Loss of all personal freedom.

Nurses General Nursing

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allnurses Guide

BostonFNP, APRN

2 Articles; 5,581 Posts

Specializes in Adult Internal Medicine.
I'm apparently in the minority because I agree with you that there is too much micromanagement and privacy invasion in nursing. Things didn't use to be this way. Back when I first started nursing no one was drug tested for a job nor did the board question applicants' medical or mental health background. Flu shots weren't mandatory. Many here self riteously state it's your choice to work as a nurse so you need to accept these invasions of privacy or find another job. Frankly I think that is just sad. Why are nurses presumed guilty and required to submit to urine and hair samples to prove you are not a druggie? Why are so many nurses forced into "recovery" programs if they have a mental health illness?

It didn't used to be that way, true, but that alone isn't evidence that things are any worse (or better) the way they are now.

We should leave the flu shot debate out of this because it just opens up another can'o'worms!

Drug testing is an interesting issue. Does anyone debate the fact that drug abuse and drug diversion is a major problem in the healthcare system? I will have to go back an look for the actual studies, but there were several in the past five years which have shown the majority of healthcare worker diversion involved nurses and medical assistants (I think it was about 3 out of every 4 cases). Factor in the risk to employers if impaired individuals are providing patient care, and it seems to be a reasonable path towards drug testing, especially under suspicion. I do find it frustrating that other public health/safety professions have large unions which have protected them from being screened.

As far was the mental illness component, you are right it needs to get treated as such, but does that also make it without consequence? If a law is broken then there is a risk for a penalty. If an individual is impaired or diverting (and thereby breaking a law, as well as putting patients/coworkers at risk) is it unreasonable for the licensing board to to "force" them into a recovery/monitoring program? What would you do instead?

Specializes in Critical Care.
I have no problem with not hiring smokers, or offering and paying for health insurance to smokers. Maybe because 50% of our practice is pulmonary. Then again, I could consider smokers an annuity!

That's a sad commentary. I see so many smokers and ex smokers struggling to breathe and sadly it is too late for them. It is terrible and I wish I could do more to alleviate their suffering. Even worse coworkers witnessing these patients struggle to breathe isn't enough for many to quit because the addiction is so strong. I worry about family members who smoke when I implore them to stop. I wouldn't wish the suffering of not being able to breathe on anyone, yet alone my worse enemy.

Specializes in Critical Care.

To Boston FNP, nurses with mental illness but without drug diversion have been forced into recovery programs. I totally agree if a nurse is diverting drugs there must be consequences. But that is not the same thing as nurses with anxiety, depression, bipolar etc being forced into treatment programs when they have done nothing wrong and had no issues at work. I've read on here of cases where nurses with a past history of mental health issues being forced into treatment programs when the board asks them to list any past mental health issues. I don't agree with this at all.

As to another OP that said because we are licensed we should accept and expect higher standards and responsibilities I just want to point out that many workers such as CNA's and beauticians are also licensed. Licensure is not reserved to high ranking, high authority type jobs. Many non healthcare jobs are licensed.

Long Term Care Columnist / Guide

VivaLasViejas, ASN, RN

22 Articles; 9,987 Posts

Specializes in LTC, assisted living, med-surg, psych.
To Boston FNP, nurses with mental illness but without drug diversion have been forced into recovery programs. I totally agree if a nurse is diverting drugs there must be consequences. But that is not the same thing as nurses with anxiety, depression, bipolar etc being forced into treatment programs when they have done nothing wrong and had no issues at work. I've read on here of cases where nurses with a past history of mental health issues being forced into treatment programs when the board asks them to list any past mental health issues. I don't agree with this at all.

Thank you. It astounds me that some people think nurses with mental illness should be subjected to the same punitive measures as those who have drug/alcohol or diversion problems. From everything I've read on the Nurses/Recovery forum, monitoring programs are unnecessarily harsh and often do more harm than good, and that's for the ones who actually need the so-called "help". No one deserves to be humiliated and ripped off, least of all a nurse who has a mental health condition s/he didn't ask for, doesn't want, and which doesn't hurt others.

elkpark

14,633 Posts

As to another OP that said because we are licensed we should accept and expect higher standards and responsibilities I just want to point out that many workers such as CNA's and beauticians are also licensed. Licensure is not reserved to high ranking, high authority type jobs. Many non healthcare jobs are licensed.

