Pre- employment drug testing

chances-r · Oct 27, 2009

Hello everyone! I was just in a different area:first year in nursing, and there was an interesting post. So i went looking around the site and found this area.
The post was about being prescribed a narcotic, xanax prn for anxiety and the person was worried about it showing up on their preemmployment drug screen. This is a very interesting question and it led me to think about what are the rules for pre employment drug screening. If anyone could help, Id greatly appreciate it!
Do you have to disclose information as to what meds you are on?
If it is a narcotic do you have to disclose this info?
I know the med that I am worried about is confidential information, and it may show up on a drug screen, how do I deal with that? If i tell them what I am on, I am worried I will be judged and maybe the decision as to whether or not I will be hired wont be affected, but I feel like alot of people will look down on me and may find another reason to fire or dismiss me from the job.
I am not on an amt that will impair my judgement, I am actually on a VERY LOW DOSE and always have been- actually tapering down but that is a slow process- I just dont feel like I shouldnt have to disclose this information. I take my meds as prescribed, I see the Doctor regularly- if i couldnt function or the doctor felt my judgement was impaired, I would not be allowed to keep my license and get behind the wheel and drive. I never disclosed this info to my nursing school, as I felt it was none of their business- but there is nothing about being on this med effecting your scope of practice or being able to get your nursing license. I have never had any convictions or court cases or whatever- and that was the only thing that would effect the status of getting your nursing license where I am from. So it leaves me in the dark as to what are my rights and what is waived when it comes to employer/employee rights. Im a new grad and i think this is something every nursing school should take time out for: Your rights as a nurse and a potential candidate.
Thanks for any and all help and opinions

VM85 , I am replying with your entire message quoted so I can address the many topics you have brought up. These are my own opinions and I hope some others will also express their thoughts. Let me start off by saying if you believe you have something to worry about ; you DO have something to worry about. Pre-Employment drug screens are serious business. If you are positive for any drug that you do not have a prescription for , you might be facing horrendous consequences.When you sign a consent to be tested you give away all rights. I do agree that it is none of anyone business if your doctor has given you medication and you are being monitored. But many meds are abused and thus put up a red flag even when prescribed. If you are on a narcotic , you should taper down and stop completely. Realistically, no nurse should be on narcotics while involved with patient care. If you are taking xanex , it will be quite a while before they are out of your system. Go to an independent lab and have yourself tested before applying for a job and getting screened. Please don't think I am encouraging anyone to deceive their employer or condoning drug use. But the facts are brutal : a positive screen will be the beginning of years of emotional and financial hardship, and possibly end any chance to work as a nurse.The system does not allow for any deviation and does not differentiate between use and abuse. You sound as if you might have the beginnings of a drug problem. Nursing is not a place to be impaired. Take care of whatever your issues might be and then the road and your mind will be clear. Good Luck ...

Cherybaby · Oct 27, 2009

I can't speak for any other state but my own (Florida). Most drug screens will test for opiates and benzos. While you may have a script for these drugs, the nursing board here frowns upon nurses being under the influence of any drug that will impair judgment, even if your dose is low. Some places will not hire a nurse that has these meds show up on their drug screen, even if it is prescribed. That is their call to make. You should tell your employer what meds you are on prior to being drug tested. That way, it doesn't look like you are hiding anything. Some places will ask you to bring in your bottles of meds to show that you are indeed prescibed these medications. I was hired for jobs despite being on xanax many times. There were no issues. However, I was turned down from a few places for being on an opiod (this was PRE-addiction) for a knee injury. The LTC didn't want to risk an impaired nurse on the floor. It's going to vary depending on the job you apply for...but in Florida, the nursing board is very clear about which drugs are NOT okay to be on while working.

Contact your State Board for advice on this.

Dixiecup · Oct 27, 2009

I am a manager in a position where I hire nurses and C.N.A. Our pre-employment drug screens have a paper to write down all meds you are on before you take the test.

Having been on probation myself it put things in a different perspcective for me. I have did grug screens on people who have had scripts for as many as 5 different narcotics and as long as they have a prescription they are good to go, we hire them. (I am not the last word on who gets hired)

It's hard to believe of all the nurses in the US that none of them are going to be on medication. It's just not realistic. Nurses need medication just like the rest of the population.

We have even hired people who have felony convictions on their record after hearing an explantion and what happened. There are always two sides to every story.

If this had not been the case I wouldn't have a job myself!

