targa

Who cares what your mother wants?!? It's your life. You make your own decisions. Apply for financial aid... get a part-time job, and go to school. Learn to stand up to people now. It will serve you well when you're older.

The Aiken article has been thoroughly vetted... it is a watershed. I think the bottom line is................. that BSN nurses are better prepared to think critically, a process which improves patient outcome. The writing is on the wall... and sooner or later states will begin requiring that new grads have a BSN. Some teaching hospitals are trying to achieve an all-BSN workforce. While some might say that that goal is unrealistic, I don't think it's a stretch to say that, all things being equal, a unit manager will hire a BSN over an ADN any day. I personally know a lot of nurse managers, and I know what they're looking for. There might come a time, sooner than we think, when ADN nurses will be considered nothing more than "technicians", and BSN nurses will be making all the important patient-care decisions (as well as managing). This is not a fantasy; this debate is going on right now at my nursing school. The nurses who control the state boards and professional associations are, for the most part, BSN-educated and higher. The line is already in the sand.....................

Just a note about a couple of things: 1. True random drug tests are computer-generated; the names are chosen by a complex computer algorithm. If a unit manager gets info from an outside source that a nurse might be doing drugs off-premises, she has 2 choices: (1) gather info the RIGHT way, via her own observations and those of other nurses, all of which are documented, which can then lead to a direct request for a drug test; or (2) she can ask people to take a "random" drug test, which includes the suspect. However, if the nurse in question hires a competent lawyer, and the lawyer finds out that the test wasn't truly random, then the hospital is going to be in trouble. 2. I wouldn't live in Texas for all the money in the world. I don't need anyone to tell me how to live my life outside of work. There's an old saying: "If you wanna run my life, then pay my bills".

What an interesting thread: https://allnurses.com/forums/showthread.php?threadid=112202 Hmmm....

Yes, and if you'll read one of my prior posts, my own suggestion was that the OP contact the unit manager of miss coke-head, and suggest that she keep an eye out for unusual behavior or declining performance, WITHOUT naming names. A complaint to the BON would be useless. Once a unit manager is aware of a potential problem, the problem will reveal itself in due time, if in fact there is one.

Thanks, Leslie. I'm glad I was able to change one mind. It's a tough issue, but then, if it were easy there would be no disagreement. Peace!

That's right: management will take the information (and yes, it really IS a rumor... a report from a non-employee about off-premises behavior) and the nurse in question will be watched. And eventually she will be tested, after management compiles some HARD evidence of her declining performance and unusual behavior. You and I aren't that far apart. The end result will be the same: she'll be disciplined and offered rehab. We differ on the route taken... the right way takes more time, but the right way sticks when it is challenged. One really doesn't have to have a license and 10 years in an ICU to understand this.

You obviously have a reading problem, Ms. Fish. I AGREE that if she's impaired, she shouldn't be caring for patients. I've never written anything to the contrary. You ARE uninformed about the legal protections afforded to employees. You evaded my direct challenge: just what is it about due process that you don't like? Employers can't make employment decisions, like who should be drug-tested, on the basis of rumor and innuendo. I don't need to have a PhD in nursing to understand that. I know enough about "the realities" of nursing to discuss this issue intelligently and responsibly. I've worked directly with hospital HR personnel and nurse managers about this very issue. You really don't know what you're talking about. You are responding on an emotional level ("oh my god, what about the patient?!?") which probably explains why you are probably not in nursing management, because your emotional decision to order a nurse to submit to drug testing on the basis of rumor, without more, would likely have adverse consequences for the hospital. I fail to see how my student status impacts the weight and worthiness of my statements. Think before you write.

I don't take anything personally. I'm providing correct information to people who obviously are uninformed. I would agree that if the nurse in question has a drug addiction which is affecting her job performance, she should not be taking care of patients. Where you and I apparently part company is the manner in which her employer should determine her suitability for continued employment. I believe in due process for everyone, not just for everyone who is spotless in behavior. The end (ensuring a safe environment for patients) does not justify the means (forcing someone to take a drug test on the basis of rumor). You would feel the same way if you were falsely accused of doing something and your job was on the line. By the way, I don't need luck... I'm doing quite well in nursing school. But thanks for the sentiment.