I don't believe I said that licensure is reserved to "high ranking, high authority type jobs," and, you're right, there are many licensed occupations outside of healthcare. But what they all have in common is that what they do for a living affects the general health/welfare of the public. Hence, they are licensed precisely because they are considered to have a higher level of responsibility and accountability to the general public, a higher level of responsibility and accountability that they voluntarily assume by choosing to enter their particular occupation or profession, and are therefore held to higher standards of conduct and responsibility than other, non-licensed occupations.

For those bemoaning the whole drug testing at hire and random, a brief listing follows.

Police officer, Firefighter, EMS, Nurses, Doctors, NPs, PAs, CNAs, MAs, truck drivers, factory workers, construction workers, electricians , bus drivers, teachers, teachers aides...etc.

We nurses aren't special, well not in that respect ;)

I can tell you from first-hand experience that the monitoring programs are hideous, expensive and demeaning in everyway possible. I got a DUI on an off-night and was never impaired at work in anyway (trust me they tried to prove it by an investigation). They also suck way, way too many people in. A nurse can be charged with multiple felonies r/t to drug diversion at work and have been stoned at work and another nurse can have a mental health issue (anxiety / depression) for which she sought treatment or had unsubstantiated reports of drug / etoh use by a disgruntled spouse or even had a simple possession charge years before going to nursing school and they are all sucked into the same program with the same consequences. I decided to go along with the monitoring farce. Why? We are back to simple economics. I have a lot invested in my career and in the end to throw it all away would be more expensive then going along with the flogging. Essentially that is why employers would choose to hire a nonsmoker (among other work challenges smokers present) . If smokers cost them another $6000 a year why would they hire one? Later today I'm going to post a brief educational experience with a pre & post test on nurse smoking for my DNP Capstone. If you are interested give it a look and partake. Thanks all

allnurses Guide

BostonFNP, APRN

2 Articles; 5,581 Posts

Specializes in Adult Internal Medicine.

I have never heard of nurses being forced into recovery programs for having mental illness and a valid prescription. As an employer (not a lawyer) I would think this would fall directly under the ADA (which protects discrimination or harassment against mental illness unless an employer has objective evidence of a significant safety risk). There are nurses being put into recovery program for valid prescribed medications?

Wuzzie

5,116 Posts

I have never heard of nurses being forced into recovery programs for having mental illness and a valid prescription. As an employer (not a lawyer) I would think this would fall directly under the ADA (which protects discrimination or harassment against mental illness unless an employer has objective evidence of a significant safety risk). There are nurses being put into recovery program for valid prescribed medications?

I think there was a recent thread about this from a nurse who was but darn if I can find it.

I have never heard of nurses being forced into recovery programs for having mental illness and a valid prescription. As an employer (not a lawyer) I would think this would fall directly under the ADA (which protects discrimination or harassment against mental illness unless an employer has objective evidence of a significant safety risk). There are nurses being put into recovery program for valid prescribed medications?

Yeah it happens. Usually in two forms. First, the nurse has an incident at work and its reported by the employer or a therapist / physician treating the nurse feels compelled to report the treatment to the BON. Neither of these situations need involve substances of any kind or if they are involved they are prescribed. The nurse is then referred to a monitoring program which is centered around recovery from substance abuse. Therefore the nurse doesn't get treated for what's ailing them but rather for what the programs offers (12 step stuff / inpatient / outpatient). In some cases nurses on meds for their condition have the "medical necessity" of those meds reviewed by social workers and other nurses who actually over-ride provider decisions on how to best treat them. There is much wrong with these scenarios not the least of which is medical confidentially, therapeutic relationships and basic medical qualifications to prescribe a treatment regimen. Also, the allegations of mental health stability don't have to be proven. I've seen nurses in these programs who have been stuck there based merely on allegations by ex-spouses and others with a ax to grind. Sound like a witch hunt? It is in my opinion

Oldmahubbard

1,487 Posts

Sounds like a nightmare

allnurses Guide

BostonFNP, APRN

2 Articles; 5,581 Posts

Specializes in Adult Internal Medicine.

That sounds horrendous and the legality of is suspect at best; from a provider standpoint I can't even wrap my head around how a patient with a diagnosis and a valid treatment plan/script could be put into a program without due cause. Someone should call the ADA.

That being said, I would think those unfortunate cases represent a minority of people in the programs though, correct? ''

Nursing boards do seem to be vigilantes when it comes to GMC evaluations. I wonder if this is holdover from the "olden days".

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