Pre- employment drug testing

[VM85]

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

[Cherybaby]

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

Things are very bad here, Morte. We have some of the lowest requirements in the country to be able to be a nurse. We are absolutely inundated with new grads who have below par education. You used to have to have at least a B average to get into nursing school, along with taking an exam similar to that of the SAT's. Now, that test has been all but done away with and you can waltz into nursing school with a C average.

Getting back to the original topic and your question about depression...the nursing board here in Florida is VERY clear about their policies. It is sort of a "don't ask/don't tell" kind of situation here (not the boards suggestion, just my own observation). Most AD's won't show up on a regular drug screen, but if you are prescribed benzos (ie:xanax) for an anxiety disorder of any kind, you are up a creek without a paddle. The nursing boards stance here is to "taper off" these medications prior to working at any facility. They leave very little room for the depressed albeit competant nurse to practice.

[tewdles, RN]

sigh...no right to privacy...

They apparently would rather their depressed nurses drank alcohol than took a xanax.

[chances-r]

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.

To Cherybaby : I sincerely apologize if my post offended you in any way. My intention was to inform and I feel like I dropped the ball. I have no involvement with the BON and should have not made assumptions . As for IPN :they have been very nice and always shown me concern and respect. I am blessed and absolutely love my new job. But I will never forget the 74 applications , the 11 interviews and being told by one Human (?) Resource manager "we don't hire people like you". Anyone who is in IPN needs realize that the next IPN person will be judged from our behavior .

[Magsulfate, BSN, RN]

Simply stated... the medication that your doctor legally prescribes you is LEGAL and it is YOUR PRIVATE INFORMATION protected by LAW. As long as you are not impared and your job performance does not suffer from using these legally prescribed medications, , , it is NONE OF ANYONE'S business.

POINT BLANK.

[CASTLEGATES]

Mood stabilizers are not considered mind altering; SSRI's are acceptable. Basically any scheduled substance is a no-no, including ultram...call your BON, don't believe me.

Call your BON disciplinary committee and ask them. They're nice people and i've called them (many states) for many nurses with questions like yours. In regards to that manager hiring staff on narcotics; there are laws about being in an altered state while practicing. Ask the entity that controls and mandates this and you'll have no issues. Remember, MOST of those working in the disciplinary/diversion/rehab departments have been there, done that.

Just call and ask legit what meds can be worked under? Don't go into amounts; just say I've got a doc who's going to prescribe xyz; should I take them and if I do, what about the laws. Tell them you want to be sure because you do! It's a legit question they have to answer or publish on their website.

If anyone does a random screen on a working nurse despite what some hiring manager has done, bad things can happen so it would behoove anyone who may be prescribed anything to know your BON laws. Their job is to protect the public and legislation has recognized some civil liberties of few may be squeezed for civil liberties (safety) of many. That's why everyone's drug test crazy. No I don't believe in it or like it but that's how it is so I stay compliant with my state and my BON without rationalizing anything to anyone for anyone or suggesting cutting corners. It's just not worth it.

The reason? If someone's prescribed a narcotic, then one can divert a narcotic with an "out" and statistics show it happens and often. Also prn and non chronic narcotics are mind and judgment altering so the BON's for the most part say they must not touch the public or make decisions for or treat the public. All the one's I know (for public charge of safety and liability) have the zero tolerance with practice policy.

[PhoenixTech, LPN]

I'm not an authority and may be wrong. From my experience the only drugs that aren't a part of a basic drug screen, could possibly present a problem if discovered and may be covered under some sort of confidentiality clause is methadone and suboxone. I say this because of my own experiences and the fact that you pointed out that many people are on 80+mg. Given that these particular drugs are usually given in a not so isolated, group- type of atmoshere, it's fairly easy to ascertain who is on what dose. It has been many, many years, they may have changed their dispensing protocals but this is what I remember.

I'm not saying this is what you are taking, only that from you're description, this is what it sounds like. You certainly have a right to your confidentiality, however, given that this post is in the Recovery portion of this site I'm gonna tell you what I hear in the 'Rooms' constantly. If you give only half the truth, you'll get only half the help.

