Nurse doing cocaine HELP

targa · Jul 15, 2005

I sincerely hope noone thinks it's "okay NOT to report this nurse". I suspect the biggest reason people are encouraging the OP to not report the illegal activity is out of fear of litigation. We are becoming a society which doesn't want to take action out of fear of appearing before a judge and jury and having to justify why we did the right thing. Sooooo very unfortunate.

Sorry, psychrn03, but I disagree. Committing an illegal act is not necessarily grounds for discharge from employment. In fact, in some states, a person's employment status may be protected even after a criminal conviction. It all depends on the state, the contract of employment (if there is one), the terms of the nurse practice act in question, and the employer status (some public employees have greater legal protections than employees of private concerns).

Here, however, there is not enough evidence to convince the HR department to even confront the nurse, let alone compel her to take a drug test. Unless her job performance is visibly impacted by her drug use, the employer is on shaky grounds in initiating any action based on the flimsy evidence recited by the original poster. If I were the legal advisor to the hospital HR staff, and all I had was a report by a non-employee that some nurse was seen using cocaine off the hospital grounds, my advice would be to do nothing. The hospital faces legal risks if it attempts to take action without sufficient proof. There is no such proof here.

Further, departing from the legal analysis, I'm not convinced that witnessing a single incident of cocaine use is compelling enough to cause you and others to get on your high horse of moral indignation. People do things to themselves all the time: they drink, they smoke, they smoke pot, they take a few more prescription pain meds than prescribed, they engage in sex, etc. Until 2003, when the Supreme Court tossed the law out on privacy grounds, it was illegal in Texas (and some other states) for two men to have sex with one another. Would you have advocated firing a gay nurse for engaging in oral sex with another man in a bathhouse? Let's see... presume for a moment that that gay nurse was picking up STD's and then not using sterile technique when he returned to work. Was he placing his patients at greater risk than the nurse whose weekend cocaine use had metabolized before she returned to work on Monday morning?

The fact is, the only consideration here should be the nurse's job performance. If she is performing her duties as expected, it is really none of your business what she does off the job. If her cocaine usage is heavy and she is becoming adversely impacted by it, that will soon become evident and she may well be fired (or forced into rehab) soon enough. But in the meantime, we do not live in a "Minority Report" world where we punish people for what we think they might do. Your feelings of moral superiority are disturbing.

jwhitaker23 · Jul 15, 2005

I don't know if the hospital would really be on that shaky of ground by doing a "random" drug test. While I agree that what you do on your own time is up to you, if you feel that this nurse's patients are in danger because of her drug use, then you should report her. The patients safety and well being should be the key here, not whether a friendship is in danger, a lawsuit could be brought or someone's feelings may get hurt.

TypicalFish · Jul 15, 2005

Sorry, psychrn03, but I disagree. Committing an illegal act is not necessarily grounds for discharge from employment. In fact, in some states, a person's employment status may be protected even after a criminal conviction.
I find this a continuing and tiresome argument-several people keep posting here in defense of this nurse. I am sure that the above poster has some "legal" points; but that is splitting hairs, what most people here are saying is this: IF this nurse has a drug habit, then she should not be caring for patients. I don't think that that is being on a "moral high horse"-would you as quickly defend someone's "right" to drink and drive?I wonder if some of the "defenders" may have some of their own issues with this subject to be taking common-sense suggestions so personally. It's not about "judging" someone, it is merely about what is safe, what is not safe. And even if you wanted to "defend" the nurse doing coke, wouldn't be better to report her, and get her help-what happens if she makes a mistake and it comes out that she was using? What would her "protected legal status" be then?

rn/writer, RN · Jul 15, 2005

further, departing from the legal analysis, i'm not convinced that witnessing a single incident of cocaine use is compelling enough to cause you and others to get on your high horse of moral indignation.

the reaction many of us had was that the cocaine-using nurse was not only doing something illegal, she was doing it brazenly in front of another nurse. lori was po'd that this unthinking/uncaring person put her on the spot. you don't have to get on a "high horse of moral indignation" to say this nurse has a problem. she works in an icu, for pete's sake.

people do things to themselves all the time: they drink, they smoke, they smoke pot, they take a few more prescription pain meds than prescribed, they engage in sex, etc. until 2003, when the supreme court tossed the law out on privacy grounds, it was illegal in texas (and some other states) for two men to have sex with one another. would you have advocated firing a gay nurse for engaging in oral sex with another man in a bathhouse? let's see... presume for a moment that that gay nurse was picking up std's and then not using sterile technique when he returned to work. was he placing his patients at greater risk than the nurse whose weekend cocaine use had metabolized before she returned to work on monday morning?