EXACTLY

I practiced law for over 22 years, and served as counsel to hospitals and other health-care organizations. I have written drug-testing guidelines for hospital facilities on the west coast. In addition, I continue to read professional journals and cases regarding employment law. I KNOW what goes on behind the scenes in most health-care workplaces. You know only about the demands made upon your co-workers, in one specific facility that contractually required compliance with a request for immediate testing. Most facilities have no such requirement. I don't have a problem with random drug testing, or testing of applicants for unfilled positions. I really don't see what my status as a nursing student has to do with the discussion. What's your point?

People can contract to do anything. I never stated otherwise. Most hospitals have not required nurses to comply with an immediate and unexplained demand for drug testing. I doubt that many will be doing so in the future. This might be possible where an employer is "the only game in town". Personally, I would never work for such a facility. By the way, since your behavior is spotless, how about let's install a camera or two in your home? Since you don't do anything wrong, what's the problem?

The problem might be your reliance on religion to get you through problems, rather than rational thought. Freud made a compelling argument that religious thought is a form of mental illness. Read "Future of an Illusion" (1927). http://www.nyfreudian.org/abstracts/abs_volumes/vol-21.htm

"The Mgr will have that nurse doing drug screening faster than her head can spin!" No... that's just not gonna happen. A sordid tale of a "nurse displaying illegal activity in public" sounds so compellingly damning, but it's simply not enough to cause HR and the nurse manager to initiate a drug screening. I'm amazed at the number of nurses who don't understand the concept of "due process". Maybe the nursing schools should be teaching a course in basic principles of law. One may not be compelled to give evidence against himself/herself in a workplace investigation unless there is reasonable suspicion that the person is using illegal narcotics. The definition of "reasonable suspicion" has filled tens of thousands of pages of court decisions, but suffice it to say that it does NOT exist where the only evidence in support of reasonable suspicion is the statement of a witness regarding what he/she has allegedly seen. Otherwise, every one of us could maliciously cause harm to innocent persons by claiming to see something we did not, thereby initiating an investigation into someone's life. Large employers such as hospitals have to comply with a huge and complicated assortment of state and federal law regarding employees... like the Civil Rights Act of 1964, the ADA (disabilities), ADEA (age), OSHA regulations, the federal Drug Free Workplace Act of 1988, DOT drug testing regulations, and privacy laws and regulations. In addition, there is the matter of union contracts and other employee agreements. If hospitals do not properly initiate investigations of employee conduct, there are huge ramifications in the form of claims for defamation, infliction of emotional distress, assault and battery, malicious prosecution, invasion of privacy, and retaliation. The most common and accepted basis for beginning an investigation and requesting a drug test is well-documented evidence by a supervisor and fellow employees of work performance and behavioral problems on the job site. I have advised both employers and employees regarding workplace investigations. One cannot demand that an employee take a drug test simply because a stranger has orally reported an employee's off-premises use of what appears to be a controlled substance. If you believe otherwise, you are sadly and naively mistaken.

I'd like to point out three short phrases upon which this whole matter turns: 1. "physiological or psychological dependence": there is evidence of usage here, but not of dependence; 2. "upon probable cause": probable cause will not exist if based solely upon the word of [an admittedly biased] single witness; and 3. "substantial evidence that a professional has an active addictive disease": the OP's testimony alone would not constitute substantial evidence, nor do there appear to be facts tending to show "addictive disease", as opposed to occasional use. I don't mean to be a contrarian; we are a nation of laws... and nursing is a tightly-regulated profession where standards of conduct are judged by legal norms. While I certainly wouldn't want a coke addict tending to me in an ICU, absolutely nothing will be gained by making a report to the BON. If I were the OP, I would do this (and read carefully): I would visit my friend, the DON (or unit manager, I forget who it is), and suggest that she pay close attention to whether one of her employees is under the influence of an illegal substance while on the job... nothing more need be said. I'm willing to bet that some people have already noticed a few things about someone. Take it from there.

