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nursingpins:     T1 - It is a bigger problem than most know about - often overlooked Waiting for
                 ocdgirl2000 to respond #RNchat
                 10/29/2009 20:39


ocdgirl2000:     #rnchat T1 frequently methadone clinics are blamed for diversion of their medication,
                 when more likely is pain management or Dr's offices.
                 10/29/2009 20:41


OSUMarkRN:       T1: I think it is still on the rise. #RNchat
                 10/29/2009 20:42


InfusionNurse:   Happening a lot in the OR...diverting instead of wasting.. #rnchat
                 10/29/2009 20:42


ocdgirl2000:     #rnchat T1 methadone is one of the most overdosed drugs around, but usually the pills,
                 not the liquid. pills often RX'd by Docs,not clinics.
                 10/29/2009 20:42


bthenextstep:    T1 my experience has been limited to what I read, and hear about. just had an incident
                 locally #rnchat
                 10/29/2009 20:42


nursingpins:     T1, I have seen act go on for a long time (with nurses)- but all get sloppy & do
                 themselves in (without interv.) #RNchat
                 10/29/2009 20:44


ocdgirl2000:     #rnchat T1 opiate use and abuse is ridiculously high. and overlooked. addiction to pills
                 escalates, then..they end up with us!
                 10/29/2009 20:44


EllenRichter:    T1 We were hoping that computerized dispensing units would prevent misuse, but anyone
                 who is creative can get around that #RNchat
                 10/29/2009 20:44


bthenextstep:    so are we asking the question of why it is happening? or how to prevent it? T1 #RNchat
                 10/29/2009 20:44


bthenextstep:    @EllenRichter T1 my argument for that is.. a computer is only as good as its user.
                 #rnchat
                 10/29/2009 20:45


ocdgirl2000:     #rnchat T1 before U know it, they are on lollypops, patches, diluadids, snorting, then
                 nothing helps, the pain of withdrawal worsens.
                 10/29/2009 20:45


rnchat:          @bthenextstep Haven't asked either yet, but you can answer that if you'd like. More about
                 how big the problem is. #RNchat
                 10/29/2009 20:46


OSUMarkRN:       T1: I think there is a very large hidden population who have learned to adapted to
                 computerized documentation. #RNchat #RNchat
                 10/29/2009 20:46


EllenRichter:    T1 @ocdgirl2000 boy you must have some hair-raising stories #RNchat
                 10/29/2009 20:46


bthenextstep:    T1 I'd only be guessing at how big the problem is. Lately I have read more and more
about it. And now seeing it locally! #rnchat
                 10/29/2009 20:47


nursingpins:     T1, I think the comp. systems helps - esp. smaller unit doses for MS and Dilaudid
                 #RNchat
                 10/29/2009 20:47


ocdgirl2000:     #rnchat T1 the addictive personality usually is a behavioral thing. recognize the
                 BEHAVIORS.
                 10/29/2009 20:47


ocdgirl2000:     #rnchat T1 recognize the symptoms of opiate withdrawal vs pain do you know the
                 difference?
                 10/29/2009 20:48


EllenRichter:    TI @nursingpins Dont be fooled--there are staff who swap pts' narcotics for saline, even
                 small doses add up #RNchat
                 10/29/2009 20:48


nursingpins:     @ocdgirl2000 behaviors that are common (I've seen) works many extra days - mood
                 swings etc - you are right. #RNchat
                 10/29/2009 20:49


rnchat:          @ocdgirl2000 T1 - so what are the key behavioral clues? #RNchat
                 10/29/2009 20:49


EllenRichter:    T1 @ocdgirl2000 No, tell us what opiate withdrawl symptoms are #RNchat
                 10/29/2009 20:49


ocdgirl2000:     #rnchat T1 when I first started doing this I didn't know!LOL! also there is a "seeking"
                 behavior quality that goes along with this.
                 10/29/2009 20:50


EllenRichter:    T1 Many times healthcare professionals get hurt & take narcotics, only to find they get
                 hooked on them. Then seeking @ work starts #RNchat
                 10/29/2009 20:51


AnthonyBurich:   Sorry that I'm late. Nursing school student, Northern California. Howdy. #rnchat
                 10/29/2009 20:52


bthenextstep:    T1 behavioral or not: one is having an RN treat another RN's patient for pain - knowing
                 the patient has not had any pain. #RNchat
                 10/29/2009 20:52


ocdgirl2000:     #rnchat T1 yes there is pain, stomach, cramping, diarrea, back,legs,inability 2 sleep,
                 runny nose,watery eyes,(flu-like) profuse diaphoresis
                 10/29/2009 20:52


