RNwithHonors

Hello all. Its been a few years since Ive posted on this topic, but I felt looking back I owed a status update to all those who supported me. There are a few things I want to cover, but, First let me say that Ive remained at the same Hospital in which I successfully started at in June of 2012. Not only that: but I've thrived, just as I did in RN school (for those of you who keep telling me that it doesnt matter how exceptionally well I did in RN school/clinical: I respectfully disagree because statistically history has a way of repeating itself) I can tell anybody with full confidence, who has judged me with blunt rude comments or passive aggressiveness--That I have NEVER been written up as a working RN, never have caused harm to one patient, and last but not least, I not only moved up the ranks of becoming Charge Nurse---But now Im a newly promoted Nurse Manager as a member of my Hospitals Administration, overseeing 4 different units in the hospital (approximately 150 Nursing Employees). I brag for the purpose of spiting every last RN here who judged someone like me... Furthurmore as I am one of those responsible for hiring and firing at my Facility, and I truly hope that any rude poster comes my way begging for a job one day... I promise to give you what you deserve, give you what you have coming--which would be NOT simply evaluating your prospective talent or liability factors as if I were an RN assessing a patient in a "focal manner". Instead, I woukd take the time and effort to give you a fair chance at working for at the Hospital that so wonderfully gave me the chance I deserved. Never did I initially believe I would be a member in Administration consulting with Risk Management and the CEO on a fairly regular basis, regarding the development and accoubtability of the Nursing Department, but I never gave up or saw myself as "less than"(just like that quack MRO from the "Puritan Facility" did). Also since attaining a secure job, my anxiety decreased significantly, and now Im completely off the benzos (for over a year now). Sure if I were to take them now, which is when I no longer "need" them it would probably make me drowsy--but I never took them because I wanted to get anything more than healthy productivity. (So in other words im compliant with the prns, because as I have no need--I never take!!) I just needed to vent that out to all the narrowminded "improvisationally confident" judemental RNs who ever commented coldly about me, and hey, maybe you work for me--and you will never know it, because I wont treat you with the disdain you showered me with. (Its a small world Now then, to every good Nurse who also believed in me: thank you for giving me the support I needed to help me realize my dreams to come true!!!!!

1) Jenny, I understand the half-life of benzodiazepines, very clearly. But it's more than the half-life that I always cared about in planning whether or not I could take a PRN. specifically, so that I never EVER went into work with any residual effects of the medication I use the scientific formula for drug metabolism. *5 multipled by the half-life=complete metabolism* (ie. if the half-life is 5 hours, then metabolism is complete in a healthy patient with no liver issues within 25 hours+-4) Like i stated earlier: I didn't take it the night before if I knew I might even have the slightest possibility of waking up with some residual effects. My calculations always left me with a sharp mind and clear consistent clinical judgement. I was always very cautious, because patients and their families mean the world to me--ARE the world to me... If you want to make this into an "ostracizing witch hunt" of sorts: then why don't you consider research that has proven, due to the many years of society flushing "diazepam" down the toilet, trace amounts of diazepam have been found in the roots of potatoes. (Diazepam is historically one of the first benzodiazpines synthesized decades ago) You might want to lay off the french fries, mashed potatoes, etc unless you want to deem yourself as clinically incompetent. Also, while we're on topic, benzodiazpeines DO NOT act in the identical fashion as alcohol. While etoh and benzos are both CNS depressants, etoh does not potentiate the GABA system leading to increased levels of GABA, while benzos do, etc. But I digress. 2) I have seen certain RNs lack clinical judgement, who weren't on any psychotropic medication. For example, Jenny, had you educated a patient under your care who is experiencing anxiety, by saying: "alcohol and xanax (benzo) are the same, so if you get anxious and you run out of xanax--you can go ahead and take a shot of tequila" --This would be an example of a Nurse who doesn't use psychotropic medication, but just violated the Nurse Practice Act by "reducing the patients capacity to safely adapt, via poor planning, by neglecting common pharmacological principles leading them to potential bio-psycho-social harm" (alcohol is statistically more dangerous than benzodiazepines) Even though I got great grades in RN school--I FAR EXCELLED IN CLINICAL with my ability to problem solve on my feet & make quick decisions. Jenny, I would take awesome care of you, your family, friends, or fiance if I had the privilege to be assigned care for you as RN.

