I have recently had a lot of positive UDS pts, and the excuses I hear as to why they are positive simply blow my mind! Anyone have any good stories? I'll start with my favorites.....
+ marijuana: I was trapped in a car with 10 other people smoking and the windows were broken
+methamphetamine: I don't use it, I just cook it, and usually not at my own house
+cocaine: I was asleep, and my boyfriend blew it up my nose. The 2 gay men that live next to me put cocaine in their air vents, and it must have got into my apartment.
**my all-time favorite: well, of course my wife is positive for cocaine, you have no idea how many cokes she drinks everyday**
Klone, all of our moms are tested for drugs per our hospital policy. I would be surprised at any hospital that doesn't do this. We have found many moms and babies positives which required medical intervention for the babies and ofcourse a social work being involved. Seeing what I've seen, I'm glad we test all of our moms.
In denial! :-) I dont know any. Not much experience yet. I wish they would be able to let a nurse know though. Plus we shouldnt pass judgment because I do believe its a chronic disease and is just like eating an extra large pizza with cad. Its hard to say no.. sometimes it takes one time and its an addiction. First step is admitting it and then so on
Specializes in Nurse Leader specializing in Labor & Delivery.
I agree. It makes me unconfortable that every single woman should be undergoing drug testing, and without consent.
Of course, I say this coming from someone who lives in Colorado, where more than half of my OB patients smoke marijuana in some quantity or another throughout their pregnancy (some only occasionally, some smoke daily). I just tell them that occasional use is probably not a huge problem, but I encourage them to not use it daily. I'm far more concerned about alcohol and tobacco use in pregnancy.
Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
I agree. It makes me unconfortable that every single woman should be undergoing drug testing, and without consent.
I don't see at as any different from any other screening. Diabetes, STDs, Strep B.... all of these are things that can impact the development/health of the fetus, and knowing about them changes the way that we provide care for the mother and baby.
When you only test "for cause" you're missing out on finding out about the cases where drug abuse is unexpected (we know it happens across all socioeconomic demographics, and not all drug users have track marks!), and if you only test "with consent" you're missing out on finding out about the cases where the drug abuser doesn't want to admit what they've done to their unborn child.
Testing EVERY patient just as a matter of routine means that you're not discriminating against any one particular class of people, PLUS you're enabling your facility to provide the best possible care for the baby because you have all the information ahead of time.
If you know a baby is going to be born with a heart defect, you can have NICU personnel present at the birth, or you can schedule a C-section to save the stress of lady partsl birth, or you can have a surgeon present to do a repair immediately, or whatever. If you don't know in advance, none of those interventions can be set up in advance and the child has a decreased chance of surviving without deficits.
How is it any different with drug-exposed newborns? Wouldn't you want to know, in advance, that you need to be watching for signs of withdrawal? Or if this is just prenatal testing, wouldn't you want to know about the mom's drug use so that you can encourage her to get treatment, explain the risks to the fetus, etc.?
I just don't see this as "none of my business" -- it concerns the health of my patient and my patient's baby, so that automatically makes it my business.
and one of the potential unintended sequelae is that these women will birth at home. You take the loss of custody out of this equation, and I would be more comfortable.
I don't see at as any different from any other screening. Diabetes, STDs, Strep B.... all of these are things that can impact the development/health of the fetus, and knowing about them changes the way that we provide care for the mother and baby.
When you only test "for cause" you're missing out on finding out about the cases where drug abuse is unexpected (we know it happens across all socioeconomic demographics, and not all drug users have track marks!), and if you only test "with consent" you're missing out on finding out about the cases where the drug abuser doesn't want to admit what they've done to their unborn child.
Testing EVERY patient just as a matter of routine means that you're not discriminating against any one particular class of people, PLUS you're enabling your facility to provide the best possible care for the baby because you have all the information ahead of time.
If you know a baby is going to be born with a heart defect, you can have NICU personnel present at the birth, or you can schedule a C-section to save the stress of lady partsl birth, or you can have a surgeon present to do a repair immediately, or whatever. If you don't know in advance, none of those interventions can be set up in advance and the child has a decreased chance of surviving without deficits.
How is it any different with drug-exposed newborns? Wouldn't you want to know, in advance, that you need to be watching for signs of withdrawal? Or if this is just prenatal testing, wouldn't you want to know about the mom's drug use so that you can encourage her to get treatment, explain the risks to the fetus, etc.?
I just don't see this as "none of my business" -- it concerns the health of my patient and my patient's baby, so that automatically makes it my business.
I work in the ER and we test probably half the pts and we never get consent. The voluntarily give us the urine, or do it unknowingly if they're critical. I can't imagine having to try to get consent, it just wouldn't work.
BSNbeauty, BSN, RN
1,939 Posts
Klone, all of our moms are tested for drugs per our hospital policy. I would be surprised at any hospital that doesn't do this. We have found many moms and babies positives which required medical intervention for the babies and ofcourse a social work being involved. Seeing what I've seen, I'm glad we test all of our moms.