While it's true that given the desire, time and energy someone may be able to find out your identity, this is a confidential site in itself. I don't think that given the professions on this site, anyone really has the time to put forth so much effort. So it say's to me that unless you used your birth name as your handle, you can't even be honest with yourself as to what you are taking because none of us would know you anyway. It reminds me of how hard it was to admit to myself that I had a problem. Even when I knew deep down I did.

I'm not projecting and forgive me if I offend you. It's not my intent. This is a site, especially this thread, where we assist each other and sometimes that assistance would be more harmful if it wasn't given honestly. I hope you get the answers that you seek and that you are sucessful whether you disclose or not.

[Magsulfate, BSN, RN]

OKay, I digress.. regress,,, undress,, whatever! haha.. okay,, Call your state board to be 100 percent sure. Any answer you get on here is not legal and cannot be used as an excuse if you get into trouble with your job and a legal prescription that you are taking.

[Magsulfate, BSN, RN]

Wait, let me say one more thing,,, maybe you shouldn't be taking clonidine or lopressor as they can make you sleepy and drowsy looking..... also prozac? heck no don't take that,, it might make you a little goofy too.. and we can go even further and say... don't take advil.. it makes some people sleepy,, heck it puts my hubby out like a light.. i love the stuff...

[Silverdragon102, BSN]

Please remember we can't, as per terms of service, offer any medical or legal advice. If you are worried about issues regarding medication discuss them with your PCP or nursing board

[Magsulfate, BSN, RN]

i scanned through the texas nurse practice act and this is what i found as far as drugs/alcohol. there is also another section on reporting impaired nurses and tpapn, etc.

sec. 301.452. grounds for disciplinary action.

(a) in this section, “intemperate use” includes practicing nursing or being on duty or on call while under

the influence of alcohol or drugs.

(b) a person is subject to denial of a license or to disciplinary action under this subchapter for:

(1) a violation of this chapter, a rule or regulation not inconsistent with this chapter, or an order

issued under this chapter;

(2) fraud or deceit in procuring or attempting to procure a license to practice professional nursing or

vocational nursing;

(3) a conviction for, or placement on deferred adjudication community supervision or deferred

disposition for, a felony or for a misdemeanor involving moral turpitude;

(4) conduct that results in the revocation of probation imposed because of conviction for a felony or

for a misdemeanor involving moral turpitude;

(5) use of a nursing license, diploma, or permit, or the transcript of such a document, that has been

fraudulently purchased, issued, counterfeited, or materially altered;

(6) impersonating or acting as a proxy for another person in the licensing examination required under

section 301.253 or 301.255;

(7) directly or indirectly aiding or abetting an unlicensed person in connection with the unauthorized

practice of nursing;

(8) revocation, suspension, or denial of, or any other action relating to, the person’s license or

privilege to practice nursing in another jurisdiction;

(9) intemperate use of alcohol or drugs that the board determines endangers or could endanger a

patient;

39

(10) unprofessional or dishonorable conduct that, in the board’s opinion, is likely to deceive, defraud,

or injure a patient or the public;

(11) adjudication of mental incompetency;

(12) lack of fitness to practice because of a mental or physical health condition that could result in

injury to a patient or the public; or

(13) failure to care adequately for a patient or to conform to the minimum standards of acceptable

nursing practice in a manner that, in the board’s opinion, exposes a patient or other person

unnecessarily to risk of harm.

© the board may refuse to admit a person to a licensing examination for a ground described under

subsection (b).

(d) the board by rule shall establish guidelines to ensure that any arrest information, in particular

information on arrests in which criminal action was not proven or charges were not filed or

adjudicated, that is received by the board under this section is used consistently, fairly, and only to

the extent the underlying conduct relates to the practice of nursing.

and then......

sec. 301.453. disciplinary authority of board; methods of discipline.