OSUMarkRN:       @EllenRichter T1 Do you believe we should allow nurses to work if they have a Rx for
                 pain meds? #RNchat
                 10/29/2009 20:53


bthenextstep:    @AnthonyBurich welcome! #rnchat
                 10/29/2009 20:53


ctsinclair:      RT @EllenRichter @nursingpins Dont be fooled--there are staff who swap pts' narcotics
                 for saline, small doses add up #RNchat (shakes head)
                 10/29/2009 20:53
ocdgirl2000:     #rnchat T1 1 of ours IS an RN, lost license.orthopedic, worked 4 Docs.soooo sad!!
                 10/29/2009 20:54


nursingpins:     T1, most nurses I've known use (abu) oxy and hydro at first then MS and Demerol - then
                 real problems. (we need more drug testing) #RNchat
                 10/29/2009 20:54


ocdgirl2000:     #rnchat T1 another is presently in nursing school, mom is RN too.
                 10/29/2009 20:54


bthenextstep:    @OSUMarkRN @EllenRichter T1 I don't think we should make a blanket statement about
                 any/all RN's who use/need Rx narcs #RNchat
                 10/29/2009 20:55


AnthonyBurich:   @bthenextstep Thank you! What is T1? #rnchat
                 10/29/2009 20:55


EllenRichter:    T1 @osumarkrn Tough question. Narcotics can interfere with decision-making, yet many
                 are on chronic narcs & U would never know #RNchat
                 10/29/2009 20:55


AbbieCitron:     T1 Many cases I work on, pt. starts with true pain, prescribed narcs by many MDs,
                 become seekers, then have to be put on Methadone. #RNChat
                 10/29/2009 20:55


ocdgirl2000:     #rnchat T1 one was a physician, he lost his license, but not a methadone client.
                 10/29/2009 20:55


philbaumann:     Even if you're not a nurse, I think the convo over at #RNchat is worth a lurk.
                 10/29/2009 20:55


InfusionNurse:   T1 know of an RN who got hooked post surgery, then started taking, then sold her RX to
                 an undercover narc cop and got busted! #rnchat
                 10/29/2009 20:56


OSUMarkRN:       T1: "yet many are on chronic narcs", hence why at times we are not going to see the
                 'behaviors'. #RNchat
                 10/29/2009 20:56


EllenRichter:    RT @philbaumann: Even if you're not a nurse, I think the convo over at #RNchat is worth
                 a lurk.
                 10/29/2009 20:56


nursingpins:     T1 many patient drugs are taken when admitted - need better monit. #RNchat
                 10/29/2009 20:57


bthenextstep:    @AnthonyBurich scroll back through the search string of #rnchat. T1 is about drug
                 diversion.
                 10/29/2009 20:57


rnchat:          I'm tempted to let T1 keep going the full hour. Show of hands: would you like that?
                 #RNchat
                 10/29/2009 20:57


shelisrael:      RT @PhilBaumann Even if you're not a nurse, I think the convo over at #RNchat is worth
                 a lurk.
10/29/2009 20:58


ocdgirl2000:     #rnchat T1 there have been overdoses I have heard about in past of RNs who took
                 methadone!they passed away!!!sick!!one actually owned clinic
                 10/29/2009 20:58


EllenRichter:    T1 Monitoring of colleagues' behaviors relating to drug use is a very touchy
                 situation...most would rather turn their heads away #RNchat
                 10/29/2009 20:58


OSUMarkRN:       Reposting b/c it was lost... T1 "yet many are on chronic narcs", hence why we don't see
                 the 'behaviors'. #RNchat
                 10/29/2009 20:58


bthenextstep:    @ocdgirl2000 T1 I agree w/ you. I think regardless of your occupation, nurse or patient -
                 the behavior is the problem. #rnchat
                 10/29/2009 20:58


nursingpins:     T1 You are right Ellen - I see that 1st hand. #RNchat
                 10/29/2009 20:59


bthenextstep:    T1 don't you think the RN's who are guilty of this act would find another outlet had they
                 not be/been an RN?? #rnchat
                 10/29/2009 20:59


AbbieCitron:     RT @OSUMarkRN: Reposting b/c it was lost... T1 "yet many are on chronic narcs", hence
                 why we dont see the behaviors. #RNChat
                 10/29/2009 20:59


SeerGenius:      #rnchat i'm a lurker and not a nurse, but T1 sounds interesting - and not in a fetish kinda
                 way, but informing way.
                 10/29/2009 21:00


ocdgirl2000:     #rnchat T1 the brain is wired for addiction in some and not in others. addiction info is
                 fascinating! I would highly reccommend classes!
                 10/29/2009 21:00


EllenRichter:    @rnchat What is question #2? Now you have me curious! ;) #RNchat
                 10/29/2009 21:00


nursekris99:     T1: Cancer nurse. See problems all the time from family members. #RNchat
                 10/29/2009 21:00


AnthonyBurich:   @OSUMarkRN Very similar to "functioning" alcoholics - and we know there are LOTS of
                 them around. #rnchat
                 10/29/2009 21:00


bthenextstep:    RT @AnthonyBurich: @OSUMarkRN Very similar to "functioning" alcoholics - and we
                 know there are LOTS of them around. #rnchat
                 10/29/2009 21:00


OSUMarkRN:       @AnthonyBurich T1: agree #RNchat
                 10/29/2009 21:00


nursingpins:     @AbbieCitron - as long as they get the meds - will not see the behav. The problem is
                 when they dont have them. #RNchat
                 10/29/2009 21:01
ocdgirl2000:     RT @ nursingpins: T1 many patient drugs are taken when admitted - need better monit.
                 #RNchat omg! I second THAT!!!
                 10/29/2009 21:01


rnchat:          @EllenRichter It's about how nurses can leverage social web - but this convo amazing. I
                 can save that topic for the next chat. #RNchat
                 10/29/2009 21:02


