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Likely to be hired soon. Worried about drug test d/t prescribed meds

Posted

Specializes in med-surg. Has 5 years experience.

I am applying to the local hospital shortly and I am pretty sure I will get the job.  I know that sounds bold or maybe arrogant but it appears they really need nurses AND I have several contacts in their organization who worked with me while I assumed a private duty nursing role (POA) over a 3 month period as my father died from cancer.  One contacted me yesterday to ask if I would be interested in taking on a bedside nursing role.  I am extremely grateful for the care he received through this facility and had nothing but exceptional interactions with HC staff as I was advocating for him.  I really don't want to screw this up.  This opportunity is a dream for me.

Here's the problem:
I was re-diagnosed (as an adult) with ADHD about a year and a half ago and have been taking prescribed stimulants (amphetamine salts) daily since.  Due to this new opportunity, I have been taking breaks consisting of 2-5 days from my medication to see how it alters my functioning and also performing at-home urine drug screens.  They are urine screens and function just as an OTC pregnancy test would.  After one day, it's been showing to be out of my system.  The days off are OK but my productivity and attention are definitely messy (exacerbated by full-time mom duties with a toddler).
Reflecting on my practice in the specialty I have chosen, I definitely don't see how my diagnosis (while I was un-medicated) could have ever negatively impacted my patients.  However, it has induced a great deal of anxiety for me because I have felt as if I have to work harder than my colleagues often.  I worked for years without medication but have yet to return to my specialty medicated.  I am TERRIFIED about the drug test!  I wish to keep my diagnosis private from my employer.  I also want to avoid opening pandora's box and potentially be at the mercy of the BON.  Any advice and/or experiences in this matter?

Greatly appreciated!!
J

Emergent, RN

Specializes in ER. Has 28 years experience.

There are lots of nurses on prescriptions for controlled substances. Just bring RX documents. 

EllaBella1, BSN

Specializes in ICU. Has 6 years experience.

Just tell your employer and bring the RX information. It's not wise to hide that you are taking meds. If you get injured on the job the first thing they will do is drug test you, and it will be a lot harder to explain everything after the fact than it is to be upfront from the start. 

Daisy4RN

Specializes in Travel, Home Health, Med-Surg. Has 20 years experience.

Your only chance here is to be honest from the beginning. You will probably need a pre employment physical, this is where this will come up. Bring all pertinent records and hopefully it will be fine. The last job I had I was worried about not passing the physical bc of health condition and meds. I was upfront and honest with all questions, the MD just wanted an extra note from my Rheumatologist stating I was OK to work. don't ever lie or hide info, it will catch up to you. Hope it all works out!!

Falcon RN, BSN, RN

Specializes in med-surg. Has 5 years experience.

3 hours ago, Daisy4RN said:

Your only chance here is to be honest from the beginning. You will probably need a pre employment physical, this is where this will come up. Bring all pertinent records and hopefully it will be fine. The last job I had I was worried about not passing the physical bc of health condition and meds. I was upfront and honest with all questions, the MD just wanted an extra note from my Rheumatologist stating I was OK to work. don't ever lie or hide info, it will catch up to you. Hope it all works out!!

What area were you entering into?  I have never heard of a physical needed for employment.  I know this place doesn't do that but a trucker friend had to so that he could obtain his CDLs (DMV ordered), I believe.  I find that to be a bit intrusive for an employer to obtain that information.  Honesty is a high value of mine but, in this instance, I am concerned that it could impact perceptions of me and possibly limit my opportunities for growth.  Maybe I'm just being paranoid though.  It is possible that HR keeps that information to themselves.  I don't know and wish I did because that would make me feel a lot better.

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 24 years experience.

I had to have a physical before I started my LTC job.

Some places do require it; others not. I had to even do a treadmill kind of test and prove I could life a certain amount of weight (I forget how much).

EVERY job I was offered, in every case, I was required to do a drug screen within 48 hours of offer. I was on  certain medications and provided the proper documentation and was OK.

Daisy4RN

Specializes in Travel, Home Health, Med-Surg. Has 20 years experience.

53 minutes ago, Falcon RN said:

What area were you entering into?  I have never heard of a physical needed for employment.  I know this place doesn't do that but a trucker friend had to so that he could obtain his CDLs (DMV ordered), I believe.  I find that to be a bit intrusive for an employer to obtain that information.  Honesty is a high value of mine but, in this instance, I am concerned that it could impact perceptions of me and possibly limit my opportunities for growth.  Maybe I'm just being paranoid though.  It is possible that HR keeps that information to themselves.  I don't know and wish I did because that would make me feel a lot better.

Every nursing job I have ever had required a physical, some more involved than others. No matter what is involved you can count on a drug screen, just bring you records and RX info. Only give up what is requested and no more. I have not heard of anyone not getting the job if they are able to perform the specifics of that particular job. Good luck!

klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 15 years experience.

There are plenty of people in healthcare who take legally prescribed ADHD meds. It’s really not a big deal. Be honest about it. It shouldn’t be an issue at all if you can provide the valid RX. 

FolksBtrippin, BSN, RN

Specializes in Psychiatry, Pediatrics, Community, Nurse Manager. Has 5 years experience.

You don't tell your "employer." You tell the people who do your drug test. Occupational health does not give that info to your supervisor, your coworkers, etc. You still have privacy.