Sorry, psychrn03, but I disagree. Committing an illegal act is not necessarily grounds for discharge from employment. In fact, in some states, a person's employment status may be protected even after a criminal conviction. It all depends on the state, the contract of employment (if there is one), the terms of the nurse practice act in question, and the employer status (some public employees have greater legal protections than employees of private concerns). Here, however, there is not enough evidence to convince the HR department to even confront the nurse, let alone compel her to take a drug test. Unless her job performance is visibly impacted by her drug use, the employer is on shaky grounds in initiating any action based on the flimsy evidence recited by the original poster. If I were the legal advisor to the hospital HR staff, and all I had was a report by a non-employee that some nurse was seen using cocaine off the hospital grounds, my advice would be to do nothing. The hospital faces legal risks if it attempts to take action without sufficient proof. There is no such proof here. Further, departing from the legal analysis, I'm not convinced that witnessing a single incident of cocaine use is compelling enough to cause you and others to get on your high horse of moral indignation. People do things to themselves all the time: they drink, they smoke, they smoke pot, they take a few more prescription pain meds than prescribed, they engage in sex, etc. Until 2003, when the Supreme Court tossed the law out on privacy grounds, it was illegal in Texas (and some other states) for two men to have sex with one another. Would you have advocated firing a gay nurse for engaging in oral sex with another man in a bathhouse? Let's see... presume for a moment that that gay nurse was picking up STD's and then not using sterile technique when he returned to work. Was he placing his patients at greater risk than the nurse whose weekend cocaine use had metabolized before she returned to work on Monday morning? The fact is, the only consideration here should be the nurse's job performance. If she is performing her duties as expected, it is really none of your business what she does off the job. If her cocaine usage is heavy and she is becoming adversely impacted by it, that will soon become evident and she may well be fired (or forced into rehab) soon enough. But in the meantime, we do not live in a "Minority Report" world where we punish people for what we think they might do. Your feelings of moral superiority are disturbing.

You don't work with her. You have no knowledge regarding her work performance. You in fact have no direct knowledge of her alleged "habit" other than what your male friend told you, which is hearsay. She used cocaine once in your presence, at a non-work location. I don't believe that that, in itself, is grounds for discipline or discharge, even if proven; that would depend on the nature of the employer (public or private), the state you are in (worker protection laws vary), and whether she is protected by a union agreement. Cocaine is excreted in the urine primarily as benzoylecgonine. Benzoylecgonine has a longer biological half-life (5-8 hours) than cocaine (0.5-1.5 hours), but can only be detected for about 24-48 hours after cocaine use. If you make any statements to this woman's employer, and disciplinary action is taken against her, she will likely learn your identity in the course of legal proceedings (as she will almost certainly contest a discharge). Then she may initiate legal action against you for defamation. It comes through crystal-clear that you don't like this woman and that you view yourself as your friend's savior. However, my advice is to do nothing. You're not responsible for all the ills in the world, and you risk involving yourself in legal proceedings that will likely be resolved in the woman's favor (i.e., she won't be fired and she will sue you).

Yes, inmates and detainees are the only class of citizen in the USA who are CONSTITUTIONALLY entitled to adequate medical care. Do I wish that ALL Americans were entitled to that benefit? Yes. Is it fair to deprive someone of that benefit because of a crime they committed? No. That's what is meant by "cruel and unusual punishment". It's only just and moral that the government provide for the basic needs of people it incarcerates. Providing medical care to inmates is what separates us from countries like Iran and Saudi Arabia. By the way, the inmate I spoke of, who was denied HIV meds because of the MD's personal biases, hadn't been convicted of a crime. He was a pretrial detainee, who got no meds for seven months. When the charges were dropped, he was released, and continued his irrevocable immune decline. He died about a year later. The medical contractor paid a settlement midway through the trial. Business as usual...