AnthonyBurich:   @bthenextstep Most definitely! #rnchat
                 10/29/2009 21:03


rnchat:          NOTE: I've decided to hold off on another topic. T1 seems to have sparked some juicy
                 awesomeness. Continue my friends! #RNchat
                 10/29/2009 21:03


RoRod101:        Hi All, Sorry to be late. Can I join? My name is Ro. I am a RN NP Nurse Educator &
                 DNP student. #RNchat
                 10/29/2009 21:03


bthenextstep:    T1 so yeah or neh to moving on to T2? I'm good w/ either. :) #rnchat
                 10/29/2009 21:03


EllenRichter:    @rnchat Sure, we can fill an hour with this topic (T1) :) #RNchat
                 10/29/2009 21:03


bthenextstep:    T1 so should RN's be drug screened ? yearly? I remember only on hire? #rnchat
                 10/29/2009 21:04


ocdgirl2000:     @nursingpins #rnchat they leverage the meds by selling, buy friends, love,superficial
                 things, distorts reality, gets worse, other addictions
                 10/29/2009 21:04


OSUMarkRN:       @bthenextstep T1: I think all h/c workers should be yearly. #RNchat
                 10/29/2009 21:05


bthenextstep:    T1 it is then #rnchat
                 10/29/2009 21:05


nursingpins:     T1 - Nurses need to be drug tested at least every 2 monts - or we will not change things
                 - sorry to say. #RNchat
                 10/29/2009 21:05


EllenRichter:    Welcome latecomers @rorod101 @anthonyburich @nursekris99 @seergenius #RNchat
                 10/29/2009 21:05


bthenextstep:    @ocdgirl2000 so then we're still on the behavior of addiction. I agree w/ that. #rnchat
                 10/29/2009 21:05


rnchat:          @RoRod101 Welcome, Ro. Here's T1 - http://bit.ly/1VZZNc #RNchat
                 10/29/2009 21:06


bthenextstep:    @OSUMarkRN T1 I do as well. #RNchat
                 10/29/2009 21:06


EllenRichter:    T1 ~For sure, random drug testing of health care professionals would certainly weed out
                 noncompliant people #RNchat
                 10/29/2009 21:06
AnthonyBurich:   @bthenextstep My class just got screened pre-clinical rotation. #rnchat
                 10/29/2009 21:06


ocdgirl2000:     #rnchat T1 they have to screen us @ hire Gov is into it! LOL! I would love it! great plus 4
                 job like ours, hard to find good methadone RN's
                 10/29/2009 21:06


RoRod101:        @rnchat Thx. About to ask that. :) #RNchat
                 10/29/2009 21:06


InfusionNurse:   shld be tested 2 when behaving suspiciously! RT @OSUMarkRN: @bthenextstep T1: I
                 think all h/c workers should be yearly. #rnchat
                 10/29/2009 21:06


AnthonyBurich:   @EllenRichter Thank You!! #rnchat
                 10/29/2009 21:07


bthenextstep:    @bamagirlRN That was my point. LOL I think the behavior is the issue - AND they
                 happen to be RN's. #RNchat
                 10/29/2009 21:07


EllenRichter:    T1 And those health care professionals on legitimate prescription drugs can have results
                 waived with valid rx #RNchat
                 10/29/2009 21:07


bthenextstep:    T1 I believe there is a protocol for testing when suspicion is found. But why not yearly
                 testing - period. #rnchat
                 10/29/2009 21:08


nursingpins:     T1 - Critical care nurses are so strange - would be hard to tell when a behav. is new - ;)
                 #RNchat
                 10/29/2009 21:08


OSUMarkRN:       @EllenRichter T1 agreed. #RNchat
                 10/29/2009 21:08


chuymatt:        so, are we talking someone watching me as I pee? I must say, the feeling with jobs like
                 that is that we are not trusted. #rnchat
                 10/29/2009 21:08


ocdgirl2000:     #rnchat T1 they should also breathalize RN's as well. especially in the AM.
                 10/29/2009 21:08


bthenextstep:    @EllenRichter T1 good point about the valid Rx. #rnchat
                 10/29/2009 21:08


OSUMarkRN:       @nursingpins OUCH! #RNchat
                 10/29/2009 21:08


bthenextstep:    @nursingpins T1 HAH.. you are so right. Sad.. but true. #rnchat
                 10/29/2009 21:09


EllenRichter:    T1 I'm wondering if we would have many staff left to work if there were random drug
                 tests!!! #RNchat
                 10/29/2009 21:09


nursekris99:     T1: Our company has a random testing policy, but has yet to enforce it. #rnchat
10/29/2009 21:09


bthenextstep:    @chuymatt T1 so then how do you keep the workplace safe without offending someones
                 trust? (w/ yearly screening) #rnchat
                 10/29/2009 21:10


ocdgirl2000:     #rnchat T1 you would be surprised how high the blood ETOH level is 4 someone who has
                 a tolerance is!people who drink maintenance q day?heh!
                 10/29/2009 21:10


