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Can a nurse who has chronic, severe pain take narcotics if her physician can vouch that the meds do not impair her judgment?

Monday May 19, 2014
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Question:

Dear Nancy,

Can a nurse who has chronic, severe pain take narcotics if her physician can vouch that the meds he is prescribing has no effect on her judgment and can help her meet the physical demands of her job? I am curious as I know many nurses who have injured themselves while on the job or who have a medical condition that might require narcotics.

Nina



Dear Nancy replies:

Dear Nina,

Your question is a good one that can only be answered by your primary care physician and other physicians who are familiar with narcotic pain medication and their effects, if any, on one's functioning in a nursing position. This is an issue that comes up frequently in the real world and its resolution depends on many factors, including the pain medication involved, the nurse's response to the medication, how often the medication is prescribed to be taken and the nurse's responsibilities in his or her job.

Having said that, it is important to underscore that impairment of any type during one's professional practice is not acceptable. Each state nurse practice act and its rules clearly include impairment of any kind as a possible basis for disciplinary action against the nurse, whether there is a patient injury or not.

Rather than wait until there is a problem, whether it be a patient injury or a nurse injury (as you mention), it is best for the nurse to discuss this issue with his/her employer backed by a letter from the prescribing physician detailing what the medication is, its possible effects that might result in impairment and any other information that would impact the nurse's ability to function in a safe and effective manner within the job responsibilities.

Even with a glowing letter of support, however, it is important to remember that it is the nurse licensee who is accountable for his or her own conduct and judgment concerning the ability to provide safe and competent care to patients.

Simply taking a prescription medication that might cause impairment does not mean you cannot work or be hired in a particular position. The issue is whether you can practice nursing safely while on the medication. The Americans with Disabilities Act protects workers with disabilities. A person who needs a medication to treat a medical condition that is a disability under the act cannot be discriminated against solely on that basis if the individual is otherwise qualified and can perform the functions of the job. The bottom line is whether one safely can practice the particulars of the nursing position one holds and not place patients or others in harm's way.

Regards,
Nancy




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.