Nursing students on medication

ixchel · Mar 7, 2014

To ixchel yes I would be very offended if what you describe happened to me and I would have a major problem with it. But that is not what the OP described. They described a nursing student who stated that they took Adderall TO STAY AWAKE. I take my meds as prescribed, see my physician every four months for a med check and make contact in between as needed, am in contact with disability services at my school, and life goes on. Without my meds, I can not function. Plain and simple. I am in fact as the OP described this student. Does it mean he is taking a med that is not prescribed for him. No. But based on what he did say and what she in fact saw, I can not believe any practicing nurse would not be concerned. Very few at my school know about my disability and the meds I take. I have learned that these types of meds are favored among college students, especially during finals.[/quote']
Agreed. But if you read through this read of this thread, you will see that the OP also describes the behaviors they observed, and those behaviors are typical of those with ADHD. I am not saying that this person does or doesn't have ADHD. What I am saying is that it really isn't up for the nurse to judge AT ALL. The OP has yet to describe what was unsafe about the way the student was with the patients, which lends credibility to the fact that there was no specific unsafe action. There is NEVER an appropriate time to judge someone for why they take a medication if there is no specific instance of unsafe care.

jetsy62 · Mar 7, 2014

I read everything and I guess that is what upset me. I am responding to the initial post. Not what got added to it, then more got added, then the OP responded to that, then more got added, then the whole post went off topic, etc. It is not up to the OP to conduct an investigation or judge. But I still feel they have a responsibility to report what the student said and subsequent behavior then be done with it. Maybe he misspoke, maybe he forgot to take his meds on time, maybe they are prescribed to him and there needs to be an adjustment of some kind. But that is NOT what he said. If she just thought he was jittery, I agree that she is making a judgment call and that is wrong. But when he made the statement about taking meds to stay awake, he crossed a line in my mind. He took it from her being judgmental to validating a concern that warrants further investigation as appropriate. As with a lot of things, this is just my personal opinion, and yes, we all have one and mine is no more valid than anyone else's.

ixchel · Mar 7, 2014

I read everything and I guess that is what upset me. I am responding to the initial post. Not what got added to it then more got added, then the OP responded to that, then more got added, then the whole post went off topic, etc. It is not up to the OP to conduct an investigation or judge. But I still feel they have a responsibility to report what the student said and subsequent behavior then be done with it. Maybe he misspoke, maybe he forgot to take his meds on time, maybe they are prescribed to him and there needs to be an adjustment of some kind. But that is NOT what he said. If she just thought he was jittery, I agree that she is making a judgment call and that is wrong. But when he made the statement about taking meds to stay awake, he crossed a line in my mind. He took it from her being judgmental to validating a concern that warrants further investigation as appropriate. As with a lot of things, this is just my personal opinion, and yes, we all have one and mine is no more valid than anyone else's.[/quote']
Agreed. Again. ?
If you want to know my honest personal opinion, I think the student *was* a moron for saying that. Professional opinion and person opinion can contradict each other. In this case, for me, it does. There were a whole slew of better responses that could have been given. If you step back even further, though, was it okay that a question was even asked in the first place? I don't know.
This thread did go a bit all over the place, but I think for some of us (maybe you included), it is a difficult topic to get thrown around lightly. ADHD is perhaps one of the most judged condition I've had first hand experience with (and by first-hand, I mean as a parent and spouse to people with it, not as someone affected by it, so maybe I should say second hand?). Battling people over the validity of it is frustrating and tiring. To feel the judgment of it within the nursing community makes me even more frustrated because we are at the forefront of evidence based practice, and yet, largely we still get this one wrong. Perhaps it is too easy to hop on the defensive when we hear something that sounds judgmental. IDK. I just know the fights I have had to have on behalf of my boy, even with family who recognize his problematic behaviors (and of course they have so many ideas of what to do - like cutting out food dyes and processed sugars. It's a miracle, they say!!! A friend of a friend of a friend's kid was CURED!!!!!)). I know that we have such a long way to go before this condition is universally recognized as the neurobiological developoment disorder that it is. It begins with us. It begins with conversations like this. Someone says, "someone is on this medication and I feel they will be unsafe on it," and then someone responding with, "well, why do you feel that way?" and then also responding with true education on it. I think the problem with this thread is in the delivery, but I hope that the message remains valid.
OP, I am genuinely curious, how has the situation unfolded since you posted? Did you get someone else to observe? I apologize if I have seemed critical of your thoughts on this, and I hope you understand that it is more the dispelling of inaccurate information that I am hoping for. I do understand that patient safety is your priority. I am curious to know if you did get someone else to observe, and if they shared your feelings on the potentially unsafe care.

