Nurse on chronic pain medications, are they discriminated against?

[Red Lantern]

I would like some feedback or experiences or just comments on a nurse, ER specialty, for 15 years, and got burned out and wanted to slow down. I applied for a clinic and when asked to give drug test offered to also include my medications. I have nothing to hide. When my results came back the medical director, of Occ Med., form their home state called and notified me that they are concerned about judgements and decision making due to medications. He wanted my family doctor to provide a list of all meds and a letter of my competency. I started to feel disciminated against but could understand their side. I had been on these meds for several years and workd in a Trauma Center of 300+ patients a years. Never had complaints or issues but was just getting burned out. (the hospital did nothing to help with burnout). My doctor understood the issue and gave a good letter of confidence. Recieved a call from Occ Med Doc this week and said that they felt my decision making process would be impaired. I could appeal and have a pain doctor evaluate me but ultimately they get final say. So I amd waititng to get scheduled for eval by pain doctor but feeling more frustrated and know that most doctors, esp. OccMed under treat, and if he says again after this next eval about my decision making process I feel like saying maybe you are right, I did apply to you clinic! I know I am avoiding surgery and thise complications but with accredidations and experience just feel disriminated against. Maybe this is just to vent. Anybody else have a comment?

[MunoRN, RN]

It's discriminatory if they are not hiring you based on something that isn't relevant to your ability to do the job, so the question is whether or not some medications can affect job performance. There are studies that show employees on chronic pain/anxiety meds are more likely to make errors. I'd argue these studies weren't well controlled (error rates of employees randomly chosen to be un-medicated wasn't assessed), but nonetheless there's an argument to made that this is a work related concern, and therefore non-discriminatory.

[VivaLasViejas, ASN, RN]

I have to admit that I wasn't overly fond of the idea of letting an employer know that I take Klonopin nightly for chronic anxiety, but I'm going to pop positive on the UDS anyway so might as well be upfront about it. I take it at night so I'm clear-headed AND calm the next day (stuff has an amazingly long half-life, which is why I don't need it more than once in a given 24-hour period). Am I functional on it? YES---a lot more than I would be if I were crawling out of my skin with anxiety, which is what happened when I had a severe manic/depressive episode a couple of months ago that got completely out of control and ended with me losing my job.

I think the same goes for any other controlled or mind-altering substance: If you're used to it and know how your body reacts, and if you're on it for long-term maintenance or prevention of a medical condition, there should be no issue with work performance and no harassment on the part of an employer or one's state BON. But that's just my opinion; YMMV.

[xxLionessxx]

When I was not taking pain medication I would literally be in such horrific pain that I didn't make sense- I was out of my head in pain & couldn't function. All I could think about was the pain I was in. When I began taking narcotic pain medication from a Pain Management Specialist it changed my life. I was able to concentrate on work & my patients. I was a much better nurse while on the pain meds than when I was off. I know this is a huge stigma for nurses to work while on pain meds, & when I was younger, less experienced as a nurse, or less experienced as a pain patient I would've probably vehemently disagreed w/working while on pain meds. Now, if I didn't tell you I was on narcotics you'd never know it. I try to explain it like this; for someone who doesn't need legitimate pain meds & who only takes them for the psychological effect it definitely changes their affect. However, when you're in such terrible pain you can't function you're woefully below a normal baseline, & pain meds only lessen the pain enough for you to function normally, which is why ppl wouldn't know I was on them if I don't tell them. There is a tremendous difference between being a pain med addict & addictive behavior and being a chronic severe pain patient & seeking legitimate pain relieving medication. There may still be a physical dependency, but there is no psychological dependency. This is the difference. There have been vast & thorough studies done to explain the difference & they clearly show that those who take opiates/narcotics for legitimate pain relief have an extremely low precedence to become addicted to them.