AnthonyBurich:   @EllenRichter Do you think a healthcare pro consuming narcotics on a script is still a
                 danger to patients and coworkers? #rnchat
                 10/29/2009 21:10


nursingpins:     T1 - Drug div. is a much bigger problem with nurses than most know about - I see it!
                 #RNchat
                 10/29/2009 21:10


chuymatt:        "to clock in, swipe your card, pee in the cup and breathe into the mouth piece." #rnchat
                 10/29/2009 21:10


RoRod101:        T1 Have not seen 1st hand. But one thing I keep in mind is nurse are human first,
                 therefore susceptible to human afflictions. #RNchat
                 10/29/2009 21:10


OSUMarkRN:       @nursekris99 T1: that's the prob with most random test P&P - it is never enforced.
                 #RNchat
                 10/29/2009 21:10


RoRod101:        @EllenRichter Thanks for the welcoming party. :) #RNchat
                 10/29/2009 21:11


chuymatt:        @bthenextstep keep a random drug testing policy that is signed off with hire. Ed. on s/sx
                 of diversion. Test those who seem it. #rnchat
                 10/29/2009 21:11


bthenextstep:    @AnthonyBurich @EllenRichter w/ that in mind.. aren't we all a pot threat to the patients?
                 (mere safety - not just nard use)#rnchat
                 10/29/2009 21:12


nursingpins:     T1 -nurses are human - same addict. personalities as gen. pop - but WE have more
                 axcess. #RNchat
                 10/29/2009 21:12


nursekris99:     @OSUMarkRN They DON'T test the ones who need it, and threaten people they just
                 don't like. But no one pees in a cup. #RNchat
                 10/29/2009 21:12


EllenRichter:    T1 @anthonyburich Yes, working with patients' lives requires a sharp mind, not a drug-
                 induced state. But I know there R exceptions #RNchat
                 10/29/2009 21:12


ocdgirl2000:     @RoRod101 #rnchat howdy! this is a fun chat!LOL! welcome!
                 10/29/2009 21:12


Geek2Nurse:      Hopping in late - Psych RN working toward PMHNP. My super power is insight into
                 *other* people's problems (not so easy with my own!) #rnchat
                 10/29/2009 21:13
false2scams:     T1 @ocdgirl2000 No, tell us what opiate withdrawl symptoms are #RNchat
                 http://tinyurl.com/yjrrqck
                 10/29/2009 21:13


chuymatt:        @bthenextstep T1 on further thought, yearly testing does not seem like a horrible thing to
                 do. #rnchat
                 10/29/2009 21:13


philbaumann:     I worked in one facility that had random tests. No biggie - unless you didn't drink fluids for
                 an entire 12-hour shift. :) #RNchat
                 10/29/2009 21:13


bthenextstep:    @philbaumann what.. a nurse not drink fluids for a 12hr shift? never heard of such a
                 thing? ;) #rnchat
                 10/29/2009 21:14


AbbieCitron:     T1 So I'm curious, how and when is drug testing done at your hospital? or is it done?
                 #RNChat
                 10/29/2009 21:14


chuymatt:        I think that there might need to be further policies in place to address addiction as a
                 disease too. For those who are, Tx. #rnchat
                 10/29/2009 21:14


ocdgirl2000:     #rnchat T1 you go in room w-out anything to hide stuff, they don't stare so close, not so
                 bad!we do this to patients 2x/wk! get levels of RX
                 10/29/2009 21:14


EllenRichter:    T1 I know that firefighters, pilots, & many other professions require mandatory testing &
                 there are urine kits used to taint results #RNchat
                 10/29/2009 21:14


RoRod101:        @ocdgirl2000 Hey there! #RNchat
                 10/29/2009 21:15


nursingpins:     You are right Ellen - some nur are still the best - even when imp! - It is the tail end when
                 they get sloppy that does them in. #RNchat
                 10/29/2009 21:15


bthenextstep:    @chuymatt but it would still have to be done randomly.. so that no one could prepare
                 ahead. #rnchat
                 10/29/2009 21:15


chuymatt:        @bthenextstep I have a timer set on my watch for q2h to drink some water. So sad.
                 #rnchat
                 10/29/2009 21:15


bthenextstep:    @AbbieCitron i only know of the initial hire screening.. then only when suspected will they
                 drug screen. #rnchat
                 10/29/2009 21:16


AnthonyBurich:   @bthenextstep Agreed! Random prevents any detox attempts or other shenanigans.
                 #rnchat
                 10/29/2009 21:17


RoRod101:        @bthenextstep That's how I know it too. #RNchat
                 10/29/2009 21:17
bthenextstep:    @EllenRichter I think we all could agree - regardless of what can/could be implemented:
                 someone will always find a way around it. #RNchat
                 10/29/2009 21:17


nursingpins:     YES - Randon tests are needed. #RNchat
                 10/29/2009 21:17


ocdgirl2000:     #rnchat T1 @chuymatt addiction IS a disease.& it is treatable,or we would not be in
                 business!bless addiction treatment & funding 4 doing it
                 10/29/2009 21:18


EllenRichter:    @bthenextstep T1 Yes!! Anyone who is cunning & manipulative can find a way to beat
                 ANY system #RNchat
                 10/29/2009 21:18