Having said that, it does send up a red flag to a proscpective employer and not many facilities think like we do. We are known for giving everyone a chance. Otherwise, some people would never have a chance to work. Our policy is everyone is to be given the benefit of the doubt, and if you have a prescription for whatever med you are on, you can get a job at our facility. But as I stated, we are not the norm.

juliedhl · Oct 27, 2009

In reply to your post on pre-employment drug testing, I agree with the posts made by the previous two nurses however I am curious as to why someone might jump to such a conclusion that you might have a problem when in fact none of us knows the underlying reason for you using whatever medication you were prescribed. I believe firmly that medicines were designed to be used in certain health situations and only as prescribed and under the care of a doctor. If that is not the case then only you know. If you are new to the field and are just worried about making an entry into the field, then I say consult your MD, taper down until you are off the meds, go for a UDS in a private testing lab as the other nurse suggested and talk to someone you trust about your concerns. Never try to hide or cover up something. Be up front and honest especially with yourself because if you carry around a secret then you won't be able to work to your potential. Nursing is a wonderful field and the most trusted profession in the world and we have to be present to live up to that reputation. I have worked as a nurse for the past 15 years and have seen alot of abuse and misuse by members of our profession. It is very common for nurses and doctors to be associated with substance abuse due to the stress of the job. Be excited about nursing, confident but not overly, never hesitate to ask questions, and always strive to know more and most important be yourself without any influencing factors.

chances-r · Oct 27, 2009

With all respect to Cherybaby ,I feel her suggestion to "Contact your State Board for advice on this" could be a huge mistake. The State Board will most likely take this inquiry and mandate evaluations , outpatient treatment and place her under monitoring. I am under IPN contract and had to get a doctors note to take a benadryl. The BON is not a warm and fuzzy place. There is plenty of information and help to be found elsewhere.

hippienurse · Oct 27, 2009

When I got my job I was taking my chronic pain meds, and had PRN xanax for anxiety. I was no longer taking the xanax except for rare cases (maybe once in 6 months?) but told them anyway. I had a doctors note stating I had been on my maintenance pain meds for such and such a time and was fine to work. People on chronic pain meds do not get a "high" from them. They take away the pain. They were fine with that. You can take your pain meds and work as a nurse. As long as you tell them the truth and have a letter from your doc bcking you up. I am sure some places give grief about it, but being upfront is the best idea. It will look bad if later on down the road they find out and you never told them to begin with... Good lucK!

VM85 · Oct 28, 2009

Thank you every one for your responses. It really did help me out. No I dont have the beginning signs of a drug abuse problem. I do not use illicit drugs or recreational drugs or misuse or abuse my prescription. The ONE and only prescription I am on is for a legitimate reason and I am monitored and it is my decision to get off of it slowly- but eventually I do want to be off of it. I am not trying to defend myself, confusion can be due to the vague post as I dont want to share my prescription name with anyone, but just wanted to clear that up.

I am a new nurse and I have never had to do pre employment drug testing- this job may not even make it mandatory, I dont know. I was just curious as to how to handle these situations as they arise. A posting I had read in another section was about another person on allnurses taking Xanax, not me- I do not take anythin for my anxiety, I use breathing techniques and have gone to councelling. And the medication I am on does not impact judgement if on a proper dosage and if taken correctly( most people on are on 80+mgs, I am now on 14 mgs). To me any medication can be abused, whether prescription or OTC- I just feel like since I take mine as I am prescribed and do have a prescription, and it doesnt impair my judgement that I should not have to disclose it. But personal opinions and what you have to do in reality are two different things, so I guess I was just curious as to how to handle this. I do want to be honest and up front but am worried about bein judged and it affecting their decision(even though they wont say that that was the reason, they may find another). this medication does come up on drug screens if tested for it, but I was told by someone else who is a nurse, that they can not test for it due to confidentiality- so I dont know what to believe, I suppose that could be true, but it also may be the type of test and what they are looking for could be different from facility to facility. It may not even be such a big deal honestly, and I may be just over thinkin it. I am just nervous as a new nurse and then I have this issue in my head- so I am curious, and glad I posted this on here- thank you everyone!

