Is this nurse having any difficulty
performing her job duties? Is it impairing her judgement? I think that these
are concerns that need to be weighed. I would be very careful, though, due to
the disability act. Many nurses take antianxiety and antidepressant
medications. Weigh each situation individually and see if the medication helps
the nurse perform her job duties or hinders them.
Brenda W. Chance, RN, RAC-C
MDS Coordinator
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-----Original Message-----
From: Echo Bristol
[mailto:[EMAIL PROTECTED]
Sent: Saturday, November 01, 2003
9:21 AM
To: [EMAIL PROTECTED]
Subject: Re: A little off topic
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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