Were my patient's rights violated?

[Nurse-JP]

I am an RN and got addicted to opiates. I was taking the opiates from the sharps container in the nurses station. I was using opiates for a little more than a year and I got sick and tired of it because I went into depression and thought about suicide frequently. I finally got the courage to go to my primary care physician to ask for help and advice and disclosed my addiction. He referred me to a drug detox facility in town. I got checked in the very next day. After I got discharged, I enrolled in their Intensive Outpatient Program and planned on starting to go to Narcotics Anonymous.

I had a follow up appointment with my primary care physician again and in that visit, he told me that I have to report my addiction to the State Board and surrender my license, or he will do it himself. Feeling cornered, I did go to the board myself hoping that I can be enrolled in the Board's chemical dependency monitoring program. I have surrendered my license and working towards getting it back.

Did my primary care physician have the right to use the information I told him as a patient and use it to give me an ultimatum to surrender my license to the Board?

[ckh23, BSN, RN]

I'm no expert, but to me it sounds like he had no right to demand such a thing. I think he would have violated doctor patient confidentiality. However, I don't know if he has any obligation to report since you would be caring for patient that could result in patient harm.

I know it's a little late now, but you were probably better off consulting with a lawyer before going through all of this.

[CaregiverGrace]

Did u actually tell your gp that you were taking narcs out of a sharps bin? I don't know the rules and regs on that as far as patient confidentiality, but I don't think you used much common sense in telling your doc that kind of information. You basically told him you committed a crime, which may well be within his rights to report.

[LegzRN]

If an ER MD can inform the state about a patient's UDS coming up + for cocaine and having them take their driver's license (or pt having seizures), I can see this as being plausible.

[classicdame, MSN, EdD]

maybe so. I know in my state I have the obligation to report an impaired nurse or physician so I can see why that might go both ways.

I am so glad to hear you are on the road to recovery

[roser13, ASN, RN]

I don't understand the question. Of course your MD has an obligation to report. You're lucky that he gave you the option to report yourself.

[evolvingrn, BSN, RN]

If you are putting the safety at others at risk then i think he can? an addicted nurse is a danger to others. Im glad your working on getting it back. Our policy at my facility is that if you turn yourself in (before your caught) they will work with you. Good luck and i wish you the best.

[2011NursingStudent]

Looked this up b/c I was curious...

In recent years, many courts have held that doctors also owe duties to protect non-patients who may be harmed by patients. For example, without a patient's permission or knowledge, doctors may warn others or the police if the patient is mentally unstable, potentially violent, or has threatened a specific person. In some states, the duty to report or warn others "trumps" the right to confidentiality or privileged communication with a doctor. Courts will decide these matters by balancing the sanctity of the confidentiality against the foreseeability of harm to a third party.

Because you were causing forseeable harm to third parties, there was likely an exception to doctor-patient confidentiality so he could have reported it.

[Flo., BSN, RN]

In my state we have the duty to report a suspected physican or nurse.

[suanna]

You are in a tough position and I can sympathise with you. I have been on Rx pain meds for some years and fear every year my employer, or a disgruntled co-worker may decide to cause trouble for me and notify the board I am "addicted". I have never diverted or taken narcotics from work, and although I have been on these meds for some time I still feel I am taking them for what they were prescribed to treat. (I don't use narcotics while responsible for patient care). None-the-less the BON is often more likely to err on the side of licence restriction until overwhelming proof is offered by the nurse. As to your rights, in your state your physician may have had no choice than to ensure a report was made to the BON. He would be risking his licence to not ensure a report was made. Not to mention he is risking personal liability for any harm you may cause to patients if you relapse (God willing never).

[Chin up]

You are in a tough position and I can sympathise with you. I have been on Rx pain meds for some years and fear every year my employer, or a disgruntled co-worker may decide to cause trouble for me and notify the board I am "addicted". I have never diverted or taken narcotics from work, and although I have been on these meds for some time I still feel I am taking them for what they were prescribed to treat. (I don't use narcotics while responsible for patient care). None-the-less the BON is often more likely to err on the side of licence restriction until overwhelming proof is offered by the nurse. As to your rights, in your state your physician may have had no choice than to ensure a report was made to the BON. He would be risking his licence to not ensure a report was made. Not to mention he is risking personal liability for any harm you may cause to patients if you relapse (God willing never).

Suanna,

If you have a valid prescription and are taking them as prescribed, you have nothing to fear. I am sure your employee handbook states this. Please look into this so you can stop worrying about it. The only time you will have trouble is if you are doctor shopping or abusing them. But if you have a legitimate reason, a primary physician and are taking them the way it is written, it is absolutely legal. The only thing I will tell you is to stop discussing this with coworkers. They don't need to know and it is another thing you won't have to worry about. Take care. Peace!

[Altra, BSN, RN]

Yes, he probably had a duty to report this if you did not self-report.

Where/how you obtained your meds is irrelevant.