AbbieCitron:     RT @bthenextstep: I think we all could agree-regardless of what can/could be
                 implemented: someone will always find a way around it. #RNChat
                 10/29/2009 21:18


bthenextstep:    So then - is there such a thing as a foolproof method? #rnchat
                 10/29/2009 21:19


ocdgirl2000:     #rnchat T1 there is no way around the spit tests, sorry! they are expensive as all heck!
                 10/29/2009 21:19


Geek2Nurse:      Darnit, I keep forgetting the tag. #rnchat
                 10/29/2009 21:19


InfusionNurse:   I agree..RT @nursingpins: YES - Randon tests are needed. #rnchat
                 10/29/2009 21:19


Geek2Nurse:      T1 I'm not against random testing, tho it's a pain for me, since Adderall makes me show
                 positive for amphetamines. #rnchat
                 10/29/2009 21:19


nursekris99:     We had an alcoholic on staff;her busting meant no alcohol even at office social functions.
                 #RNchat
                 10/29/2009 21:20


Geek2Nurse:      T1 Also take occasional Valium for Meniere's symptoms, & it sticks around for a few days
                 in the bloodstream. #rnchat
                 10/29/2009 21:20


bthenextstep:    @Geek2Nurse try using tweetchat- that's what helped me. or tweetdeck #rnchat
                 10/29/2009 21:20


chuymatt:        @Geek2Nurse As long as you have the Rx, it should not be an issue. #rnchat
                 10/29/2009 21:21


Geek2Nurse:      T1 So I worry about perceptions. Even tho my Rxs are on file with HR, anyone looking at
                 lab results doesn't know that. #rnchat
                 10/29/2009 21:21


RoRod101:        @Geek2Nurse U bring up something interesting what would happen with false positives?
                 #RNchat
                 10/29/2009 21:21
bthenextstep:    @Geek2Nurse but I think these are all s/s that would be accounted for as long as they
                 are known ahead. #rnchat
                 10/29/2009 21:21


EllenRichter:    T1 @rorod101 I didnt know there could be false positive drug tests...what causes that?
                 #RNchat
                 10/29/2009 21:22


OSUMarkRN:       Ok. Need to sign off. Good night. #RNchat
                 10/29/2009 21:22


bthenextstep:    Join me for a #rnchat TweetChat at: http://tweetchat.com/room/rnchat - drug diversion is
                 the topic of discussion #rnchat
                 10/29/2009 21:22


nursingpins:     The long term imp nurses are the ones that are the most destructive in the end - and the
                 ones that need the most help. #RNchat
                 10/29/2009 21:22


AnthonyBurich:   @bthenextstep Nothing foolproof. It's a vicious cycle - just look at all of the sports doping
                 scandals. Constant oneupmanship. #rnchat
                 10/29/2009 21:22


Geek2Nurse:      T1 And I can assure you, they wouldn't want me doing patient care *off* my Adderall. :) I
                 absolutely won't pass meds without it! #rnchat
                 10/29/2009 21:22


chuymatt:        @RoRod101 usually there is a 2° check. They should also check your teeth for poppy
                 seeds... #rnchat
                 10/29/2009 21:23


ocdgirl2000:     #rnchat T1 what we do is send out our pos n patients 2 the lab for LEVELS & break
                 down to consituents of exact drug content!falses eliminate
                 10/29/2009 21:23


bthenextstep:    @Geek2Nurse only the ones who need to know should be looking at the results anyway.
                 #rnchat
                 10/29/2009 21:23


AnthonyBurich:   @nursekris99 That sucks! The action of one ruins for all. #rnchat
                 10/29/2009 21:23


RoRod101:        @EllenRichter False in the sense someone taking therapeutic meds #RNchat
                 10/29/2009 21:23


rnchat:          T1 Follow-up: So what the noblest way for facilities to approach nurses caught diverting?
                 #RNchat
                 10/29/2009 21:23


ocdgirl2000:     #rnchat T1 sorry for typos, we are like lab rats where we work!LOL!
                 10/29/2009 21:23


bthenextstep:    @EllenRichter isn't that like the poppyseed false positive? #rnchat
                 10/29/2009 21:24


AnthonyBurich:   @OSUMarkRN Good night. #rnchat
                 10/29/2009 21:24
bthenextstep:    @chuymatt hah! beat me to the poppyseed punch. LOL #rnchat
                 10/29/2009 21:24


bthenextstep:    @AnthonyBurich night! thanks for the input! #rnchat
                 10/29/2009 21:25


AnthonyBurich:   RT @chuymatt: @RoRod101 usually there is a 2° check. They should also check your
                 teeth for poppy seeds... LOL #rnchat
                 10/29/2009 21:25


nursingpins:     T1 - need to be confront. - they know when they are caught. - Phil #RNchat
                 10/29/2009 21:25


AbbieCitron:     Good Night All. Enjoyed the informative chat! #RNChat
                 10/29/2009 21:25


nursekris99:     @rnchat A hospital I worked at removed narc privileges for a certain time. Then rehab,
                 testing, etc. #RNchat
                 10/29/2009 21:26