exnursie · Oct 28, 2009

Hello everyone! I was just in a different area:first year in nursing, and there was an interesting post. So i went looking around the site and found this area.
The post was about being prescribed a narcotic, xanax prn for anxiety and the person was worried about it showing up on their preemmployment drug screen. This is a very interesting question and it led me to think about what are the rules for pre employment drug screening. If anyone could help, Id greatly appreciate it!
Do you have to disclose information as to what meds you are on?
If it is a narcotic do you have to disclose this info?
I know the med that I am worried about is confidential information, and it may show up on a drug screen, how do I deal with that? If i tell them what I am on, I am worried I will be judged and maybe the decision as to whether or not I will be hired wont be affected, but I feel like alot of people will look down on me and may find another reason to fire or dismiss me from the job.
I am not on an amt that will impair my judgement, I am actually on a VERY LOW DOSE and always have been- actually tapering down but that is a slow process- I just dont feel like I shouldnt have to disclose this information. I take my meds as prescribed, I see the Doctor regularly- if i couldnt function or the doctor felt my judgement was impaired, I would not be allowed to keep my license and get behind the wheel and drive. I never disclosed this info to my nursing school, as I felt it was none of their business- but there is nothing about being on this med effecting your scope of practice or being able to get your nursing license. I have never had any convictions or court cases or whatever- and that was the only thing that would effect the status of getting your nursing license where I am from. So it leaves me in the dark as to what are my rights and what is waived when it comes to employer/employee rights. Im a new grad and i think this is something every nursing school should take time out for: Your rights as a nurse and a potential candidate.
Thanks for any and all help and opinions

This is just my opinion, and not legal in nature... but from what I know and have read in the many yrs I have been involved in helping nurses in recovery, you should not be involved with the advice that insinuiated that you are in jeopardy of being looked at as an addict.... ( based on what you have said here)

It would be much easier to asnwer this issue if you were willing to say what med and what dx... since if you are taking a narc for chronic pain, or needing benzos for panic or anxiety issues, this could be a concern...

I suggest that you obtain a brief statement from your MD that explains what your dx is and why you are taking the med. Definitely disclose this when you are tested and provide them with your rx bottle to prove that you have a legit reason. The MRO will take this into consideration and this should not be considered as a positive screen since you have informed them that you are taking this med.

As far as this med being viewed as one that may cause you to be unable to safely work while taking it,,, without knowing what the med it is, it is impossible to say anything

I do know that FL does have a law that does not allow the use of any mood/mind altering med when working, regardless if it is prescribed. It is the only state that I know that has this law, and while I have not reviewed all 50 state BON regs, of those I have looked at, none have such a rigid law.

tewdles, RN · Oct 28, 2009

Unfortunately, nurses must submit to a pre-employment drug screen in order to be employed in many, many environments. I believe this is an unnecessary and expensive invasion of privacy. However, it is the current practice. You will need to have current prescriptions for any meds you are taking. You must list those meds on the forms at the testing facility. You may not be denied employment for prescribed medications no matter what type they are. You may demand retesting if the results are incorrect, although the employer may require you to pay for the retest ($$). I am a firm believer in people being tested if they have a performance or attendance problem...not as a condition of employment. It is really not the business of my employer that I might take xanax or some other med on the recommendation of my physician. But...that is the way of our current world...so much for personal privacy.

morte, LPN, LVN · Oct 28, 2009

I do know that FL does have a law that does not allow the use of any mood/mind altering med when working, regardless if it is prescribed. It is the only state that I know that has this law, and while I have not reviewed all 50 state BON regs, of those I have looked at, none have such a rigid law.

so, by that definition, no nurse in the state of florida is depressed? or at least appropriately treated for depression??? because AD by def. alter mood!! so, in the fine state of florida, your training is getting poorer (new law diminishing req to grad.) AND you cant be depressed.....hmmm

Cherybaby · Oct 28, 2009

With all respect to Cherybaby ,I feel her suggestion to "Contact your State Board for advice on this" could be a huge mistake. The State Board will most likely take this inquiry and mandate evaluations , outpatient treatment and place her under monitoring. I am under IPN contract and had to get a doctors note to take a benadryl. The BON is not a warm and fuzzy place. There is plenty of information and help to be found elsewhere.

I am in IPN as well. While I appreciate your concern, you can inquire as to what medications are questionable without the hammer being brought down on you. I know the nursing board does not advocate for the nurses, but they are not some big scary entity either. I asked this same question to the board of nursing many years ago when I was taking medications for my bipolar disorder. They were very nice, sent me out a list and no further inquiry was made with regard to what I was or was not taking. They absolutely did not do any of the above referenced things that you mentioned.