B.D. DNP, let me first say that, I too, am aspiring to be an NP. While I get the problem-solving angle in your logic, I don't agree with the delivery of your message. And no, I'm not defensive by nature: look at all the previous criticisms I have already taken graciously. One thing that I have witnessed which astonishes me is the lack of tact-based communication of too many Nurse Practitioners. Granted, it's only out of a small pool of NPs, that I have witnessed communicate with these abrasive communication techniques, therefore I can't, and won't, criticize NP's everywhere. Do you really "roll" with problem solving? Is mental illness at all considered to have any genetic propensity in your professional opinion? I know you may remark in your next post followed by a defensive array of semantics (just like you did to the previous poster) But, if had you considered the potential genetic propensity of mental illness before you chose to post your initial statement: well, maybe your communication delivery style may have been geared with more tact & consideration.... That being said Blue Devil, I collaborated with my provider and worked out a plan for adapting & surviving, even though it has affected my quality of life to some degree. You will be happy to know, I'm sure, that I start my first RN job on June 4th--as I finalized everything by passing my pre-employment physical today. Thank you for those of you who recall the person typing on the other end of your screen here is actually a human-being; thank you TRULY for your support.

I know that the biases of Employers such as the one who previously denied me employment are secondary to the long documented history of FAR TOO MANY RN's who were in fact impaired while at work. I mean, for heavens' sakes: look at the CA BRN for the month of March alone in the disciplinary actions portion of their website (so many poor examples of RN's who get high at work, false documenting and stealing meds etc) It's a bit of a culture shock to me, as in all of my years in pharmacy I have never stole any medication.. Not even a single Claritin! lol But I digress.. I guess it's always seemed common sense to me that to work with a patient I must have a clear and sharp mind. (whether in pharmacy or nursing) Metaphorically speaking: I never drink and drive because I dont want to die or harm any others; I never ingested prescribed psychoactive substance while working with patients because I care for them and their well being.. However, after the 30 year+ Epidemic of RN Drug Abuse... I don't blame any institution who is "uptight" in their selective process.. Hypervigilence naturally develops after recurrent trauma (RN administrators are people too). Again I don't blame the hospital, I see the bigger picture. Btw, I will be happy to let you know once I'm lucky to get my first RN job. = ) Im applying "hypervigilantly" ; )

I appreciate everybody's feedback. The best I can do is to adapt and move on with hopes of finding a different RN job soon. I am always very considerate as far as my surroundings are concerned, as I have never have taken medication while at work or clinical. (or the night before if I had clinical in the morning) Reason being: I care too much for my patients. Most of all, I thank those of you who expressed empathy. My prescriber, at my request, has reduced my already low doses so I can safely titrate down. I learned the hard way that some entities (school or employer) may be more or less conservative regarding these matters. Thank you for sharing.. = ) Respectfully, Your fellow RN

Hello everybody. First of all I would like to say I think this website is great. I've been using it throughout RN school, and recently I decided to make an account after getting my RN License. So, here is some back ground... a) When I applied to RN school, I fully disclosed all medication that I was taking, which is also by order of a providers prescription. (Vicodin, on rare occasion if needed for breathrough pain, valium 5mg prn, and ambien 10mg prn insomnia) b) In light of this information, RN school accepted me nevertheless. Throughout RN school I excelled. I maintained a 3.7 GPA, worked an average of 20 hours per week (in pharmacy), and I excelled in safe patient care, getting several recommendations from my instructors and preceptor. The situation is this... My final semester ended in December. I was literally sought out by the Director of the acute-care floor where I did my preceptorship to start working as soon as I had my RN License. I completed all the paperwork for hire, took the NCLEX in January & passed in 75 questions, and informed my other job, of 8 continuous years, that I would be moving on to be a newly employed RN. a) As part of the conditions of starting, like everyone else, I had to pass the pre-employment physical, etc. Within the process of filling out this paperwork, I honestly completed it the same way that I did my paperwork for RN School. (in other words: I was forthright about my legally prescribed medications, before I took my drug test) The drug test showed positive for benzodiazepines, but the test was deemed negative because I have a prescription for them. b) The offer was withdrawn......... c) I stated to the Doctor denying me clearance, "How is it possible that I have done approximately 500/1,000 hours of the BRN prescribed clinical hours, at this hospital, and there was never an issue when I wasn't being paid?" The doctor responded "they probably didn't know you where on these medications". I told him my RN program was well aware of it, and furthermore, I was one of the minority of students in my school that never got written up for making ANY minor or major errors: throughout my entire program, and I had practically almost all straight A's. *Nevertheless, the job where I was going to be doing what I love, & make appx 35/hr, was pulled from me just a few weeks ago, and I have been left stunned.* If I were a threat to myself or others, i could understand the offer being pulled. But come on, the Doctor actually just simply told me "if you were off the medications, you probably would have gotten the job". Now I ask for your help my fellow RNs... My question is: do you or anybody you know, who takes occasional AND LEGALLY prescribed controlled substances have a job as an RN? If so, did you disclose this in your pre-employment physical? Your input will be greatly appreciated... However, I do ask for those of you who may want to say something presumptuous or rude, please keep it to yourself. Sincerely, RNwithHonors (p.s., for those of you who may wonder: I NEVER have ingested ANY controlled substance at while at clinical or while working in the pharmacy in 8 years)