there are some big holes in this scenario. while this behavior may have been illegal, i doubt that an employer would mention stds specifically under conditions of employment and incorporate random or "for cause" testing in their policy as nearly all employers do now for drugs. second, not using sterile technique is grounds enough for closer scrutiny. and just for the sake of argument, there's a good chance that someone in a position to know about another's clandestine bathhouse activites might have a little something of their own to hide.

the fact is, the only consideration here should be the nurse's job performance. if she is performing her duties as expected, it is really none of your business what she does off the job. if her cocaine usage is heavy and she is becoming adversely impacted by it, that will soon become evident and she may well be fired (or forced into rehab) soon enough.

lori raised a concern that icu nurses have access to many narcs. this is a minefield for two reasons. one is that it sometimes takes months or years of judicious diversion for a person to get caught. meanwhile, patients suffer from being undermedicated. the other reason is the great responsibility that and icu nurse has. keeping track of complicated drips, vents, etc. can be taxing under the best of conditions. this nurse might not be coked up per se when she's at work but she can still be impaired by fatigue and clouded judgment r/t coke.

but in the meantime, we do not live in a "minority report" world where we punish people for what we think they might do. your feelings of moral superiority are disturbing.

we should not become a nation of tattletales. but too many people look the other way for fear of getting sued or making someone mad. there are situations that cry out for a response and that don't have anything to do with feeling "morally superior."

if i ever found myself with another nurse who was flaunting her illegal behavior and dragging me into the middle of it, i would be so angry. not just over the drug use, but over the assumption that i wouldn't react. for all any of us knows, this other nurse might be a very nice person. but her behavior and her judgment stink.

i wish lori would come back and give us an update.

miranda

PMHNP10 · Jul 16, 2005

Sorry, psychrn03, but I disagree. Committing an illegal act is not necessarily grounds for discharge from employment. In fact, in some states, a person's employment status may be protected even after a criminal conviction. It all depends on the state, the contract of employment (if there is one), the terms of the nurse practice act in question, and the employer status (some public employees have greater legal protections than employees of private concerns).

If you disagree that she should get help then the conversation is over; other than that I'm not sure what you are disagreeing with because I never said anything about her losing her job. But since you mentioned it, if she happens to be caught with cocaine which isn't outside the realm of possibilities given her poor judgement, it'll be pretty hard for her to work while incarcerated.

Here, however, there is not enough evidence to convince the HR department to even confront the nurse, let alone compel her to take a drug test. Unless her job performance is visibly impacted by her drug use, the employer is on shaky grounds in initiating any action based on the flimsy evidence recited by the original poster. If I were the legal advisor to the hospital HR staff, and all I had was a report by a non-employee that some nurse was seen using cocaine off the hospital grounds, my advice would be to do nothing. The hospital faces legal risks if it attempts to take action without sufficient proof. There is no such proof here.
Further, departing from the legal analysis, I'm not convinced that witnessing a single incident of cocaine use is compelling enough to cause you and others to get on your high horse of moral indignation. People do things to themselves all the time: they drink, they smoke, they smoke pot, they take a few more prescription pain meds than prescribed, they engage in sex, etc. Until 2003, when the Supreme Court tossed the law out on privacy grounds, it was illegal in Texas (and some other states) for two men to have sex with one another. Would you have advocated firing a gay nurse for engaging in oral sex with another man in a bathhouse? Let's see... presume for a moment that that gay nurse was picking up STD's and then not using sterile technique when he returned to work. Was he placing his patients at greater risk than the nurse whose weekend cocaine use had metabolized before she returned to work on Monday morning?
The fact is, the only consideration here should be the nurse's job performance. If she is performing her duties as expected, it is really none of your business what she does off the job. If her cocaine usage is heavy and she is becoming adversely impacted by it, that will soon become evident and she may well be fired (or forced into rehab) soon enough. But in the meantime, we do not live in a "Minority Report" world where we punish people for what we think they might do. Your feelings of moral superiority are disturbing.
Oh stop it. There is absolutely nothing I'm saying which is a moral judgement. My statements are based on my experience and on other's experience, and on a long long history of people using illegal drugs. I'm not making guesses. Also bear in mind that I've never said she should be arrested or fired. I've said she needs help. It's a very reasonable concern.
Other than your listing of MJ and EtOH, none of what you listed jeopardizes a person's life. You are comparing cocaine use with sex, smoking...seriously? Tell ya what, it's obvious that you have your opinion for whatever reason; how bout the suggestion made for the OP to contact the BON to see what should be done given the circumstances. The OP doesn't have to give names, just seeks advice. Surely that would be an acceptable solution?