 

So long as you have a current / valid RX, shouldn't be a problem.  I have a RX for ADHD medication as well.  Depending on what the place prefers, you may have to bring proof of RX.  In one instance, my PCP was within the same healthcare system, so all they had to do was look it up; in another, I just had to bring my current bottle to my pre-employment physical and show them the date prescribed, name of RX, and - of course - my name.  It never resulted in any kind of issue.  To be fair though, I'm pretty sure they would much rather have my ADHD medicated while I'm at work... otherwise who knows what kind of hot mess (or complete obnoxiousness) might ensue!  I don't know whether or not people who are prescribed opioids come across any issues (as those would seem more likely to result in work-related safety issues if not chronic in use), but it doesn't sound like that's something you are taking anyway.

Just be honest and come prepared with valid proof.  Good luck!

Edited by ladedah1

Emergent, RN

Specializes in ER. Has 28 years experience.

BTW, if you have ADHD, you might end up gravitating to ER nursing eventually. 

Pixie.RN, MSN, RN

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 13 years experience.

On 7/17/2021 at 7:38 PM, Emergent said:

BTW, if you have ADHD, you might end up gravitating to ER nursing eventually. 

And later to clinical appeals, where each case is relatively short and different from all the others. Works well with my ER nurse brain. 😄 

DowntheRiver

Specializes in Urgent Care, Oncology. Has 7 years experience.

Do not tell your employer.

This is what happens:

You do your drug screen. It gets sent out. You test positive for amphetamines. The organization's MRO (Medical Review Officer) calls you and tells you it was positive. You tell that person you have a legal RX for the amphetamine. They will ask for the prescriber's name and phone number, a copy of the RX bottle, and/or the pharmacy info for where it was filled. The MRO then verifies the RX. If it is legit, that positive is turned into a negative. 

If it is an instant cup, Occupational Health will find out, but again that positive will turn into a negative as they will send it out and the MRO will follow the same procedure. Occ Health cannot say anything to your manager/HR unless it is a confirmed positive. 

Jedrnurse, BSN, RN

Specializes in school nurse. Has 29 years experience.

It's interesting. I've had to have a CORI and SORI for every job I've had in the last 10 years, but I haven't had a drug test since the 90's...

sleepwalker, MSN, NP

Specializes in Occupational Health. Has 17 years experience.

21 hours ago, DowntheRiver said:

Do not tell your employer.

This is what happens:

You do your drug screen. It gets sent out. You test positive for amphetamines. The organization's MRO (Medical Review Officer) calls you and tells you it was positive. You tell that person you have a legal RX for the amphetamine. They will ask for the prescriber's name and phone number, a copy of the RX bottle, and/or the pharmacy info for where it was filled. The MRO then verifies the RX. If it is legit, that positive is turned into a negative. 

If it is an instant cup, Occupational Health will find out, but again that positive will turn into a negative as they will send it out and the MRO will follow the same procedure. Occ Health cannot say anything to your manager/HR unless it is a confirmed positive. 

Exactly

Emergent, RN

Specializes in ER. Has 28 years experience.

I just want to say that next time you should find out all pertinent information before you apply for a job

It wasn't good planning to apply for the job not knowing  this information ahead of time. If you smoke pot regularly it is advisable to abstain for a month before a job interview where are you will be required to take a urine drug screen.

You made it through nursing school and it is time to put your big girl pants on. I'm sure you're capable of better planning than this and I hope you learn.

The whole issue of cannabis is very murky and irrational waters in nursing. Boards of Nursing get stuck in yesteryear I've noticed. Some of their attitudes hearken back to 1900 when women had very few career options and were treated like children.

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

22 hours ago, DowntheRiver said:

Do not tell your employer.

This is what happens:

You do your drug screen. It gets sent out. You test positive for amphetamines. The organization's MRO (Medical Review Officer) calls you and tells you it was positive. You tell that person you have a legal RX for the amphetamine. They will ask for the prescriber's name and phone number, a copy of the RX bottle, and/or the pharmacy info for where it was filled. The MRO then verifies the RX. If it is legit, that positive is turned into a negative. 

If it is an instant cup, Occupational Health will find out, but again that positive will turn into a negative as they will send it out and the MRO will follow the same procedure. Occ Health cannot say anything to your manager/HR unless it is a confirmed positive. 

This is how it works if your employer is only testing for illicit drug use which is what employers are typically limited to.  Employers of direct-care nurses however can opt to screen for all potentially impairing medications, regardless of whether or not you have a valid prescription.

The MRO reports what they've been directed to report by the employer, if it's only illicit drug or medication use then positive results where a valid prescription is presented will be reported as a negative.  If it's positive results for any medication considered potentially impairing then those will be reported to the employer as positive regardless of whether or not the prospective employee has a valid prescription.

Squidpdx, CNA, LPN

Specializes in Ambulatory Care, Community Health, HIV. Has 5 years experience.

10 minutes ago, Emergent said:

I just want to say that next time you should find out all pertinent information before you apply for a job

It wasn't good planning to apply for the job not knowing  this information ahead of time. If you smoke pot regularly it is advisable to abstain for a month before a job interview where are you will be required to take a urine drug screen.

You made it through nursing school and it is time to put your big girl pants on. I'm sure you're capable of better planning than this and I hope you learn.

The whole issue of cannabis is very murky and irrational waters in nursing. Boards of Nursing get stuck in yesteryear I've noticed. Some of their attitudes hearken back to 1900 when women had very few career options and were treated like children.

I didn't read OP to be talking about cannabis. I thought the questions was about prescribed stimulants?