NOW what?? Terrified...

Published

Hello All,

Its hard to even write this out.... I just became an RN in Florida after 15 years of being an LPN. I'm prescribed percocet and Soma for the past 4 year due to back and neck issues. While going through orientation my supervisor notice I was a little sleepy and had me take a drug test at the hospital (blood sample as I could not make enough urine). I was sent home and pulled of the schedule pending the results. This all went down early a few days ago. Now I know that THC is going to show up on my drug screen as well as the meds I'm prescribed. I get why my supervisor pulled me off and drug tested me and understand there are consequences for my actions. What I know nothing about is what the next steps will be? Will I get fired? Will they send me to IPN and put me back on the schedule once I finish? Will they let me work anywhere else as a RN while I go through the program? How expensive is the program? I just feel so lost right now.....

Yeah admitting you have a problem is the key to monitoring. Without it they have no real way to push all this “treatment” on you and deep mine your bank accounts. However, the way it was presented to be was that it was the only way to save my professional life. Once again I wish I had legal counsel at the time (my fault). Once you admit you have a problem and sign the monitoring contract you are in for a multi year ride that is horrible in my experience. Get a lawyer that does this stuff and make sure you aren’t getting more punishment than the “crime” calls for. I trusted the process and it cost me thousands of dollars and untold anxiety. These programs don’t differentiate between isolated poor choices and total addiction. Or for that matter between mental health issues and addiction. Everyone is thrown in the same program whether they were high as a kite at work and stealing drugs or they simply smoked a joint (legal in many states) or bought otc oils that will pop a pee test. It’s not a good existence especially when you don’t consider yourself an addict. I wish you luck but fear you may be the next addition to this meat grinder which simply stinks

The meds/recreational drugs you are taking/using are affecting your level of consciousness, and that is reason alone for termination regardless of whether or not you have a prescription.

I would honestly assume you are going to be terminated and hope that you don't lose your license. You need to focus now on damage control so that this job doesn't affect your next one.

Specializes in Medsurg.
15 hours ago, catsmeow1972 said:

All true, but BONs and by extension monitoring programs consider the presence of ANY level of THC to be verboten. It matters not wether it’s from a little CBD oil or from the person having gotten totally baked over their weekend.
Were the issue simply what the OP has scripts for, the only concern might be what Hppy has referred to. Like pilots, nurses cannot be reporting to work seeming to be under the influence of ANYTHING.
As a level of THC has yet to be established that renders a person ‘not impaired’ the only acceptable result for The BON is zero. The THC is what will grab the attention of IPN.

What the employer does varies. Some will gently suggest a self report to IPN, others will call up the board and nail a person to the wall. Some fire, some hold a persons position. Either way, getting from here to being cleared to go back to work is not a matter of a few days/weeks. I would easily expect 6 weeks or more and that is if they don’t require any kind of inpatient or outpatient treatment (which is highly unlikely. These people think treatment programs are the fix all solution to every problem, even non-substance problems). A concern I see is that the OP has scripts for controlled substances. IPNs ‘approved’ evaluators look askance at the use of any of these things while under contract. Sure you can take them, but don’t think you’ll be allowed to work. I strongly suspect you will be required to stop those too.
If the THC does not show, you MAY have dodged a bullet, but considering the climate out there nowadays, I would dig in and be prepared for the long haul.

I was inpatient at a World renowned quaternary Medical center that was not in my state of licensure. My intracranial pressure was dangerously high to the point where I was losing my vision. I was referred emergently out of state. I was given oxygen, close monitoring, iv lasix, iv acetazolamide, iv Zofran, iv phenergan and marinol as well as other non scheduled meds.

I was off work for months while my ICP was getting stabilized on the fluid restriction, high dose lasix and very high dose diamox and very high dose toprol xl. I am normal weight so the high icp isn’t my fault. I am not a candidate for a shunt due to a connective tissue disorder. If I thought, for a minute that medication they gave me while inpatient was against board rules I certainly would have refused it. It was only 2 doses and I didn’t find out until I was discharged. They poked a hole in it and it was given sublingual. I’m not sure if they were using it for the high pressure or to help stop the 3 days of continuous projectile vomiting. this was In august of 2018. It’s on my permanent medical record that I willingly took it. I wasn’t in the position to question anyone’s expertise. At the time I didn’t even question it. I guess I should have. Should I self report those 2 doses Of THC MARINOL and send the MAR records to the BON? What kind of discipline should I expect? How will they hold me accountable for this lapse in judgement. Would they want me to stop the DIAMOX? I know pilots are not allowed to take diamox unless they have specific permission from the FAA, pilots also lose their license if they have any diagnosis that affects intracranial pressure. Do I need to see an attorney first ?

molly

Specializes in OR.
14 minutes ago, Molly90210 said:

I was inpatient at a World renowned quaternary Medical center that was not in my state of licensure. My intracranial pressure was dangerously high to the point where I was losing my vision. I was referred emergently out of state. I was given oxygen, close monitoring, iv lasix, iv acetazolamide, iv Zofran, iv phenergan and marinol as well as other non scheduled meds.