EllenRichter:    T1 The noblest way to deal with nurses (or any other health care professionals) is to offer
                 help #RNchat
                 10/29/2009 21:26


nursingpins:     Good noct all - Thanks Phill #RNchat
                 10/29/2009 21:26


bthenextstep:    @OSUMarkRN night. thanks for playing! LOL #rnchat
                 10/29/2009 21:26


chuymatt:        @bthenextstep for those who have not seen the Mythbusters episode, it was a wonderful,
                 forgone conclusion. Very entertaining. #rnchat
                 10/29/2009 21:26


bthenextstep:    RT @EllenRichter: T1 The noblest way to deal with nurses (or any other health care
                 professionals) is to offer help. well said #rnchat
                 10/29/2009 21:26


rnchat:          Holy Cow! We're coming up on another fast hour of #RNchat - feel free to continue, but
                 we'll be wrapping up soon. See next few tweets.
                 10/29/2009 21:26


ocdgirl2000:     RT @rnchat: T1 Follow-up: So what the noblest way for facilities to approach nurses
                 caught diverting? #RNchat REFER 2 TREATMENT!!!
                 10/29/2009 21:27


bthenextstep:    @rnchat noblest way is open and honest communication toward helping those who need
                 it. period. #rnchat
                 10/29/2009 21:27


RoRod101:        RT @ocdgirl2000: #rnchat T1 sorry for typos, LOL! ~ I'm not at work :0 #RNchat
                 10/29/2009 21:27


chuymatt:        @EllenRichter suspension? laying off? I have no clue. Tx must be in the plan or we will
                 be out much needed RNs. #rnchat
                 10/29/2009 21:27
AnthonyBurich:   Does the ANA or some other governing board have protocol regarding diversion? #rnchat
                 10/29/2009 21:28


Geek2Nurse:      @RoRod101 T1 In my case, it's not really a "false" positive. Adderall is an amphetamine;
                 Valium is a benzo. #rnchat
                 10/29/2009 21:28


EllenRichter:    T1 We let a staff nurse leave an hour early once a week to make her AA meetings. Thats
                 what I mean by help & support, too! Very impt #RNchat
                 10/29/2009 21:28


bthenextstep:    @rnchat i forgot how fun these chats are Phil. You DA-MAN #rnchat
                 10/29/2009 21:28


ocdgirl2000:     #rnchat T1 well, what did you expect me to say? I get paid to say that!LMAO!!
                 10/29/2009 21:28


bthenextstep:    @EllenRichter that's awesome. #rnchat
                 10/29/2009 21:29


RoRod101:        @Geek2Nurse Got it :) #RNchat
                 10/29/2009 21:29


chuymatt:        RT @bthenextstep: "@EllenRichter thats awesome." Indeed. #rnchat
                 10/29/2009 21:30


InfusionNurse:   Thanks Phil! Good chatting with everyone! Good night, till next chat! #rnchat
                 10/29/2009 21:30


rnchat:          Thank you everyone! Wonderful chat tonight! Transcript will be up in a bit. Next tweet will
                 tell you when the next #RNchat will be.
                 10/29/2009 21:30


RoRod101:        Great chat all! Nice to chat with fellow nurses. #RNchat
                 10/29/2009 21:30


Geek2Nurse:      T1 Ironically, @RoRod101, I've never done any kind of illicit drugs, don't even drink
                 alcohol. :) #rnchat
                 10/29/2009 21:31


ocdgirl2000:     @RoRod101 #rnchat I'm not at work either, lol!although sometimes it's hard to leave
                 there!typos I'm sooo tired get up at 4 am..
                 10/29/2009 21:31


bthenextstep:    RT @nursingpins: Good noct all - now that there's funny. LOL #rnchat
                 10/29/2009 21:31


AnthonyBurich:   @rnchat Thanks Phil for hosting another awesome chat. Really fun with so many great
                 participants! Thank you all - and good night! #rnchat
                 10/29/2009 21:31


EllenRichter:    T1 Very interesting topic. Thanks for all the great conversation, people! :) #RNchat
                 10/29/2009 21:32


bthenextstep:    FYI I hope I didn't miss anyone - I tried to add all the new faces to my Twitter acct.
                 #rnchat
                 10/29/2009 21:32
rnchat:         Next #RNchat - 11:30 EST (15:30 UTC) Wednesday 11/4
                10/29/2009 21:32


EllenRichter:   @ocdgirl2000 you were our specialist tonight! Thanks for your thoughts on this subject!
                #RNchat
                10/29/2009 21:32


bthenextstep:   have a great night everyone #rnchat
                10/29/2009 21:33


RoRod101:       RT @AnthonyBurich @rnchat Thanks Phil for hosting another awesome chat. Really fun
                with so many great participants! Thx all! #rnchat
                10/29/2009 21:33


chuymatt:       goede nacht, all. #rnchat
                10/29/2009 21:33


ocdgirl2000:    #rnchat @AnthonyBurich: Does the ANA or some other governing board have protocol
                regarding diversion? prob suspension! report to AADA
                10/29/2009 21:33


