Hello all. I've been an RN for 12 years, unblemished record, stellar recommendations, and most of my experience is in critical care. I started working for a large urban health system 3 months ago. I inadvertently took home a partial vial of Fentanyl from my ED shift that I should have wasted but forgot. The next morning I brought the vial back, notified the ER Charge, the House Supe, and my Supervisor. Per the direction of the House Supe, I took the vial to pharmacy for recording and immediately reported to Employee Health for a UDS. That all seemed reasonable and expected to me. Two days later I got a call from Employee Health telling me that the MRO requested an "immediate observed urine drug screen". She didn't know the reason. I assumed that meant the EH RN would watch me pee. However, what that required was me pulling my pants and underwear down to my knees, pulling up my top, and turning a full circle in front of the employee health nurse. Then she watched me pee. Needless to say, I was humiliated. I sent a written complaint to my supervisor, who forwarded it to our Director, who wrote back that she was appalled that this happened. I'm not sure what I'm going to do, but I'm wondering if anyone has experienced or heard of this kind of invasive UDS? Thanks!
When my husband entered the military, all the men had their physicals in one large room, simultaneously. They were naked, had to bend over and "spread (their) cheeks". One lone voice was heard..."SEE ANYBODY YOU KNOW?" Needless to say, sometimes a bit of humor can allay some embarrassing situations.
I work in occupational health with toxicology currently while I'm still in school. This is totally the norm. We mostly see workers from other non-health industries as patients, and the majority of them are not required to be observed for their UDS. Now, if their employer has requested, they have reasonable suspicion, or it's evident that their initial specimen has been tampered with, they must be observed while providing their urine specimen. Only our male employees can observe male patients, and only female employees can observe female patients. Thankfully, the majority of our patients are men, so I haven't observed many!
You would be surprised by how many people attempt to "tamper" with their urine specimen. I had to observe a reasonable suspicion woman just last week. Even with me uncomfortably close, she attempted to pour a bottle of someone else's urine into the specimen cup, all underneath her! Where in the world did she hide it since her clothing was out of the way? I'll leave that to your imagination because it was quite horrible.
We also see a handful of doctors and nurses each month. All of them must be observed, regardless of the reason they're taking the UDS. This is due to the type of work nurses and doctors do on a daily basis. They have people's lives in their hands, so surely they must be drug-free for the safety of their patients.
Just know that the person observing you feels awkward, too. It's no fun for us either, so don't feel humiliated. It's our job. Nobody means to make you feel uncomfortable. We don't know you personally, so we don't know if you'll try to pull something crazy on us (like the woman I mentioned ). In the end, you knew in good conscience that you had done nothing wrong. Hey, that's a lot more than many patients I see daily can say!
Specializes in Mental Health, Gerontology, Palliative.
When I was a student I did a week with the methadone clinic. The clients could be pulled in for a observed drug screen basically the person had to pee into the toilet and was watched through a window from one side. There was discussion one morning about a report that one client had such a good set up, the catheter when taped to the other side of his member was totally unable to be seen from the observation window, and of course the bladder of urine sat in his arm pit so came out warm.
I think what you went through is horribly dodgy IMO, but possibly they may have thought you put water into the fentanyl when you returned it and possibly this is the standard OP when someone is suspected of diverting.
I've worked at a place where I had to be completely naked except for socks for a pre-employment screen. My understanding is that it's up to the MRO to decide what level of scrutiny (nakedness) is needed to ensure someone isn't using a method of cheating the test, so it varies.
No fing way...Please Name the hospital or where ever this was at? I simply would not allow someone to degrad me in such fashion for a job. When I was hired at the Veteran Affairs none of this foolishness occurred.
Well aren't you a delicate blossom? I had worked in oil field construction in the past and random witnessed drug screens were the norm for everyone on the contract, from the temp receptionist to the President. A random number generator kicked out your name and off you went. Sometimes random meant twice in one month.
This second drug screening protects YOU and keeps your name CLEAN. You know how and why this happened. Why the squeemishness? Move on and try not to pocket any more fentanyl.
This second drug screening protects YOU and keeps your name CLEAN. You know how and why this happened.
I honestly do not understand what the fuss is about. If it happened on my unit, no one would not be surprised by the witnessed screening. We would not joke about it, because drug diversion is not funny, but no one would be traumatized. It would be a cautionary story to share with new RNs.
This is an aside, but your experience reminds me of a thought I've had for years re: drug testing, and for that matter, the way we were treated when we took the NCLEX (some of the things they made me take out of my pockets were insane in my opinion). Have you ever thought of this? - that criminals are innocent until proven guilty; but the rest of us, in certain situations, are basically guilty until proven innocent. I hate that. Yes, I know why it works out that way sometimes, but regardless, it makes me mad.
When I worked detox, I have had to witness patients giving urine samples. Too many of them try to rig or tamper with the test. The most common tampering attempt is with water...except that they never get the temperature right. They all overshoot and make it too hot. I can tell just by holding the container if they put tap water in. Then there are other ways that are pretty simple and very effective, but I'm not sharing those tricks here lest the unscrupulous out there get some ideas
But I'm just in the bathroom with them watching them pee--I'm not making them strip or body search them or anything like that. I do have them give me their handbag, hat, coat, or whatever extra clothing they have, and then the rest is just observation.
Witnessed drug tests are pretty common, but what you went though seems excessive, so I can understand why you complained. But I wouldn't expect much, if anything, to come of it.
That is a DOT (Department of Transportation) protocol for UDS. A lot of times the observer will follow that protocol, when in fact your facility policy might be less intrusive.
The observer should be following protocol of your organization, or that might be reason for a lawsuit.
Former Occ Health nurse. Observed UDS occurs when a specimen is flagged - temp is out of range, color is off, smell is off, unknown substance was detected in the specimen. Sometimes even something suspicious happened during the transport of the specimen. We don't just do them without a very specific protocol. Sometimes they happen instantly, such as if the temp is off or it smells off. Sometimes they happen after being sent to the lab for testing. Your specimen is usually observed by somebody of the same gender as you. Turning and lifting is very common.
I've literally had someone walk up to me and have a condom full of urine fall from their leg only for them to say "that's not mine." Sure, because I keep condoms full of urine around just in case. Many people try to fake or alter their UDS, more than you think.
). In the end, you knew in good conscience that you had done nothing wrong. Hey, that's a lot more than many patients I see daily can say!
beckysue920
134 Posts
When my husband entered the military, all the men had their physicals in one large room, simultaneously. They were naked, had to bend over and "spread (their) cheeks". One lone voice was heard..."SEE ANYBODY YOU KNOW?" Needless to say, sometimes a bit of humor can allay some embarrassing situations.