe to pull fentanyl out of a patch on a dying patient to feed their addiction....yes, it happens....my question is should all of these nurses be judged and treated the same across the board? I don’t think so.... I firmly believe that addiction and treatment have become big business and that is why they push for IPN or something similar....if the states had to fork over the cash to treat their impaired licensees, I think you hear the brakes squealing throughout the entire country....just my opinion....

I remember what happened to these nurses before IPN and other state programs. They were summarily fired, taken away in handcuffs and de-lincensed. I'm sorry that people have to pay for some features of their own alternative programs, but the alternative in the 80's was absolute disregard for the possibility of that nurse ever working again.

[beekee]

On 5/30/2019 at 2:26 PM, Zaphina said:

Wow, I have not seen nor heard of that in a while, just the age group of 65 and above..

I have them! They are probably around 40 years old. I’m under 50. My dentist is amazed they lasted as long as they have.

[Hoosier_RN, MSN]

On 6/22/2019 at 12:23 AM, beekee said:

I have them! They are probably around 40 years old. I’m under 50. My dentist is amazed they lasted as long as they have.

I'm 56 and have them, and my dentist thinks that they look better than most newer fillings

[nurse4vets17]

Is this the same for adderall?

[subee, MSN, CRNA]

I'm so confused from the above posts about teeth:). Is what the same for adderall?

[Older Male LPN, LPN]

Yes we need a unions protection -- and if the job requires nurses to be pain-free, good health, fatigue-free, always completely mentally alert, and physically able, Some of us should quit and the excellent specimens that are left should get a big raise.

[subee, MSN, CRNA]

On 1/4/2020 at 7:27 AM, Older Male LPN said:

Yes we need a unions protection -- and if the job requires nurses to be pain-free, good health, fatigue-free, always completely mentally alert, and physically able, Some of us should quit and the excellent specimens that are left should get a big raise.

That's hyperbolizing, don't ya think? Someday we will have psychomotor testing that is reliable to evaluate some parameters of performance. But until that time happens, NO employer is going to risk a story in the newspaper of a nurse on narcotics being blamed for patient harm. And the people using the narcotics are the LEAST reliable reporters of their own performance. If you have pain so severe that you have to take narcotics, do you really THINK that your work is safe? That narcotic isn't relieving your headache. It's only changing your attitude about it. I'm getting distracted just typing this.