PMHNP10 · Jul 16, 2005

IF this nurse has a drug habit, then she should not be caring for patients. I don't think that that is being on a "moral high horse"-would you as quickly defend someone's "right" to drink and drive? I wonder if some of the "defenders" may have some of their own issues with this subject to be taking common-sense suggestions so personally. It's not about "judging" someone, it is merely about what is safe, what is not safe. And even if you wanted to "defend" the nurse doing coke, wouldn't be better to report her, and get her help-what happens if she makes a mistake and it comes out that she was using?

:yeahthat:

Home Health Columnist / Guide · Jul 16, 2005

part of our professional accountablity is to maintain the standards and unhold the laws of our profession. most nurse practice acts have sections of law similar to pa:

section 14. refusal, suspension or revocation of licenses.--

(a) the board may refuse, suspend or revoke any license in any case where the board shall find that--

(1) the licensee is on repeated occasions negligent or incompetent in the practice of professional nursing or dietetics-nutrition.

(2) the licensee is unable to practice professional nursing with reasonable skill and safety to patients by reason of mental or physical illness or condition or physiological or psychological dependence upon alcohol, hallucinogenic or narcotic drugs or other drugs which tend to impair judgment or coordination, so long as such dependence shall continue. in enforcing this clause (2), the board shall, upon probable cause, have authority to compel a licensee to submit to a mental or physical examination as designated by it. after notice, hearing, adjudication and appeal as provided for in section 15, failure of a licensee to submit to such examination when directed shall constitute an admission of the allegations against him or her unless failure is due to circumstances beyond his or her control, consequent upon which a default and final order may be entered without the taking of testimony or presentation of evidence. a licensee affected under this paragraph shall at reasonable intervals be afforded an opportunity to demonstrate that he or she can resume a competent practice of professional nursing with reasonable skill and safety to patients.

(f) any hospital or health care facility, peer or colleague who has substantial evidence that a professional has an active addictive disease for which the professional is not receiving treatment, is diverting a controlled substance or is mentally or physically incompetent to carry out the duties of his license shall make or cause to be made a report to the board: provided, that any person or facility who acts in a treatment capacity to impaired professionals in an approved treatment program is exempt from the mandatory reporting requirement of this subsection. any person or facility who reports pursuant to this section in good faith and without malice shall be immune from any civil or criminal liability arising from such report. failure to provide such report within a reasonable time from receipt of knowledge of impairment shall subject the person or facility to a fine not to exceed one thousand dollars ($1,000). the board shall levy this penalty only after affording the accused party the opportunity for a hearing, as provided in title 2 of the pennsylvania consolidated statutes (relating to administrative law and procedure).

http://www.dos.state.pa.us/bpoa/lib/bpoa/20/nurs_board/nurseact.pdf

if professional consultation needed, please pm me. any member of the mod team can be contacted too for guidance.we're allways glad to help our peers. please feel free to contact us if you want to give us an update to post here. if the op wishes to maintain silent on the outcome that's ok.