EllenRichter:   RT @AnthonyBurich @rnchat Thanks Phil 4 hosting another awesome chat. Really fun
                with so many great participants! TY & good night! #RNchat
                10/29/2009 21:34


ocdgirl2000:    #rnchat here's a good link http://www.samhsa.gov/
                10/29/2009 21:37

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RNchat Transcript: October 29, 2009

  • 1. nursingpins: T1 - It is a bigger problem than most know about - often overlooked Waiting for ocdgirl2000 to respond #RNchat 10/29/2009 20:39 ocdgirl2000: #rnchat T1 frequently methadone clinics are blamed for diversion of their medication, when more likely is pain management or Dr's offices. 10/29/2009 20:41 OSUMarkRN: T1: I think it is still on the rise. #RNchat 10/29/2009 20:42 InfusionNurse: Happening a lot in the OR...diverting instead of wasting.. #rnchat 10/29/2009 20:42 ocdgirl2000: #rnchat T1 methadone is one of the most overdosed drugs around, but usually the pills, not the liquid. pills often RX'd by Docs,not clinics. 10/29/2009 20:42 bthenextstep: T1 my experience has been limited to what I read, and hear about. just had an incident locally #rnchat 10/29/2009 20:42 nursingpins: T1, I have seen act go on for a long time (with nurses)- but all get sloppy & do themselves in (without interv.) #RNchat 10/29/2009 20:44 ocdgirl2000: #rnchat T1 opiate use and abuse is ridiculously high. and overlooked. addiction to pills escalates, then..they end up with us! 10/29/2009 20:44 EllenRichter: T1 We were hoping that computerized dispensing units would prevent misuse, but anyone who is creative can get around that #RNchat 10/29/2009 20:44 bthenextstep: so are we asking the question of why it is happening? or how to prevent it? T1 #RNchat 10/29/2009 20:44 bthenextstep: @EllenRichter T1 my argument for that is.. a computer is only as good as its user. #rnchat 10/29/2009 20:45 ocdgirl2000: #rnchat T1 before U know it, they are on lollypops, patches, diluadids, snorting, then nothing helps, the pain of withdrawal worsens. 10/29/2009 20:45 rnchat: @bthenextstep Haven't asked either yet, but you can answer that if you'd like. More about how big the problem is. #RNchat 10/29/2009 20:46 OSUMarkRN: T1: I think there is a very large hidden population who have learned to adapted to computerized documentation. #RNchat #RNchat 10/29/2009 20:46 EllenRichter: T1 @ocdgirl2000 boy you must have some hair-raising stories #RNchat 10/29/2009 20:46 bthenextstep: T1 I'd only be guessing at how big the problem is. Lately I have read more and more
  • 2. about it. And now seeing it locally! #rnchat 10/29/2009 20:47 nursingpins: T1, I think the comp. systems helps - esp. smaller unit doses for MS and Dilaudid #RNchat 10/29/2009 20:47 ocdgirl2000: #rnchat T1 the addictive personality usually is a behavioral thing. recognize the BEHAVIORS. 10/29/2009 20:47 ocdgirl2000: #rnchat T1 recognize the symptoms of opiate withdrawal vs pain do you know the difference? 10/29/2009 20:48 EllenRichter: TI @nursingpins Dont be fooled--there are staff who swap pts' narcotics for saline, even small doses add up #RNchat 10/29/2009 20:48 nursingpins: @ocdgirl2000 behaviors that are common (I've seen) works many extra days - mood swings etc - you are right. #RNchat 10/29/2009 20:49 rnchat: @ocdgirl2000 T1 - so what are the key behavioral clues? #RNchat 10/29/2009 20:49 EllenRichter: T1 @ocdgirl2000 No, tell us what opiate withdrawl symptoms are #RNchat 10/29/2009 20:49 ocdgirl2000: #rnchat T1 when I first started doing this I didn't know!LOL! also there is a "seeking" behavior quality that goes along with this. 10/29/2009 20:50 EllenRichter: T1 Many times healthcare professionals get hurt & take narcotics, only to find they get hooked on them. Then seeking @ work starts #RNchat 10/29/2009 20:51 AnthonyBurich: Sorry that I'm late. Nursing school student, Northern California. Howdy. #rnchat 10/29/2009 20:52 bthenextstep: T1 behavioral or not: one is having an RN treat another RN's patient for pain - knowing the patient has not had any pain. #RNchat 10/29/2009 20:52 ocdgirl2000: #rnchat T1 yes there is pain, stomach, cramping, diarrea, back,legs,inability 2 sleep, runny nose,watery eyes,(flu-like) profuse diaphoresis 10/29/2009 20:52 OSUMarkRN: @EllenRichter T1 Do you believe we should allow nurses to work if they have a Rx for pain meds? #RNchat 10/29/2009 20:53 bthenextstep: @AnthonyBurich welcome! #rnchat 10/29/2009 20:53 ctsinclair: RT @EllenRichter @nursingpins Dont be fooled--there are staff who swap pts' narcotics for saline, small doses add up #RNchat (shakes head) 10/29/2009 20:53
