Are Nurses Drug Tested? | Polices and Guidelines

Most registered nurses are drug tested by their hospital, physician’s office, healthcare clinic, or medical facility.

It ensures they can provide adequate medical care and aren’t physiologically impaired.

Drug screening frequency varies greatly depending on the institution.

However, not all independent establishments test their employees routinely.

For instance, they may perform screenings monthly, yearly, or random.

In other situations, nurses work for years without a mandated drug test.

Some nurses take drug tests only before being hired or applying for a new position.

Drug test frequency and randomness often depend upon the organization.

Military and Navy Nurses

Military or navy nurses take routine drug tests to ensure they are not under the influence of illegal/impairing narcotics.

Organizations prioritizing patient safety and employee compliance also perform routine drug tests.

It ensures that employees aren’t working under the influence of potential drugs or alcohol.

Aside from working nurses, nursing students who apply for the nursing program must participate in drug testing.

If a nurse or student is on prescription drugs, the positive results of those drugs may be excused or omitted from testing.

However, organizations look at the level/amount of drugs in the individual’s system.

It ensures that the nurse/student isn’t abusing the prescription drugs beyond their recommended or prescribed dosage.

When Drug Tests May be Required

Organizations and healthcare facilities may require drug testing when hiring a nurse or accepting a student for a program.

Nurses may also participate in periodic or randomized testing, which varies greatly depending on their employer.

In some legal cases, defendants may take a drug test to rule out illegal substances as a possible cause of injury.

Lastly, a nurse involved in a medical error that causes harm to a patient’s health may need to take a drug test.

It ensures drugs or alcohol aren’t a cause for the patient-related medical error.

Types of Drug Testing

Those requested/required to take a drug test may need to take one of several tests.

It includes urine, blood, saliva, and hair sample tests.

The most common type of test is the urine test, which can measure recent drug usage.

Depending on the test, the results can confirm whether an individual has taken a substance within a certain period.

It also confirms the number of drugs in the nurse’s system (if any) at the testing time.

Hair samples may identify potential drug usage for a more extended period than a pee test.

However, these tests are much less common.

A hair sample test may be used in legal testing for court cases but are likely never used for regular drug screenings.

Blood, saliva, and other forms of testing may also be required.

However, they are much less common than a urine test.

What Institutions Perform Drug Tests?

Most healthcare facilities, government agencies, and private companies perform drug tests.

Any industry that provides healthcare services to patients or conducts business with customers typically requires testing.

It ensures that employees are coherent and not impaired while performing their duties.

It’s vital in direct care settings where the risk of harming patients is exceptionally high.

Places That Perform Drug Tests:

  • Hospitals
  • Government facilities
  • Community clinics
  • Physician offices
  • Nurse practitioner offices
  • Mental health services
  • Nursing homes
  • Urgent care centers
  • Emergency departments
  • Emergency medical services
  • Legal divisions

False Positives

While rare, a drug test may show a false positive when testing an individual for illegal substances.

In other words, the test may confirm that an individual has particular drugs in their system when they never used the drug.

One complaint some people have with randomized testing is that they may test positive for a drug they never took.

Individuals rarely test positive for a drug test if they haven’t used drugs.

However, it can cause headaches for those considered positive for drugs they haven’t taken.

Prescription drugs, cross-reacting substances, and human error regarding reading the test are reasons for a false positive.

Conversely, false negatives can occur when an individual uses a drug but tests negative for the substance.

Individuals falsely identified as using drugs or illegal substances may speak with their employer or seek legal counsel if needed.

Causes of a False Positive Drug Test:

  • Antibiotics
  • Antidepressants
  • Antihistamines
  • Antipsychotic drugs
  • Cannabinoid or CBD oil
  • Caffeinated drinks (i.e., tea)
  • Certain foods (i.e., poppy seeds)
  • HIV medication
  • Mouthwash
  • Over-the-counter drugs
  • Secondhand smoke

Other False Positive Causes:

  • Cross reacting substances
  • Defective testing equipment
  • Inaccurate test readings/human errors

It’s essential for nurses who receive false positives to consult their human resources department or equivalent.