targa · Jul 16, 2005

Part of our professional accountablity is to maintain the standards and unhold the laws of our profession. Most nurse practice acts have sections of law similar to PA:
Section 14. Refusal, Suspension or Revocation of Licenses.--
(a) The Board may refuse, suspend or revoke any license in any case where the Board shall find that--
(1) The licensee is on repeated occasions negligent or incompetent in the practice of professional nursing or dietetics-nutrition.
(2) The licensee is unable to practice professional nursing with reasonable skill and safety to patients by reason of mental or physical illness or condition or physiological or psychological dependence upon alcohol, hallucinogenic or narcotic drugs or other drugs which tend to impair judgment or coordination, so long as such dependence shall continue. In enforcing this clause (2), the Board shall, upon probable cause, have authority to compel a licensee to submit to a mental or physical examination as designated by it. After notice, hearing, adjudication and appeal as provided for in section 15, failure of a licensee to submit to such examination when directed shall constitute an admission of the allegations against him or her unless failure is due to circumstances beyond his or her control, consequent upon which a default and final order may be entered without the taking of testimony or presentation of evidence. A licensee affected under this paragraph shall at reasonable intervals be afforded an opportunity to demonstrate that he or she can resume a competent practice of professional nursing with reasonable skill and safety to patients.
(f) Any hospital or health care facility, peer or colleague who has substantial evidence that a professional has an active addictive disease for which the professional is not receiving treatment, is diverting a controlled substance or is mentally or physically incompetent to carry out the duties of his license shall make or cause to be made a report to the Board: Provided, That any person or facility who acts in a treatment capacity to impaired professionals in an approved treatment program is exempt from the mandatory reporting requirement of this subsection. Any person or facility who reports pursuant to this section in good faith and without malice shall be immune from any civil or criminal liability arising from such report. Failure to provide such report within a reasonable time from receipt of knowledge of impairment shall subject the person or facility to a fine not to exceed one thousand dollars ($1000). The Board shall levy this penalty only after affording the accused party the opportunity for a hearing, as provided in Title 2 of the Pennsylvania Consolidated Statutes (relating to administrative law and procedure).
If professional consultation needed, please PM me. Any member of the Mod Team can be contacted too for guidance.We're allways glad to help our peers. Please feel free to contact us if you want to give us an update to post here. If the OP wishes to maintain silent on the outcome that's ok.

I'd like to point out three short phrases upon which this whole matter turns:

1. "physiological or psychological dependence": there is evidence of usage here, but not of dependence;

2. "upon probable cause": probable cause will not exist if based solely upon the word of [an admittedly biased] single witness; and

3. "substantial evidence that a professional has an active addictive disease": the OP's testimony alone would not constitute substantial evidence, nor do there appear to be facts tending to show "addictive disease", as opposed to occasional use.

I don't mean to be a contrarian; we are a nation of laws... and nursing is a tightly-regulated profession where standards of conduct are judged by legal norms. While I certainly wouldn't want a coke addict tending to me in an ICU, absolutely nothing will be gained by making a report to the BON. If I were the OP, I would do this (and read carefully): I would visit my friend, the DON (or unit manager, I forget who it is), and suggest that she pay close attention to whether one of her employees is under the influence of an illegal substance while on the job... nothing more need be said. I'm willing to bet that some people have already noticed a few things about someone. Take it from there.

Roy Fokker, BSN, RN · Jul 16, 2005

I find this a continuing and tiresome argument-several people keep posting here in defense of this nurse. I am sure that the above poster has some "legal" points; but that is splitting hairs, what most people here are saying is this: IF this nurse has a drug habit, then she should not be caring for patients. I don't think that that is being on a "moral high horse"-would you as quickly defend someone's "right" to drink and drive?I wonder if some of the "defenders" may have some of their own issues with this subject to be taking common-sense suggestions so personally. It's not about "judging" someone, it is merely about what is safe, what is not safe. And even if you wanted to "defend" the nurse doing coke, wouldn't be better to report her, and get her help-what happens if she makes a mistake and it comes out that she was using? What would her "protected legal status" be then?

As I posted before -- I have absolutely no problems with people using drugs.

I DO have a problem if those people who use drugs have their ability impaired and they are at work.

If you see me out on Saturday night and I wash down beer after beer - are you going to report me for alcohol dependency? Ofcourse not. But you will (and should) report me if I come in the next day badly hungover and impaired.

Simple.

gypsyatheart · Jul 16, 2005

I have not read all 13 pages of this thread, just the 1st and last couple of pages...and all I can say is...... WOW! :smackingf

I can not believe this is even an issue! A nurse displayed illegal activity, in public, in front of strangers.....

Does she need to be reported? Uh...yeah! :uhoh3: I can not believe this is even a question! All that needs to be done is an anonymous call to the Nurse Mgr of the unit...if the OP is not comfortable, then someone else does it. Simply state that so and so nurse was observed to be doing an illegal substance. The Mgr will have that nurse doing drug screening faster than her head can spin!

And, no there is not an issue w/random drug screens. I worked w/a group of nurses that were very, shall we say, coke happy. Their little party lasted for quite a while, maybe a year or so. Guess what happenned to each and every one of them...got reported (not by me, this is when I was still quite naive, many years ago); drug tested, sent through a diversion program and at last count at least 3 of them had permanently lost their licenses d/t not staying clean. One of them ended up in jail.

