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**
Here's the deal, though...as the article about drug testing in the ED states....what is the purpose of drug testing unless it's going to change your care? If someone comes into the ED with an MI, will his care be different if the MI was caused by cocaine?
If a woman comes into L&D with an abruption, her care is going to be the same whether it's an abruption caused by crack use or an abruption caused by something else. I can see a possible argument for neonatal abstinence, but really, when we have a mom who has had known opiate use, we don't treat that baby any differently until/unless they start developing symptoms. We don't automatically send an infant of an opiate user to the NICU, we monitor the infant and send him/her when they start scoring higher on the NAS. Nevertheless, I can see why it would be something that would need to be known for optimal infant care, which is why many hospitals/states that require consent for maternal drug testing, do NOT require consent for infant drug testing.
Right. But you previously stated that it was against the law to do a UDS without consent, it's not. You're getting consent and unlawful mixed up. It maybe your hospital policy to get consent or not, but again that's not against the law.
Specializes in Nurse Leader specializing in Labor & Delivery.
Here are the recommendations for hospital policy, as created by a drug task force here in CO:
Considerations for testing pregnant or postpartum women for AOD use: Consent Any policy should allow testing (without consent) of unconscious or intoxicated patients or patients with signs and symptoms of complications of intoxication (e.g. unexplained seizure activity). It is recommended that hospital policy require written consent for drug testing for postpartum women. If written consent for testing is required, policy should clarify who is responsible for obtaining the consent for testing (e.g. RN, MD, etc.) Hospital policy should define what should occur if the mother refuses to consent to be tested. The SEN Steering Committee recommends the following: Ensure mother is evaluated by hospital social worker Automatically test the infant for AOD exposure Encourage hospital social worker, RN, or MD to notify child welfare
Specializes in Nurse Leader specializing in Labor & Delivery.
Right. But you previously stated that it was against the law to do a UDS without consent, it's not. You're getting consent and unlawful mixed up. It maybe your hospital policy to get consent or not, but again that's not against the law.
You're right, I previously thought it was state law, but it appears that it's individual hospital policy based on interpretation of that state's law. I still believe that in some states, it is in fact unlawful to do a UDS on a woman in L&D without her consent, I just know now that in CO, it's only unlawful if the results are used in criminal proceedings.
You're right, I previously thought it was state law, but it appears that it's individual hospital policy based on interpretation of that state's law. I still believe that in some states, it is in fact unlawful to do a UDS on a woman in L&D without her consent, I just know now that in CO, it's only unlawful if the results are used in criminal proceedings.
Specializes in Nurse Leader specializing in Labor & Delivery.
So I've learned that ACOG, AAP and DHHS all recommend that drug testing of pregnant women only be done after consent, unless the medical situation demands otherwise. I think that is a pretty compelling argument against routine drug testing of all women in pregnancy/L&D.
So I've learned that ACOG, AAP and DHHS all recommend that drug testing of pregnant women only be done after consent, unless the medical situation demands otherwise. I think that is a pretty compelling argument against routine drug testing of all women in pregnancy/L&D.
Specializes in Nurse Leader specializing in Labor & Delivery.
I don't know. I could be completely wrong. Nevertheless, we now know that UDS without consent is illegal if results are used in any kind of criminal proceedings, and obtaining consent before a UDS is a recommended practice by ACOG and the AAP. That's good enough for me to be comfortable in the hospital policies at which I've worked to not do routine drug testing on every woman, particularly without her consent.
I don't know. I could be completely wrong. Nevertheless, we now know that UDS without consent is illegal if results are used in any kind of criminal proceedings, and obtaining consent before a UDS is a recommended practice by ACOG and the AAP. That's good enough for me to be comfortable in the hospital policies at which I've worked to not do routine drug testing on every woman, particularly without her consent.
Then you need to change your wording since the post previous you said you knew it was illegal in some states. It's not illegal.
Specializes in Nurse Leader specializing in Labor & Delivery.
Originally I thought it *was* illegal. I was led to believe that it was a state law, rather than hospital practice. And yes, I do imagine that there might indeed be some states or jurisdictions in which it is in fact illegal to do it at all without consent. Do I know this for fact? No, I do not. That is why I said "I believe" meaning, I imagine it's possible or likely. This semantical argument is odd.
Nevertheless, what I stated in my last post is still relevant. It's illegal if you turn the information over to legal authorities (which is why I asked earlier, for those that do routine testing, what do you do with that info if she tests positive for THC or barbiturates - something that nobody has answered), and the practice is NOT recommended or endorsed by ACOG and AAP. That's good enough for me.
Originally I thought it *was* illegal. I was led to believe that it was a state law, rather than hospital practice. And yes, I do imagine that there might indeed be some states or jurisdictions in which it is in fact illegal to do it at all without consent. Do I know this for fact? No, I do not. That is why I said "I believe" meaning, I imagine it's possible or likely. This semantical argument is odd.
Nevertheless, what I stated in my last post is still relevant. It's illegal if you turn the information over to legal authorities (which is why I asked earlier, for those that do routine testing, what do you do with that info if she tests positive for THC or barbiturates - something that nobody has answered), and the practice is NOT recommended or endorsed by ACOG and AAP. That's good enough for me.
It's not semantics when you say you believe it's illegal in some states, with no actual proof. You're trying to backtrack and doing a poor job of it. It's not that hard to say you were wrong.
Specializes in Nurse Leader specializing in Labor & Delivery.
I'm pretty sure I did say that I could be wrong. As I learned more about it, I posted it here. Hopefully we all learned something interesting from this thread. :) I'm okay with being wrong and learning new information. Peace out.
SionainnRN
914 Posts
Right. But you previously stated that it was against the law to do a UDS without consent, it's not. You're getting consent and unlawful mixed up. It maybe your hospital policy to get consent or not, but again that's not against the law.