jetsy62 · Mar 7, 2014

I do understand. I feel your pain. I had a teacher in my last year of high school (I graduated June 2013), after receiving my 504 plan, tell me that I could not have ADHD because I did not act like one of "those" students. Hello! Yep, have it, diagnosed and medicated since early childhood, will probably always have it. Also have auditory processing disorder. Being very basic, there are 8 tests to diagnose this one, failed all eight and go back every two years to be retested. It is what it is. So yes, I do have a problem with people that take it to stay awake. My suggestion, get proper sleep. I was shocked at the prevalence of this on college campuses and it should be addressed when/if encountered.

nurseprnRN, BSN, RN · Mar 7, 2014

Are we done here yet?

psu_213, BSN, RN · Mar 8, 2014

Does it mean he is taking a med that is not prescribed for him. No. But based on what he did say and what she in fact saw, I can not believe any practicing nurse would not be concerned.

First, based on the OP, what was actually seen that was so offensive? Also, please spare us the fake drama. Suppose a student says "I really felt nauseated this morning. My mom had some ODT zofran, and I felt better after that." He/she is taking a med not prescribed for them! He/she may have gastroenteritis and they are coming to clinicals where they could infect staff and patients! Shouldn't they be reported?

Let's say a fellow nurse says that she took a vicodin 12 hours before to help her sleep. They were prescribed after a recent leg injury. She says she wasn't in pain, but it helps her sleep. If I were a close friend I would warn her about the addictive qualities of the drug, and give her better alternatives to help her sleep. If she is just a coworker, my choices are ignore it or turn her in for a "non-prescribed" use of a narc. Well, this practicing nurse would ignore it.

klone, MSN, RN · Mar 8, 2014

This thread did go a bit all over the place

Seems appropriate for a thread on ADD, no?

ixchel · Mar 8, 2014

Seems appropriate for a thread on ADD no?[/quote']
You made me giggle! Truth!

SleeepyRN · Mar 8, 2014

No nursedirtybird there was no intention to contribute to any stigma of any psychiatric disorder I do not know of any nurses with a real psychiatric disorder in my line of work but I do know of nurses who are so stressed outside of their heads that they need a drug to be able to function at work...thy are given indefinate citalopram...my argument rather was that surely it is better to address what is causing the stress rather than internalising it and having to take meds ....[/quote']
In your words, you state that the best thing to do is address the problem. Taking an antidepressant IS addressing the problem. The problem is a chemical imbalance that leads sufferers of depression to not cope with stress well.
You most certainly ARE adding to the stigma of mental health. You also stated that you don't know any nurse who has a real psychiatric disorder. That is probably because they are on medication, coping well, leading productive lives, and you simply are unaware they have any mental health issue because their medication is working.

lilredrunner · Mar 8, 2014

Big, sticky issue there.. Back in the 80's, when my mom went through nursing school, she had to get on Lithium to get control of her anxiety and depression issues. That was pretty much the only thing that got her through, and then she was an RN for 30 years after that. And she was a good one, too.

So.. You're never going to find an easy answer for that, and perhaps the fault lies less with students playing by bad rules, and more with the schools and rule systems themselves that push people to need medications or make bad decisions with said medications.

kjnsweets · Mar 9, 2014

I do appreciate the information that you all have given me. I do believe that there are people that abuse it but there are the ones that truely need those types of medications. I really just took this student at his word. Even if he had said I take this for ADD or ADHD if had seen the same behavior I think I would have still questioned it. Thank you for all of the advice.

jadelpn, LPN, EMT-B · Mar 9, 2014

This is the first I have heard of "chemical cheating". However, I am not sure how different a medical stimulant taken solely for staying awake is from a few red bulls and a pot of coffee--