Explain that the test isn’t accurate to get retested.

In this case, the testing facility may use different equipment or perform the test after a cross-reactive substance leaves the body.

You may also want to consult the testing facility directly to determine why a false positive is showing.

Make sure you disclose any substances you’ve taken that may result in a false positive.

For instance, describe any over-the-counter medications or foods you’ve consumed that can impact the test results.

Finally, you may need an attorney if your follow-up test is positive and your employer cannot provide further assistance.

When a Nurse Tests Positive for Drugs

Depending on the facility or organization and the extent of the situation, their disciplinary response varies significantly.

Disciplinary actions may include severe, mild, or no punitive measures.

Some nurses have reported no punishment or disciplinary actions taken on them.

Others were required to take mandatory counseling and participation in AA (or other drug-related) meetings.

In harsher cases, nurses may experience paid/unpaid time off, getting fired, losing their license, and possible legal action.

Legal actions may include jail time and fines, particularly if a patient is injured or harmed.

What Drugs do Nurses Get Tested For?

Nursing students, LPNs, registered nurses, nurse practitioners, and CRNAs may be tested for different drugs.

It includes common drugs like cannabis, cocaine, methamphetamines, opiates, psychoactive substances, and other drugs.

They may also test for barbiturates, benzodiazepine, methadone, methaqualone, phencyclidine (PCP), and propoxyphene.

Common Drug Tests Include:

  • Amphetamines
  • Barbiturates
  • Benzodiazepine
  • Cocaine
  • Marijuana
  • Methadone
  • Methaqualone
  • Opiates
  • Phencyclidine (PCP)
  • Propoxyphene

The tests a nursing school, healthcare facility, or government institution require varies based on the circumstances.

For instance, nurses who appear inebriated may receive an alcohol test.

Those with other behavioral challenges or signs of drug use may receive marijuana, cocaine, or opiate tests.

Randomized examinations can also include any of the previously mentioned tests.

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How Often do Nurses Get Drug tests?

Drug testing frequency varies depending on the institution, government facility, or nursing school.

Many nursing schools require students to get tested during their admission process.

Healthcare institutions and government facilities also require testing when hiring new applicants.

Nevertheless, these establishments may perform randomized, quarterly, or yearly tests for their employees.

These tests can result from the institution’s policies, the employee’s position/title, or state requirements.

They may also test nurses when a medical error occurs, during a lawsuit or when a nurse shows signs of potential drug use.

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Can You Fail a Drug Test and Keep Your Job as a Nurse?

It is very challenging for most nurses to keep their job if they fail a drug test, especially if they fail numerous tests.

Many states and healthcare institutions have strict policies regarding patient care and professionalism.

Hospitals that maintain staff who use illegal drugs open themselves up to lawsuits, malpractice, and other legal challenges.

They also put patients at risk who require the utmost care, attention, and professionalism.

Nevertheless, nurses who use prescriptive drugs and follow hospital guidelines may keep their jobs.

Each facility has policies for handling these situations based on state laws, the nurse’s discipline, and other circumstances.

As a result, it’s vital for nurses using prescriptions and legal drugs to consult their employers regarding their drug policies.

Do Nursing Students Get Drug Tests for Clinicals?

Most clinical sites require nursing students to get drug tested before participating in rotational or residency programs.

These screenings ensure students are not impaired while learning, providing patient care, or doing hands-on training.

In addition to partaking in a drug screening at the program’s start, students may also get tested during their clinicals.

In these instances, the clinical site may require additional tests if the student shows signs or may be impacted by drugs.

Can I Refuse to Get Drug Tested?

Most schools, hospitals, government facilities, nursing homes, and healthcare institutions have strict drug testing policies.

Nurses who refuse drug testing may face disciplinary action, including unpaid leave, job changes, and license suspension.

Nursing students who reject drug testing may face application rejection, suspension, or immediate program dismissal.

Every healthcare institution, nursing school, and government facility has policies regarding test refusal and results.

Therefore, licensed nurses and nursing students must determine the consequences of refusing a drug test.

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