Nursing students on medication

CountryMomma, ASN, RN · 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.

Which is odd, because you refuse to tell us what these terrible behaviors were.

NurseNightOwl, BSN, RN · 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--

When people who do not truly have ADD take a medication like adderall, it not only "hypes" you up like coffee (except think more along the lines of speed -- the med is made of amphetamine salts), it also gives you a sort of laser focus and motivation which would be extremely helpful for things like homework, organizing things, cleaning, etc. All of this I know from friends from my humanities degree days lol. And it is extremely commonly abused/used by people without prescriptions by students to stay awake to pull all-nighters, study, etc. However, I noticed in my nursing program that the culture of this was nowhere to be found, like it was at the university where I got my English degree. If people were doing it, they were smart enough not to say anything, probably because you'd be much more likely to be drug tested in a nursing program than a different one.

All of that to say, I disagree with the OP wanting to bring the student under suspicion for unfounded claims, but I understand why they jumped to this conclusion they did. Abuse of adderall is very, very common and because it can give an edge academically, some schools/universities are trying to figure out ways to know if students are doing it, but drug testing en masse or on suspicion is just not practical, I guess.

kjnsweets · Mar 9, 2014

Ok so this is what we( not just me) observed to be specific. This student in question could not stand still. His eye movement was very erratic and to try and talk to him one on one was not possible for not being able to stand still long enough. I was not the only nurse that observed his behavior. There were other nurses also and they had the same concerns. There was a conversation about how hard school was and about some of them were having to work and go to school and adding clinicals was making it hard for them to stay awake. That was when this student made the comment that he got a prescription for adderall from his dr to help him stay awake for clinicals. Nothing was said at that time until a few days later when we were talking to one of the new hires and she stated that there are students that do this. It's termed chemically cheating is what I was told. This student is no longer at my hospital. I don't know if he graduated or not. I do know that if I see another student acting the way he was whether or not he has a medical condition or not. I will go to my team leader with my concerns and let them handle it or they can observe the student or employee. Nothing else has happened with this situation. I have learned alittle from this conversation but it did offend me because most if you all thought that I was automatically degrading people with mental disorders and neuro disorders. If that is so then I would be degrading myself because as said before I take celexa for diagnosed depression. Not sure if this is all of the information that so many of you have said I was vague on....but there it is.

SleeepyRN · Mar 9, 2014

I will go to my team leader with my concerns and let them handle it or they can observe the student or employee.

That is all that needs to be said. State your observations of student/employee and that they appear unsafe at that time. No need to mention medications. That can be determined by the higher ups or instructor and school.

ixchel · Mar 9, 2014

Ok so this is what we( not just me) observed to be specific. This student in question could not stand still. His eye movement was very erratic and to try and talk to him one on one was not possible for not being able to stand still long enough.

In my opinion, a person abusing Adderall would not behave the way you describe here. A person with ADHD without adequate medication would, though. From my own perspective, I can tell you that this exact description is the way my son is if he skips his morning meds. I just asked him, and he says that methylphenidate does make him feel more awake. So perhaps this student was telling you the truth, but left out the ADHD part.

This description you share may be a valid cause for concern, but not exactly the way you're looking at it. I don't think taking methylphenidate is the problem here. I think taking *too little* when you have ADHD can potentially lead to an issue of patient safety if you have a severe manifestation of it. Without adequate treatment, they are exactly as you just described. My heart goes out to this student. Sounds like he's not being adequately treated.

ComeTogether, LPN · Mar 10, 2014

Seems appropriate for a thread on ADD, no?

Was juuuust gonna say that! *squirrel*

OCNRN63, RN · Mar 10, 2014

It's because they have told us that they are on it and they have voices to their fellow students that they are on it to stay awake. We have a new RN that we hired and she says that in school she was out on a board and that was a very big issue. Some of them saw it as cheating. I wouldn't make these accusation if I didn't know for sure it was going on

I do not understand this post. "The have voices to their fellow students that they are on it to stay awake." What does that mean? "We have a new RN that we hired and she says that in school she was out on a board and that was a very big issue." Again, ??? "Some of them saw it as cheating." Saw what as cheating?

I would be very careful about leveling this accusation. If you see someone who is obviously impaired, then yes, you need to bring it to the attention of your manager and their clinical instructor. But you don't know for a certainty who is taking what, so I wouldn't say "So and So is abusing Adderal" unless you've seen the prescription bottle and have counted the pills, etc.

kjnsweets · Mar 10, 2014

Sometimes iphone makes typos. They have voiced to to us and their fellow classmates they are on this to stay awake for clinicals. Also I meant that one of our new hires was put on a board while she was in school and that was an important issue for that board. They termed it chemically cheating.

ixchel · Mar 10, 2014

Sometimes iphone makes typos. They have voiced to to us and their fellow classmates they are on this to stay awake for clinicals. Also I meant that one of our new hires was put on a board while she was in school and that was an important issue for that board. They termed it chemically cheating.

Do you mean she was reviewed by the board for misconduct? Or that she served as part of the board? I think we're getting lost in translation. May be a dialect thing.

llg, PhD, RN · Mar 10, 2014

I know I am coming late to this thread ... but it disturbs me that so many people think that it is none of the staff's business if the students (or ANYONE) involved in patient care may be impaired due to drugs, alcohol, etc. If we ever suspect someone is impaired, we have an obligation to speak up. Whether the medication was legally prescribed or not is irrelevant at that point. Impaired should equal "away from the bedside" -- even if the person has a legal right to take the med.

Focusing on what you may think the OP's attitudes are towards certain meds only distracts us from the real issues. Some people (students and staff alike) are taking things to stay awake, reduce pain, ease anxiety, etc. Sometimes, those medications do NOT affect their performance. But sometimes, they do. And if we suspect a colleague to be impaired, we need to speak up and report that to the appropriate person for follow-up.

SleeepyRN · Mar 11, 2014

I know I am coming late to this thread ... but it disturbs me that so many people think that it is none of the staff's business if the students (or ANYONE) involved in patient care may be impaired due to drugs, alcohol, etc. If we ever suspect someone is impaired, we have an obligation to speak up. Whether the medication was legally prescribed or not is irrelevant at that point. Impaired should equal "away from the bedside" -- even if the person has a legal right to take the med.
Focusing on what you may think the OP's attitudes are towards certain meds only distracts us from the real issues. Some people (students and staff alike) are taking things to stay awake, reduce pain, ease anxiety, etc. Sometimes, those medications do NOT affect their performance. But sometimes, they do. And if we suspect a colleague to be impaired, we need to speak up and report that to the appropriate person for follow-up.

I agree we have an obligation to report what we see as unsafe behavior. This can range from being due to medications or sleep deprivation. That is why I don't think the medication should be brought up when reporting it. State your observation, and let them take it from there. I would imagine that person would immediately be assessed by supervisor or instructor, and THEN be subject to random drug test.

nurseprnRN, BSN, RN · Mar 11, 2014

What does, "Put on a board" mean? I asked that waaaaaaay back at the beginning of this thread. I mean, I was put on an executive board, and I serve on another board, but I don't think that's what you meant. Some kind of local terminology?

Oh, hell, I don't care. This thread has gone about as far as it can go, anyway.