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Good Comment. I am not in a position to take any action and I am
not dealing with a real situation at this time. I was questioning my own
quickly formed opinion on this issue during a discussion at work. This
weekend I received several private emails on this topic and had some great
e-mail conversations. I learned a lot about this issue and have now realized
this is a bigger topic than I first thought. Again thanks for all the
replies. Jeanne
Just a comment-Many
persons with mental and physical problems are protected by the Disabilities
Act and whatever action you take should be supported by concrete documentation
to support allegation of incompetence or inability to perform job.
-----Original
Message-----
From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of
[EMAIL PROTECTED]
Sent: Sunday, November 02, 2003 9:58
AM
To:
[EMAIL PROTECTED]
Subject: Re: A
little off topic
Thanks for all the comments. I really
appreciate and respect them. I am not totally swayed to change my
opinion but I am keeping an open mind and listening. Remember though
my concern is about nurses who deliver specific hands on care such as
medication administration. Jeanne
I agree with Holly - I think it
needs to be decided on a case by case basis, whether it is affecting the
nurses performance or not. It may be considered discrimination to make
a blanket statement, when someone needs a med to function, etc. But if
it is putting residents in danger then you may want to terminate the
employee or at least see that she gets help so that she can function
safely.
----- 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.
----- 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
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