I was off work for months while my ICP was getting stabilized on the fluid restriction, high dose lasix and very high dose diamox and very high dose toprol xl. I am not a candidate for a shunt due to a connective tissue disorder. If I thought, for a minute that medication they gave me while inpatient was against board rules I certainly would have refused it. It was only a 2 doses and I didn’t find out until I was discharged. They poked a hole in it and it was given sublingual. I’m not sure if they were using it for the high pressure or to help stop the 3 days of continuous projectile vomiting. this was In august of 2018. It’s on my permanent medical record that I willingly took it. I wasn’t in the position to question anyone’s expertise. At the time I didn’t even question it. I guess I should have. Should I self report those 2 doses and send the MAR records to the BON? What kind of discipline should I expect? How will they hold me accountable for this lapse in judgement. Would they want me to stop the DIAMOX?

molly

Ahh, hell I wouldn’t peep. Unless you are on the radar of one of these things, it isn’t relevant. IMO, it’s not relevant regardless, but these people have the unique ability to twist a persons statements into whatever they need to justify trapping them into treatment and contracts. It is is truly an ‘anything you say can and will be used against you....” Plus, any quack that tries to claim a drug problem based off of appropriate usage of medication, as you describe, would be roast beef for a lawyer.

what is being referred to here in terms of THC is the OP having used either CBD or actual THC (I’d have to refer back to the post), NOT under a doctor’s order. Never minding the reason she got pulled for a test to begin with, having what is effectively a controlled substance show up that cannot be explained by a valid prescription is the issue.

Specializes in Medsurg.

A person above said we had the same standards as pilots. I know for a fact that pilots aren’t allowed to take diamox or have any intracranial pressure issues. I will be on diamox for life. I wasn’t aware the BON AND FAA had the same rules. But I guess it is the safest. When I am in a plane I can certainly tell the barometric pressure changes. I could never work where there were rapidly changing barometric pressures.

Specializes in ED RN and Case Manager.

@Molly90210

Are you in a Nursing Board Monitoring program?

If you are- than the program must keep a record of any drug you ingest- both prescription or OTC.

If you’re not- than no, you don’t need to disclose anything to the BON. When you took that Marinol, you were being treated for a life-threatening emergency. You were in a hospital setting, not working, and not at risk of being in your work setting, potentially “under the influence”. The BON is not interested in these cases. Their primary mission is to “Protect the Public” from nurses that may be taking care of patients while altered. I was one of those nurses & legitimately ended up in a state nursing compliance program. I needed to be monitored. Based on what you’ve shared, you do not.

As far as Diamox- I currently work with another RN that takes this medication for pseudo tumors behind her eyes. She just came back to our hospital, so apparently she passed drug screening with zero issues! (Off subject- she’s an awesome nurse)!

If Diamox is something legitimately prescribed for a medical condition, I don’t believe the BON would have any interest in these situations either. It would only be on their radar if the nurse was reported as appearing to be at work “impaired” or “under the influence”, etc. If this occurred, the BON would be obligated to do a further investigation.

As it is now- if you aren’t currently in a monitoring program- don’t worry about it. Your 2 doses of Marinol never needs to be disclosed. And keep taking your Diamox as prescribed. Please, stay healthy by treating your condition as the physician recommends!

One more note- don’t beat yourself up over taking the Marinol. You were being treated for an emergent condition with elevated ICP & projectile vomiting. You did nothing wrong! Vomiting must be controlled in this situation. If this occurred again- you could potentially need the same treatment & the benefits would outweigh the risks. If you happened to have to take a UDS after discharge, you would have your medical records to back you up.

Best wishes! ?

Specializes in ED RN and Case Manager.

@erocafeller

As others have mentioned, your prescription meds may or may not be an issue if you have valid prescriptions for these. Usually, they would be fine with a prescription (e.g., during an employment screen)- except that it was mentioned that you appeared sleepy. I’m not sure how that will play out since they may say that your RX meds may cause a danger to patients if the nurse isn’t awake & alert. Since they could handle this many different ways, I can’t even speculate on that.

THC- yes, this WILL definitely be a problem, if detected. Again, as others stated, this isn’t accepted even in states where sale of it is legal. Even CBD oil has caused huge issues for nurses. What may work in your favor is that you weren’t able to submit a UDS so they obtained blood, instead. From what I’ve read, THC has a much shorter detection period in blood. If you didn’t ingest it in the 3-4 days before your blood test, you may get lucky. The metabolites are detected in urine for days, weeks or months, depending of the amount & frequency that marijuana is taken. That’s why nursing compliance programs usually order urine drug tests. They can catch a “slip-up” or relapse from weeks ago. However, they don’t usually order blood (except for alcohol PeTH testing) as most substances are only detected for hours after ingested. Marijuana is a little longer; but, still, only detected in blood from a few hours to 3-4 days. It’s a much shorter period than in urine.

