Loss of all personal freedom.

Accolay · May 10, 2018

I'm also a veteran. I've made my way in this world not being a protected class from that service, so it irks me that some veterans believe that they should have special privileges due to that (of course beyond those who have mental and physical wounds from war- millions who served never touched conflict. The GI Bill was by far compensation enough.) I want full discolosure: is the OP a smoker, or are they ranting on behalf of the rights of downtrodden smokers everywhere? How does one insert an eyeroll here?

My disclosure is that I'm not a smoker. While I was in the service, I wonder how much second hand smoke I received from smokers and how much more I worked while the smokers were taking their multiple breaks per day? Fun fact: smoking used to be allowed everywhere in the military.... until they noticed the tar was caking up equipment's internals (sensitive electronics) thereby increasing maintenance costs and increasing health costs during and after service. Is that loss of personal freedom or is that rational decision making?

There is freedom for and freedom from. You want to smoke? You're welcome to it as long as 1. Healthcare costs for others don't increase because you pay your fair share. 2. I don't have to inhale either passing by or on your clothing 3. I don't have to see it i.e the millions of cigarette butts that can take a long time to degrade in the environment. I want my freedom from that.

Wuzzie · May 10, 2018

I was kind of thinking the same thing Accolay but you had the balls to say it. In my opinion someone's "personal freedom" stops when it affects my health or my pocket book.

SpankedInPittsburgh, DNP, RN · May 10, 2018

I was kind of thinking the same thing Accolay but you had the balls to say it. In my opinion someone's "personal freedom" stops when it affects my health or my pocket book.

YEP!!!!!

Your personal freedom shouldn't cost me a dime, give me cancer or even force me to smell your horrendously stinky self

SpankedInPittsburgh, DNP, RN · May 10, 2018

Boston,

From what I've seen the mental health cases are in the minority. From what I've seen The majority are DUIs, then hot pee tests, then ancient history cases (treatment before becoming a nurse), then diversion. What I've never seen in any of my groups or talking to other nurses in similar situations is one who was sent to a monitoring program is actually being impaired at work. I did treat a nurse impaired at work in the ER once in 10 years.

MunoRN, RN · May 10, 2018

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".

A valid diagnosis and treatment plan doesn't override the established right of an employer to prohibit the use of certain medications by employees in safety sensitive positions. I'm not in any way defending how Boards of Nursing utilize treatment programs, but typically they will place nurses who are taking prohibited medications at work, even if it's legally prescribed but prohibited by their employer.

HalfBoiled, BSN, RN · May 11, 2018

Let me guess.. healthcare shouldn't be a right?

I don't care about politics, because it was a unproductive distraction while I was in nursing school.

After a few years of working in health care, I do believe health care guidance and directives are agreed in the Liberal spectrum.

I mean, I don't see the justification of $300 for an Epi-Pen.

SpankedInPittsburgh, DNP, RN · May 11, 2018

Healthcare a right?

Is it?

Should it be?

I think you can argue it is. I work at a VA hospital's ER and we can't turn anybody away regardless of their ability to pay even if they are not a Vet. I'm sure other hospitals are subject to the same laws, rules and regulations. I think the issue here is who should pay for the added costs of a potential employee who wishes to continue to smoke? Should it be the employer or the employee? The nurse is / should be allowed to exercise their right of choice but should some 3rd party bear the costs of the employee's personal choice? I don't think so.

The $300 Epi-Pen is a good illustration of the broken economics of our healthcare system. Our healthcare is about twice as expensive as anywhere else and with worse results, Why? In my opinion is because we have a "mixed" public / private system. Government does quite a bit of the funding in our system but they are not allowed to set reasonable fees for services or products. As a result you have a system where the patient has no idea of the costs of the things they need beyond the deductible so they don't really care if the Epi-Pen is $3 or $3000 dollars. They ain't paying anyway. Without cost containment from going to a private system where the free market will set prices or to a public system where the government sets prices you have skyrocketing costs and mediocre results which is exactly what we have now.

Costs also go to patient responsibility. If you are a patient who simply refuses to take steps to ensure your health is it fair that you expect others to pay for your bad decisions? Should the patient bear no responsibility for his or her choices and continued choices? I don't know the answers to these questions & I'm not trying to start an argument but it seems clear to me the funding of our system the way it stands is unsustainable.

allnurses Guide · May 11, 2018

A valid diagnosis and treatment plan doesn't override the established right of an employer to prohibit the use of certain medications by employees in safety sensitive positions. I'm not in any way defending how Boards of Nursing utilize treatment programs, but typically they will place nurses who are taking prohibited medications at work, even if it's legally prescribed but prohibited by their employer.

Yes, but if an employer prohibits a medication (or prohibits smoking or wearing a short skirt or anything else) and the employee disregards that than the employer has a right to fire the employee but I don;t think the employer has any duty or even business reporting that to the BON and the BON should immediately drop that once it finds the employee has a valid script. I mean if an employer catches an employee having relations in the on-call room, should they report that to the BON as a break in the GMC? That's crazy.

mmutk, BSN, RN, EMT-I · May 12, 2018

Surprised to hear this post from someone in the military. Sounds very political.

If an employer doesn't want to hire you because you failed your drug test or you weigh 500lbs it's their choice.

I take it the OP is not a fan of being in a 'right to work' state.

Horseshoe, BSN, RN · May 12, 2018

Surprised to hear this post from someone in the military. Sounds very political.
If an employer doesn't want to hire you because you failed your drug test or you weigh 500lbs it's their choice.
I take it the OP is not a fan of being in a 'right to work' state.

Do you actually mean an "at will" state?

MunoRN, RN · May 12, 2018

Yes, but if an employer prohibits a medication (or prohibits smoking or wearing a short skirt or anything else) and the employee disregards that than the employer has a right to fire the employee but I don;t think the employer has any duty or even business reporting that to the BON and the BON should immediately drop that once it finds the employee has a valid script.

If something is just a workplace infraction that doesn't potentially place a patient at risk for harm then no, nursing boards typically don't consider that to be under their purview. And again, I'm not advocating for how nursing boards deal with these issues, but generally if an employer has prohibited certain medications based on an intention to ensure patient safety, and an employee violates that prohibition, then it's seen as an inability of a nurse to comply with requirements that avoid patient harm. It's the same premise by which boards place nurses in recovery programs for DUI's; it's an instance where a nurse has shown an inability to avoid being impaired and putting others at risk.

I mean if an employer catches an employee having relations in the on-call room, should they report that to the BON as a break in the GMC? That's crazy.

If the patient isn't on break with their patient's covered by other staff and it puts their patients at risk then yes, that is the sort of thing that might be reported to the BON.

Susie2310 · May 13, 2018

Without cost containment from going to a private system where the free market will set prices or to a public system where the government sets prices you have skyrocketing costs and mediocre results which is exactly what we have now.

And we see pharmaceutical and health insurance company stock prices go up when political action to tackle the cost issue is not mentioned (as just recently happened).