Can a nurse work while taking long-acting, prescribed pain medications for a chronic pain issue? Can a nurse work in pain? Who determines impairment, and how is it determined? How does one pass a drug screen if he or she takes pain meds, even if only on off hours?
Nancy Brent replies:
Your question raises many issues well beyond the scope of this column. Even so, some general, initial comments can be made.
Whether a nurse who is taking long-acting prescribed pain medication or who is in pain can work safely and effectively as a nurse is a medical issue that requires a licensed physician or licensed advanced practice nurse to evaluate. Many times, nurse employees will return to work after an accident or surgery in some pain and/or on certain pain medications but have a fitness for duty certification from their licensed healthcare provider. Compliance with the employers policy concerning being fit for duty is essential.
Insofar as passing a drug test when on a prescribed pain medication, when drug tests are done in the employment setting for any reason, the employee should be asked about any medications he or she is taking, including prescribed medications. It is to the employees advantage to be asked such a question, and the employee should carefully share any and all prescribed medications with the person collecting the sample. Indeed, the medications should be listed on the form used when the urine/blood sample is collected. If an employee tests positive for any medication, and it is properly prescribed, there should be no difficulty passing the drug test.
If, however, the employee is having problems functioning safely while on duty, there may be a need to evaluate what effect the designated medication is having on the ability of the nurse employee to provide safe nursing care to patients. Or, if the employers policy states that an employee cannot report to work when taking any medication, including a prescribed medication, then the nurse employee may not be allowed to work. In either case, following the employer policy, a decision would then be made concerning the employee and his or her ability to work and continue to work at the facility.
Should you need specific advice about a particular medication and your work situation, consulting with a nurse attorney or attorney in your state who works with employees would be important.
Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.