RN's w/chronic pain, using narcotics

Editorial Team / Admin · Sep 13, 2005

I am currently, and have been, for 3 years, taking oxycontin for chronic pain. My question is, Is is legal for a nurse to work while taking pain meds? I am unable to work, or hardly move unless I get some relief from the pain. A nurse friend told me it is against the nurse practice act for a nurse to care for patients while under the influence of narcotics. Looks like I will have to stop working if this is the case. I have been a nurse for 27 years...what else could I do? What else would I want to do? answer to that last question is easy..I don't want to do anything else. Thanks for your time, and any help or suggestions.

Hello, SRbear,

I am so very sorry about the pain in your life.

Yes, this is in violation just about anywhere. You are considered working under the influence and a danger to the wellfare of your patients AND yourself.

I hope you can find some peace and be free from this pain......

SRbear · Sep 13, 2005

So, if nurses have chronic pain, they can't work if they take narcotic pain medication, so either they have to quit, or work in severe pain. Dang it..what an option. The irony is, most of my pain has been caused by being a nurse ! Then could someone please explain to me how Dr. House (yes, I know it is TV) can take lortab tablets while working in the ER?

mattsmom81 · Sep 13, 2005

There is a misconception out there that those who need narcs to control pain are automatically 'impaired', which is totally untrue. I do know of some nurses who work with duragesic patches, etc...for chronic pain conditions (endometriosis and pelvic pain, severe arthritis) Some facilities and areas of the country are more open minded than others.

So far I'm getting along with Tramadol but eventually I will need narcs too and will be in the same predicament. We have some nurses on this BB who take non narcs at work, and take the narcs at night to relax and sleep... to keep their employers happy. If you do a search, you should find a few other threads where this was discussed. :)

Good luck to you...if we can meet the job description, have a valid RX, and are not impaired, there shouldn't be a problem IMHO, (but it is for many, sadly) The impaired nurse who diverts narcs is an stereotype. Nurses who occasionally use Vicodin for their arthritis,, for example, are the first suspects when the narc count is off.

Personally I'd like to see some lawsuits filed, through the ADA, on this issue of nurses in chronic pain who need narcs to function. Seems discriminatory the way nurses are treated in this matter. Don't we have a right to control our pain???

Best wishes and hope things work out for you! :)

doodlemom · Sep 13, 2005

Hello, SRbear,
Yes, this is in violation just about anywhere. You are considered working under the influence and a danger to the wellfare of your patients AND yourself.
This is totally NOT true. People that are on routine doses of narcotics are NOT impaired. I have had patients that were taking massive doses of narcotics and have been for a long time. They are clear enough to be able to drive and work in all kinds of businesses. The amount of medication is what controls their pain and maintains them. After they've been on the same dose for a long period of time, the drug does not effect their cognition. The problem this nurse might encounter is in finding a job because many jobs are going to test for narcotics. If she has made an agreement with a supervisor ahead of time to let them know about the problem, they could let it go. More than likely securing a job working in a hospital on the floor would be difficult. There are other nursing jobs to be had.

mdfog10 · Sep 14, 2005

I have had chronic pain for many years. I have found nothing that helps me. However, when I was searching for relief I considered this issue. Narcotics and opoids DO NOT make a chronic pain sufferer high. If I had found meds that helped me I would not tell my manager or coworkers. Unless it affected my performance , it is none of their business. I don't know how you would deal with this though if your employer did drug testing. I got my intermittent use of sick time covered through FEMLA---so I cannot be harassed about using sick time. If other work issues came up, My Nurse Practictioner was willing to stand up for me (ADA).

mattsmom81 · Sep 14, 2005

A friend of mine was required to submit to a drug test at work and had a script for Tylenol #3 from a dental procedure. When she had the test she mentioned it to the employee health nurse and got no response. My friend had to INSIST this be reported in order to avoid the potential of immediate dismissal for a 'failed' test. Seems to me this is a scapegoat situation employers use...and is very unfair. I've heard of this happening to other nurses as well.

MDfog10, have you used the ADA for protection due to narc use? I would be very interested how you and your NP handled this, as I anticipate being in similar situations in time and haven't an idea how to successfully handle it.

mdfog10 · Sep 15, 2005

Hi Mattsmom81,

Narcotics have not helped my chronic pain , so I have not had to persue the issue. If FEMLA did not exist I probably would have to investigate a ADA case(to deal with the harrassment/discipline that comes with using your sick time.

take care

grannynurse FNP student · Sep 15, 2005

I checked the NYS NPA. It is not addressed in their NPA. And I doubt it is ib any other one. W@hat is, is the term moral wrong doing. Employers can set their own rules however.

Grannynurse

SRbear · Sep 16, 2005

Thanks so much all for the responses, and wishes that I felt better...so do I ! I also have that wish for those with chronic pain..cause ya just don't know what it is like to wake up each day, knowing that pain is your constant companion, unless you have been there yourself. I thought for years if I could just find a doctor that would give me that 'magic pill' that would stop the pain, everything would be ok. Well I finally did find a doc that gave me oxycontin, and the pain was relieved. But that 'magic pill", though it helped the pain and allowed me to move and work, created it's own set of problems..one being I lost my job last year. Funny...I can't move or work unless I take it, and I can't work because I do take it. Have a question...2 things I am unfamiliar with, FEMLA, ADA (mdfog10 mentioned these), what does this stand for and what the heck is it?

mdfog10 · Sep 16, 2005

FMLA--family, medical leave act.

http://www.dol.gov/esa/whd/fmla/

ADA--Americans with disabilities act

http://www.usdoj.gov/crt/ada/qandaeng.htm

also check your state board of registered nursing for policies on competent performance, nurses with medical condtions, etc.

good luck and take care

doodlemom · Sep 17, 2005

I think that FEMLA is supposed to be FMLA - family medical leave act and ADA is the Americans with disabilities act. Good luck. I know there is someone out there that will hire you.