What to do if you are going to need narcotics to work?

xtxrn, ASN, RN · Nov 24, 2011

I'm familiar with pseudo tumors.... If you can take the meds without being impaired, I don't see a problem. You have a valid rx, and if you don't take it earlier/more than prescribed, then there's not much anyone can say- IF you're not impaired (and you very well may not be :)).

The only policy I've ever had to deal with is taking rx as prescribed and not being impaired.

brandy1017, ASN, RN · Dec 5, 2011

I would want the shunt to make sure my pressure was kept stable and there were no permanent complications from the increased pressure.

elkpark · Dec 5, 2011

I'm no authority on anything like this, but I do recall that some people have posted here in the past that there are at least a few states in which the BON has a blanket policy that nurses cannot be taking any narcotics while working, for any reason, however legitimate. Might be worth checking out the policy in your state.

xtxrn, ASN, RN · Dec 6, 2011

I'm no authority on anything like this, but I do recall that some people have posted here in the past that there are at least a few states in which the BON has a blanket policy that nurses cannot be taking any narcotics while working, for any reason, however legitimate. Might be worth checking out the policy in your state.

Override a valid rx???

I know that with impaired nurses, that is very true (and unfortunately, leaves many legit pain needs unaddressed).

OP- if you find out that your BON is now your doc- I'd move :)

xtxrn, ASN, RN · Dec 6, 2011

Just did a quick search of "states that ban nurses using narcotics"

"nursing board bans nurses from taking narcotics"

They all revolved around substance abuse; the one I could find (in the few minutes I was willing to spend, not knowing what state this was about) was LA- and that only said that it was an issue if the nurse was impaired.

Normal doses of narcs w/patients who take them as prescribed should not cause impairment.

Again- they DO ban them for those nurses in recovery programs. That is understandable- but there are still a LOT of nurses who are in "legit" pain who are left in agony because of the black and white thinking- and not allowing for legit pain management. :down:

fiveofpeep · Dec 31, 2011

I know of a nurse in Texas who suffered license discipline because she took vicodin the night before a shift and it showed up in a probable cause drug screen.

I am curious too about this for my state because I have a back injury, and although I would never take it at work, after a bad shift I might need to take some to be able to sleep through the pain. I don't want to contact the BRN, because that's like putting a target on your head.

KelRN215, BSN, RN · Jan 1, 2012

I think it depends on your hospital. I was told two years ago, point blank, "you cannot work if you are taking narcotics." I wasn't at the time, I was in treatment for my back and my doctor wanted me on lifting restrictions. So, of course, since nothing can be simple, I couldn't just get a doctor's note, I also had to go to Occupational Health so that the clueless people there could "clear" me for duty. The NP had no reason to say that to me, she just rudely said "what are you taking for pain?" And when I said "Motrin" she responded with, "well you know you can't work if you're taking narcotics." Last I checked, NSAIDs are not narcotics.

morte, LPN, LVN · Jan 1, 2012

Just did a quick search of "states that ban nurses using narcotics"
"nursing board bans nurses from taking narcotics"
They all revolved around substance abuse; the one I could find (in the few minutes I was willing to spend, not knowing what state this was about) was LA- and that only said that it was an issue if the nurse was impaired.
Normal doses of narcs w/patients who take them as prescribed should not cause impairment.
Again- they DO ban them for those nurses in recovery programs. That is understandable- but there are still a LOT of nurses who are in "legit" pain who are left in agony because of the black and white thinking- and not allowing for legit pain management.

(z) Being unable to practice with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition. In enforcing this paragraph, the department shall have, upon a finding of the State Surgeon General or the State Surgeon General’s designee that probable cause exists to believe that the licensee is unable to practice because of the reasons stated in this paragraph, the authority to issue an order to compel a licensee to submit to a mental or physical examination by physicians designated by the department. If the licensee refuses to comply with the order, the department’s order directing the examination may be enforced by filing a petition for enforcement in the circuit court where the licensee resides or does business. The department shall be entitled to the summary procedure provided in s. 51.011. A licensee or certificateholder affected under this paragraph shall at reasonable intervals be afforded an opportunity to demonstrate that he or she can resume the competent practice of his or her profession with reasonable skill and safety to patients.

(aa) Testing positive for any drug, as defined in s. 112.0455, on any confirmed preemployment or employer-ordered drug screening when the practitioner does not have a lawful prescription and legitimate medical reason for using the drug

This what i found for FLA.

nicksavage · May 27, 2014

Texas "(10) Other Drug Related--actions or conduct that include, but are not limited to: (A) Use of any controlled substance or any drug, prescribed or unprescribed, or device or alcoholic beverages while on duty or on call and to the extent that such use may impair the nurse's ability to safely conduct to the public the practice authorized by the nurse's license;"

You can see that it states, prescribed or unprescribed and also and to the extent so there is interpretation there. Could it come back that it is and this and that and meaning and that. Don't take a chance. Too many laws leave interpretation in them and leave you hanging.

Resource http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&ti=22&ch=217&rl=12

NurseGirl525, ASN, RN · May 28, 2014

This where the problem lies. Does it impair you. Some people have a low tolerance and narcotics make them woozy. Other people like myself have been on them forever and it does not affect me. I have been on one for over. 4 years now. Same dosage, same everything. The same doc manages it. I have no side effects from it. I have an appt. every three months for a pain management appt. Some times they do a drug test. This is mandated by law in my state. My doc knows that I am in school to become a nurse and thinks I will make an excellent one. He says I will have a special kind of empathy. No one knows that I take narcotics. There is a huge stigma out there and it is sad. Not everyone is a drug seeker. Some people are just in pain. There is absolutely nothing wrong with that.

Cricket183, BSN, RN · Jun 12, 2014

A lot of hospitals have policies against taking narcotics also (even if they are prescribed). In 2006 I was diagnosed with RSD. According to hospital policy, I was not able to take any long-acting narcotics or any short-acting narcotics within 6 hours of my shift. My pain management doctor even offered to write a letter to employee health stating that long-acting narcotics did not cause me impairment. (I had been on 25mcg Fentanyl patch while on short term disability and was not providing direct patient care at the time.) The hospital refused to allow me to return to work until I was off all long-acting narcotics. I went off the fentanyl and returned to work for 15 months. Eventually I ended up being admitted into the hospital for 3 days in a pain crisis and going on permanent disability. RSD sucks!