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

Nurses General Nursing

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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

Specializes in Urgent Care, Oncology.

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. 

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Specializes in school nurse.

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...

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Specializes in Occupational Health.
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

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Specializes in ER.

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.

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Specializes in Critical Care.
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.

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Specializes in Ambulatory Care, Community Health, HIV.
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? 

2
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Specializes in ER.
31 minutes ago, Squidpdx said:

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

LOL you're right. There's another thread where someone was prescribed medical marijuana. I already answered this thread. This was a thread mix up because I had read both threads.

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On 7/16/2021 at 9:06 AM, ThatBLURN said:

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

I know this is a late response, but just wanted to say that the site performing the drug screen will contact you if any amphetamine is detected in your urine. You will be given an opportunity to provide a valid prescription for the medication and once you do so, you will "pass" the drug screen. It's totally routine and nothing to worry about. I think you might even be protected by HIPAA from disclosure of your prescription to your potential employer, but maybe someone more knowledgeable can confirm this?

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