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Discussion

question about nurses on methadone

I work in a facility where we have a lot of patients who are addicts, recovering addicts, etc.

Sometimes we have nurses, former nurses, etc. as patients.

The question came up the other day.....if a patient comes into your facility and their medication list shows that they are on methadone, and that patient is also currently a working registered nurse....is that something you are supposed to report, or would it be a HIPAA violation to do so?

My personal opinion is that you could not report them. However, I empathize with people who have issues with addiction a lot more than I've found that some of my fellow nurses do. I can see some of my co-workers having an issue with this and trying to report it. I believe it would be a HIPAA violation to report a nurse for being on a prescribed medication when the only reason their use was disclosed is because you had access to their record which is entirely different than reporting a co-worker who you suspect is impaired.

What do you think?

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    Prescription wise, the physician knows the patient, and her profession, and has assessed her mental capacity. So if it needs to be reported, it should already be done. Unless you see a worsening mental state AND she has chosen to go back to work instead of taking time off to heal, I don't think reporting is appropriate. If she's been a nurse for years, presumably she is competent on those long term meds, or she would have been fired.

    On an OD, the patient is off work, and will remain so while in hospital. She will be assigned a counselor, and that person will have to assess her ability to function on day to day tasks.

    So in both situations, I'd say that a nurse assigned for 12 hours doesn't have the knowledge to consider someone competent or incompetent, especially considering they are currently off sick. A nurse with leukemia, and a 102F fever wouldn't be competent either, but she's sick. MAYBE after weeks of treatment the team could conclude that a career change is needed. I certainly would want to have the entire team in agreement if I was going to mess with someone's livelihood.

    If you work with someone, and you notice lapses in care, that's a whole nother kettle of fish.

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