(a) if the board determines that a person has committed an act listed in section 301.452(b), the board

shall enter an order imposing one or more of the following:

(1) denial of the person’s application for a license, license renewal, or temporary permit;

(2) issuance of a written warning;

(3) administration of a public reprimand;

(4) limitation or restriction of the person’s license, including:

(a) limiting to or excluding from the person’s practice one or more specified activities of

nursing; or

(b) stipulating periodic board review;

(5) suspension of the person’s license for a period not to exceed five years;

(6) revocation of the person’s license; or

(7) assessment of a fine.

(b) in addition to or instead of an action under subsection (a), the board, by order, may require the

person to:

(1) submit to care, counseling, or treatment by a health provider designated by the board as a

condition for the issuance or renewal of a license;

(2) participate in a program of education or counseling prescribed by the board;

(3) practice for a specified period under the direction of a registered nurse or vocational nurse

designated by the board; or

(4) perform public service the board considers appropriate.

© the board may probate any penalty imposed on a nurse and may accept the voluntary surrender of a

license. the board may not reinstate a surrendered license unless it determines that the person is

competent to resume practice.

(d) if the board suspends, revokes, or accepts surrender of a license, the board may impose conditions

for reinstatement that the person must satisfy before the board may issue an unrestricted license.

now this is just texas, other states have their own rules. but if i'm not mistaken, this means what i said a few days ago, as long as it is a legal prescription and it does not impaire the nurse, then there is nothing the board can discipline you for. this is my interpretation of these rules... i am not an attorney, and this is not a legal advice forum,,, as we have already said. i am just posting the rules, exactly as stated on http://www.bon.state.tx.us/about/pdfs/npa2007.pdf . i did not read in there anywhere that you cannot take any prescription drugs that your doctor prescribed you.

as far as not letting nurses take pain medication because there is a risk they could divert/steal, that is well,, crazy. because we all know anyone can divert/steal, not just the nurses who have a legal prescription. why would anyone divert/steal when they've got a prescription? to get more? then why not get the good stuff?? i have yet to meet a nurse who has a prescription for dilaudid and morphine who has diverted... (better yet, never met a recovering nurse that only diverted vicodin/norco or other pills) . with that kind of pain, the nurse cannot physically work in a patient care environment anyways.

personally, i would never call my state board and tell them the prescriptions i am taking, that is none of their business as long as i am meeting the minimum standards of nursing care in the state of texas. and i am an awesome nurse.

[VM85]

Thanks everyone!!!! No one has offended me and I am thankful of any opinions or experiences you have all shared. I have talked to a person in the professional who is an expert on this type of thing(a former instructor) I was open and honest with her and she spoke to me about it. Of course she isnt the board and I havent gotten around to calling and asking them, but I am planning on it. I was not looking for any legal or medical advise, just a question with a complicated situation. And I would hope people would not hunt me down- But I do know of at least one person who knows who I am on this site- they did come across me and say oh hey!!!!! Your on allnurses- and then started to recite a thread I had started lol. That person is not a stalker just a friend and former classmate that also uses this site that mustve come across me at some point and time. Anyways, I appreciate every one responding and for your input! It did help and directed me to where to go! Thanks again!

[Cherybaby]

To Cherybaby : I sincerely apologize if my post offended you in any way. My intention was to inform and I feel like I dropped the ball. I have no involvement with the BON and should have not made assumptions . As for IPN :they have been very nice and always shown me concern and respect. I am blessed and absolutely love my new job. But I will never forget the 74 applications , the 11 interviews and being told by one Human (?) Resource manager "we don't hire people like you". Anyone who is in IPN needs realize that the next IPN person will be judged from our behavior .

Absolutely no offense taken. Everyones experience with IPN and the Nursing Board varies greatly. So far, my experience with them has been positive. However, I have seen other nurses go through real challenges with the Board and then, subsequently, with the IPN process.

I am glad you have a job that you love and that you made it through to the other side. I am in my last week of IPN. I know that 74 applications, 11 interviews and nasty HR managers are probably on the horizon for me as well. I will think of you as I embark on that journey, knowing that positive outcomes are possible.

Continue to make the rest of us look good! :)