Wow... what a bunch of judgmental nursing "professionals". Inmates (those already convicted of a crime) and pretrial detainees (those who are being held pending trial) are constitutionally entitled to adequate medical care under the 8th and 14th Amendments to the Constitution. This includes the right to medication, and the right to have already-prescribed medication continued by a detention facility. I've personally litigated a dozen cases against detention facilities on behalf of inmates who were denied medical care. For the most part, the facility's MD discontinued medication that the inmate/detainee's personal physician had prescribed, without consulting with the personal physician. This happens so often and in so many facilities that I could have a law practice specializing in it, if I wanted it. These unlawful actions are often aided and abetted by nurses who should know better. One should be careful about letting his/her personal feelings influence an inmate's treatment. One MD discontinued an inmate's HIV meds, stating that he was a "drug addict" who didn't deserve them. Thank god the head nurse in the facility had the backbone to testify against the MD. You might think most/all inmates are "working the system", and some are in fact "slick". You act at your peril, though, when your cynicism and personal feelings influence your treatment decisions. If a corrections nurse has reached the point where he/she can't be empathetic, caring, and compassionate because "these criminals don't deserve it", it's time to find another specialty to work in.

True enough. I understand your point of view. No offense meant or received. regards, targa

Well, I don't know how they handle things in Texas (where everything is bigger, including egos)... instead of a discreet word with the offending grouch, perhaps there's a pistol-whipping in the parking garage... but I'm not making any CHARACTER judgments whatsoever. Just a simple point: rudeness at any time is unacceptable behavior for a professional, regardless of the circumstances, workload, stress of the day, PMS status, or blood-sugar level. If a staff nurse isn't up to the task of training a student, he/she should possess enough professionalism to handle the matter in a way other than that discussed here. Perhaps professionalism hasn't migrated to certain work environments... but at the school I attend, it's expected of everyone, from students right on up to the dean, and across the street to the staff nurses. I have never encountered bad behavior from a clinical instructor, nor have I heard of any problems, and the staff nurses across the street are some of the busiest in town, with extremely sick patients. I feel for people whose experience is different... but it isn't my intent to start a p**sing match about this. It's my opinion. And it's how I intend to practice.

LOL... you need a career change, or a job change. Here's how adults handle things: you honor a commitment. If the unit can't honor its commitment to train, the commitment should be ended. And one individual shouldn't be allowed to alter the commitment, or jeopardize a unit's reputation or that of its other nurses. As for me "being a baby", you know nothing about me. Suffice it to say that I've handled way worse matters than a grouchy unit nurse. No one is going to "eat me"... that person will be getting a very bad case of indigestion.

I'm sorry... but there's no excuse for rudeness. Talk to your clinical instructor, who will talk to the unit manager, and to the DON if necessary. If the unit can't clean up its act and provide the clinical experience which they contractually agreed to provide, then the school should move its students to greener pastures. To make excuses for the grouchy nurse is nonsense. She needs an attitude readjustment.

The federal Fair Credit Reporting Act (15 U.S.C. 1681 et seq.) requires credit bureaus to share their data with those who have a legitimate business need for the information, and employers generally qualify. Employers are given broad access to an individual's credit report, and they can use the data to evaluate eligibility for "employment, promotion, reassignment or retention." In short, as far as your employer or prospective employer is concerned, your credit rating is an open book. Credit bureaus typically track not only your bill-paying habits, but also all companies that have asked to see your credit rating when you apply for credit, insurance, a place to live or a new job. The result is that employers increasingly use credit bureau files to find out whether an employee is job hunting with other companies. And prospective employers may use a shaky credit report to conclude that it is risky to hire you. However, the Fair Credit Reporting Act does give you some rights: to know how and whether a current or prospective employer is using credit information about you. An employer must get your written permission before peeping at your credit report. And the words granting permission can't be buried deep within a job application form or other wordy document; you have to sign separately to signal your approval. However, nothing in the law prevents a prospective employer from refusing to hire you if you refuse to grant them permission to access your credit info. You sign, or you move on. That's life. And under this administration, it's only going to get worse. Just wait until Congress passes the new bankruptcy bill (should be any day now). It will be harder to discharge your debts. targa (licensed to practice law in several states)

You feel badly about being 22 and single?!? You have a lot to learn... Youth is wasted on the young.