----- Original Message -----
Sent: Friday, October 31, 2003 8:21
PM
Subject: Re: A little off topic
I think my opinion would depend upon
which benzo was prescribed, the reason for it, and the physician's opinion.
I know that in South Carolina, one requirement for renewing or keeping one's
nursing license is being "mentally and physically fit to perform" the job.
The board will investigate claims of someone being mentally unfit or
unstable and unable to perform the duties. Additionally, in SC, if a
nurse is involuntarily committed to any mental health facility, s/he is
required to submit a statement from a physician that s/he is mentally fit to
perform as a nurse.
If a nurse is having free-floating anxiety and
has something like ativan ordered prn, I would have no compunctions about
this person working, as long as s/he was mentally alert and
capable of working the assigned shift. However, if someone were
having disabling panic attacks, and taking big doses of Klonopin or Xanax,
or if this nurse were popping whatever prescribed benzo left and right
without regard for the prescription instructions, then I would have a
big problem with that.
It's interesting that you bring this up... I
was instrumental in a nurse being relieved of her position quite
recently. In the course of doing an assessment, I found a nurse's note
that made no sense whatsoever. I mean, this was written word
salad, with an RN signature. When I brought it to the ADON's
attention, she began to find more and more documentation by this nurse
that was either illegible, nonsensical or both. When the nurse
got wind of the situation, she was then caught rewriting entire
pages of notes, signing other names and then feeding the originals into the
shredder.
Her explanation was that the medications she
was taking (including a benzo) made her sleepy. Her physician refused
to write a statement that she was capable of performing with her medications
and declined to change any of her meds, so she was allowed to
resign. I don't know what is going to happen with the board of nursing
investigation.
However, I have a very, very good friend,
who is also an MDS Coordinator, who has a fairly significant mental health
history. She takes a couple of medications that would be considered high
powered psychoactive drugs. And she is as competent and reliable as
anyone I have ever worked with.
So, my point is, I think there are no
blanket judgments that can be made. You have to look at the
individual situation, nurse performance, etc. to make a
decision.
Holly Sox
----- Original Message -----
Sent: Friday, October 31, 2003 7:18
PM
Subject: A little off topic
What do others think about a nurse administering medication and
rendering treatments while under the influence of
his/her prescribed benzodiazapine medication. This discussion
came up today and there were different thoughts on this. I wondered what
others thought about this issue. My opinion was that you should
not perform in this type of position while
taking this type of medication as if can affect mental alertness.
Others stated that due to the stressful world we live in and the
stressful nature of nursing and that since the medication is
prescribed they saw no problem with this. Is this a moral issue a
legal issue - neither or both? Perhaps my opinion is too harsh but
I wanted to hear what other's thoughts were on this issue.
Jeanne
