Working with known drug user - PLEASE HELP

[CindyLou]

I am an RN and a CMA that worked in the hospital for 20+ years was busted in her house for drugs using/dealing. She also had drug samples in her house from the clinic area that she was working in at the time of the drug bust. She was fired and then the hospital hired her back, placing her in the nursing home. She has spoken with the DON about coming back over to the hospital and working. There is only one opening and it is at nights. I work nights. I am having a very hard time with this. I do not feel that it was morally or ethically right for them to hired her back (she has never been to rehab). I do not want her to work under me at the hospital because of my moral and ethical convictions and I feel that I would be utimately responsible for ALL of her actions. I have spoke with the DON regarding this and told her the exact above words. Her answer to me was - I have three applicants for the job and these are ....., now you tell me who you would hire out of the three. My answer was that I would continue to obtain applications until the best one came through. TheDON also told me that this person, who is now only a CNA,would not have access to any drugs. Wrong, the main med room is always locked as is the narcotic box, but the room that we mix our meds etc is not locked and this room does have drugs in it. She also told me that this person knows her stuff and is absolutely wonderful in the ER. (We work the floor and ER at the same time.) She did thank me for being honest with her but told me that the staff was not going to dictate who was hired or fired, which I understand her position with that. I do have the capabilites to go to another hospital 30+ miles away, which I would if they are hiring. I do have applications out to other states for licenses. But in the mean time, say they hire her, can I legally refuse to work with her, can I legally request drug testing on her? What kind of position am I being put into here? Someone please give me some insight on this. I will tell you that I am an RN of 1 1/2 years only and I am scared to be resposible for this person. I can talk openly with the DON and have done so, but am not getting the answers that I expected :-)! They can not give me any answer when I have asked why she was hired back in the first place. PLEASE HELP.

------------------

Cindy Lou

[Charles S. Smith, RN, MS]

I certainly appreciate your trepidation regarding this very stressful situation. I have a few questions for you? Is this person a licensed CNA? i.e. does your state board of nursing certify CNAs in any form? If your state certifies or licenses CNAs, then there is a legal mandate that this person is reported to the Board of Nursing for inquiry. Does your DON know this? Her license could be on the line for failure to report. Has this person been found guilty in a court of law for drug use/abuse/theft? If she/he has been found guilty in a court of law, the Board of Nursing requires notification. Does your hospital have an Employee Assistance Program that deals with drug issues? If so, the CNA may have gone through this department and you will not know due to confidentiality issues. If you do know, then someone is culpable for breaching confidentiality and can also be leagally sanctioned.

As to your fear of working with this CNA. If it is public knowledge that she/he was arrested on drug charges, she is still innocent until proven guilty in a court of law. The best you can do is to let the CNA know that her arrest is public knowledge. You can not and must not subject her/him to harrassment in any form while she/he is on duty or you can end up in a legal sling. I suggest you seek your Board of Nursing's advice on how to submit a formal, written objection to working with this CNA based on the requirement that you must supervise/delegate to her/him. Be careful, however, that you do not "spill the beans" about the individual involved or you could also end up being sued for libel by her/him. It is a sticky situation and if you like your place of employment and enjoy practicing nursing you may have to defer to the DON for the ultimate accountability in this issue. Ask the DON and Human Resources what your legal responsibilities are and get them in writing for your protection. Seek outside legal counsel if necessary. Good luck with this tough issue.