The original thinking was....'oh, it's fine, I only party when I'm off, it's ok...."; to "well i party all the time now, call in sick cause I'm too ***'d up to go to work", to exchanging drugs/money on breaks to going out to their cars at lunch to get high! I saw it all unfold in front of my eyes. I felt the same way...did not know what to do, was scared cause I was friends w/one of these nurses. Ran for the hills when I saw their house of cards coming down.

Don't be fooled .....being a coke addict is no joke, this person needs help, better sooner than later. Maybe your intervention will keep patients under her care safe and help save her license!

TypicalFish · Jul 16, 2005

As I posted before -- I have absolutely no problems with people using drugs.
I DO have a problem if those people who use drugs have their ability impaired and they are at work.
If you see me out on Saturday night and I wash down beer after beer - are you going to report me for alcohol dependency? Ofcourse not. But you will (and should) report me if I come in the next day badly hungover and impaired.
Simple.

Roy I am not sure why my post is in your post. The very top part of my most recent post is from a post that I was DISAGREEING with. (yikes! does that even make sense?)I was saying that there are some posters here who have been defending this nurse's drug use-which i find beyond believeable. It is a tiresome debate, because there should be no debate; this nurse is probably a danger to her patients and should be reported. period.

targa · Jul 16, 2005

I have not read all 13 pages of this thread, just the 1st and last couple of pages...and all I can say is...... WOW! :smackingf
I can not believe this is even an issue! A nurse displayed illegal activity, in public, in front of strangers.....
Does she need to be reported? Uh...yeah! I can not believe this is even a question! All that needs to be done is an anonymous call to the Nurse Mgr of the unit...if the OP is not comfortable, then someone else does it. Simply state that so and so nurse was observed to be doing an illegal substance. The Mgr will have that nurse doing drug screening faster than her head can spin!
And, no there is not an issue w/random drug screens. I worked w/a group of nurses that were very, shall we say, coke happy. Their little party lasted for quite a while, maybe a year or so. Guess what happenned to each and every one of them...got reported (not by me, this is when I was still quite naive, many years ago); drug tested, sent through a diversion program and at last count at least 3 of them had permanently lost their licenses d/t not staying clean. One of them ended up in jail.
The original thinking was....'oh, it's fine, I only party when I'm off, it's ok...."; to "well i party all the time now, call in sick cause I'm too ***'d up to go to work", to exchanging drugs/money on breaks to going out to their cars at lunch to get high! I saw it all unfold in front of my eyes. I felt the same way...did not know what to do, was scared cause I was friends w/one of these nurses. Ran for the hills when I saw their house of cards coming down.
Don't be fooled .....being a coke addict is no joke, this person needs help, better sooner than later. Maybe your intervention will keep patients under her care safe and help save her license!

"The Mgr will have that nurse doing drug screening faster than her head can spin!"

No... that's just not gonna happen. A sordid tale of a "nurse displaying illegal activity in public" sounds so compellingly damning, but it's simply not enough to cause HR and the nurse manager to initiate a drug screening. I'm amazed at the number of nurses who don't understand the concept of "due process". Maybe the nursing schools should be teaching a course in basic principles of law. One may not be compelled to give evidence against himself/herself in a workplace investigation unless there is reasonable suspicion that the person is using illegal narcotics. The definition of "reasonable suspicion" has filled tens of thousands of pages of court decisions, but suffice it to say that it does NOT exist where the only evidence in support of reasonable suspicion is the statement of a witness regarding what he/she has allegedly seen. Otherwise, every one of us could maliciously cause harm to innocent persons by claiming to see something we did not, thereby initiating an investigation into someone's life.

Large employers such as hospitals have to comply with a huge and complicated assortment of state and federal law regarding employees... like the Civil Rights Act of 1964, the ADA (disabilities), ADEA (age), OSHA regulations, the federal Drug Free Workplace Act of 1988, DOT drug testing regulations, and privacy laws and regulations. In addition, there is the matter of union contracts and other employee agreements. If hospitals do not properly initiate investigations of employee conduct, there are huge ramifications in the form of claims for defamation, infliction of emotional distress, assault and battery, malicious prosecution, invasion of privacy, and retaliation. The most common and accepted basis for beginning an investigation and requesting a drug test is well-documented evidence by a supervisor and fellow employees of work performance and behavioral problems on the job site.

I have advised both employers and employees regarding workplace investigations. One cannot demand that an employee take a drug test simply because a stranger has orally reported an employee's off-premises use of what appears to be a controlled substance. If you believe otherwise, you are sadly and naively mistaken.