That said- if you do “get by” with this occurrence, you must stop the THC immediately! I’m not judging. We each have our own past & reason for being a member of this forum. I have many regrets but have certainly grown from my mistakes. I’m almost at the end of my program & love where I am today (mentally & with my employment). This is a great place to come for support & encouragement.

Please keep us up to date. You said it was hard to write that post. Don’t be ashamed to come here & update, please. Believe me- I’ve done worse, as have many of us! We all care, which is why we’ve responded. If you have further penalties from this blood test, let us know. We’ll walk you through the process based our our experiences. I’m in a different state, but there are many nurses on this site that have been involved with IPN.

And if everything turns out okay, we’ll cheer you on- with a reminder to stop THC. You will have been lucky & given a second chance. Continuing this would be playing Russian Roulette with your nursing license.

Best of luck!

KyBeagle

Specializes in NICU.

Who is prescribing percocet for "issues"?Becareful,this is a chance to correct your choices and continue your career.Best of luck.

Specializes in Neurovascular Surgery.

Guess I'd be terrified as well.

I'm bothered by your use of opioids for 4 years and wonder why as a health professional you don't realize it's not in your best interest given all of the news about opioid use that you wouldn't seek an alternative. That with admitted use of TCH leads me to think you have a problem. I also wonder who is prescribing this for you for the past 4 years.

I'm sorry, but I find it hard to have sympathy for you.

Specializes in Home care.
19 hours ago, Molly90210 said:

I was inpatient at a World renowned quaternary Medical center that was not in my state of licensure. My intracranial pressure was dangerously high to the point where I was losing my vision. I was referred emergently out of state. I was given oxygen, close monitoring, iv lasix, iv acetazolamide, iv Zofran, iv phenergan and marinol as well as other non scheduled meds.

I was off work for months while my ICP was getting stabilized on the fluid restriction, high dose lasix and very high dose diamox and very high dose toprol xl. I am normal weight so the high icp isn’t my fault. I am not a candidate for a shunt due to a connective tissue disorder. If I thought, for a minute that medication they gave me while inpatient was against board rules I certainly would have refused it. It was only 2 doses and I didn’t find out until I was discharged. They poked a hole in it and it was given sublingual. I’m not sure if they were using it for the high pressure or to help stop the 3 days of continuous projectile vomiting. this was In august of 2018. It’s on my permanent medical record that I willingly took it. I wasn’t in the position to question anyone’s expertise. At the time I didn’t even question it. I guess I should have. Should I self report those 2 doses Of THC MARINOL and send the MAR records to the BON? What kind of discipline should I expect? How will they hold me accountable for this lapse in judgement. Would they want me to stop the DIAMOX? I know pilots are not allowed to take diamox unless they have specific permission from the FAA, pilots also lose their license if they have any diagnosis that affects intracranial pressure. Do I need to see an attorney first ?

molly

I am I the only one confused by this thread?

@erocafeller.... did you hear back on the blood test? Hope thc did not show up.

@Molly90210... you might want to start your own thread... your question/statement is in response to a Florida nurse who smoked weed and was in orientation. Your story is totally different... no don’t tell the BON about anything unless it is demanded for some odd reason. Am I missing something here? If I had surgery and was given morphine... and I wasn’t in monitoring program... I certainly wouldn’t tell the BON. That’s your business.

When I appeared “sleepy” on the job, I was hauled off to employee health and peed in a cup and forced to spend the night at the hospital (they wouldn’t allow me to drive home). It came back positive for an opioid for which I had a legitimate prescription. But it didn’t end there. There were also “levels” that were tested and they eventually came back as too high. In other words, I was taking too much of my own ***. Nothing illegal in my system.

I admitted myself into a psych unit (maybe a mistake) for depression and “dual diagnosis” because I knew in my heart, and in that cup, that I was abusing my own meds. But it was more depression and what was going on in my life that was killing me, though eventually the pills would have done it.

Six months and a new job later, they had to “protect the public” so I got signed up in monitoring. I never stopped working as a nurse. I was also lucky for that. This month makes five years for me and I’m down to the last three weeks.

My point? Yes, you CAN get in trouble with your own legitimate medications, and most definitely if the THC was in your system. But, do not despair. There is always hope. And decide what you really want and if nursing is worth fighting for, do it! Is the BON/monitoring/BS an expensive load of crap? From what I’ve seen here and experienced firsthand, yes it is. But it is a means to an end. And maybe, just maybe, you’ll get something out of it. If nothing else, I have way better coping skills than I did five years ago.

Sorry for the long post. Good luck and keep up with this forum; I wish I had been on this site the entire time to help me battle the shame, guilt and despair.

Specializes in ED RN and Case Manager.

@erocafeller Any update on your results & current situation?

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