  • 3. ocdgirl2000: #rnchat T1 1 of ours IS an RN, lost license.orthopedic, worked 4 Docs.soooo sad!! 10/29/2009 20:54 nursingpins: T1, most nurses I've known use (abu) oxy and hydro at first then MS and Demerol - then real problems. (we need more drug testing) #RNchat 10/29/2009 20:54 ocdgirl2000: #rnchat T1 another is presently in nursing school, mom is RN too. 10/29/2009 20:54 bthenextstep: @OSUMarkRN @EllenRichter T1 I don't think we should make a blanket statement about any/all RN's who use/need Rx narcs #RNchat 10/29/2009 20:55 AnthonyBurich: @bthenextstep Thank you! What is T1? #rnchat 10/29/2009 20:55 EllenRichter: T1 @osumarkrn Tough question. Narcotics can interfere with decision-making, yet many are on chronic narcs & U would never know #RNchat 10/29/2009 20:55 AbbieCitron: T1 Many cases I work on, pt. starts with true pain, prescribed narcs by many MDs, become seekers, then have to be put on Methadone. #RNChat 10/29/2009 20:55 ocdgirl2000: #rnchat T1 one was a physician, he lost his license, but not a methadone client. 10/29/2009 20:55 philbaumann: Even if you're not a nurse, I think the convo over at #RNchat is worth a lurk. 10/29/2009 20:55 InfusionNurse: T1 know of an RN who got hooked post surgery, then started taking, then sold her RX to an undercover narc cop and got busted! #rnchat 10/29/2009 20:56 OSUMarkRN: T1: "yet many are on chronic narcs", hence why at times we are not going to see the 'behaviors'. #RNchat 10/29/2009 20:56 EllenRichter: RT @philbaumann: Even if you're not a nurse, I think the convo over at #RNchat is worth a lurk. 10/29/2009 20:56 nursingpins: T1 many patient drugs are taken when admitted - need better monit. #RNchat 10/29/2009 20:57 bthenextstep: @AnthonyBurich scroll back through the search string of #rnchat. T1 is about drug diversion. 10/29/2009 20:57 rnchat: I'm tempted to let T1 keep going the full hour. Show of hands: would you like that? #RNchat 10/29/2009 20:57 shelisrael: RT @PhilBaumann Even if you're not a nurse, I think the convo over at #RNchat is worth a lurk.
  • 4. 10/29/2009 20:58 ocdgirl2000: #rnchat T1 there have been overdoses I have heard about in past of RNs who took methadone!they passed away!!!sick!!one actually owned clinic 10/29/2009 20:58 EllenRichter: T1 Monitoring of colleagues' behaviors relating to drug use is a very touchy situation...most would rather turn their heads away #RNchat 10/29/2009 20:58 OSUMarkRN: Reposting b/c it was lost... T1 "yet many are on chronic narcs", hence why we don't see the 'behaviors'. #RNchat 10/29/2009 20:58 bthenextstep: @ocdgirl2000 T1 I agree w/ you. I think regardless of your occupation, nurse or patient - the behavior is the problem. #rnchat 10/29/2009 20:58 nursingpins: T1 You are right Ellen - I see that 1st hand. #RNchat 10/29/2009 20:59 bthenextstep: T1 don't you think the RN's who are guilty of this act would find another outlet had they not be/been an RN?? #rnchat 10/29/2009 20:59 AbbieCitron: RT @OSUMarkRN: Reposting b/c it was lost... T1 "yet many are on chronic narcs", hence why we dont see the behaviors. #RNChat 10/29/2009 20:59 SeerGenius: #rnchat i'm a lurker and not a nurse, but T1 sounds interesting - and not in a fetish kinda way, but informing way. 10/29/2009 21:00 ocdgirl2000: #rnchat T1 the brain is wired for addiction in some and not in others. addiction info is fascinating! I would highly reccommend classes! 10/29/2009 21:00 EllenRichter: @rnchat What is question #2? Now you have me curious! ;) #RNchat 10/29/2009 21:00 nursekris99: T1: Cancer nurse. See problems all the time from family members. #RNchat 10/29/2009 21:00 AnthonyBurich: @OSUMarkRN Very similar to "functioning" alcoholics - and we know there are LOTS of them around. #rnchat 10/29/2009 21:00 bthenextstep: RT @AnthonyBurich: @OSUMarkRN Very similar to "functioning" alcoholics - and we know there are LOTS of them around. #rnchat 10/29/2009 21:00 OSUMarkRN: @AnthonyBurich T1: agree #RNchat 10/29/2009 21:00 nursingpins: @AbbieCitron - as long as they get the meds - will not see the behav. The problem is when they dont have them. #RNchat 10/29/2009 21:01
  • 5. ocdgirl2000: RT @ nursingpins: T1 many patient drugs are taken when admitted - need better monit. #RNchat omg! I second THAT!!! 10/29/2009 21:01 rnchat: @EllenRichter It's about how nurses can leverage social web - but this convo amazing. I can save that topic for the next chat. #RNchat 10/29/2009 21:02 AnthonyBurich: @bthenextstep Most definitely! #rnchat 10/29/2009 21:03 rnchat: NOTE: I've decided to hold off on another topic. T1 seems to have sparked some juicy awesomeness. Continue my friends! #RNchat 10/29/2009 21:03 RoRod101: Hi All, Sorry to be late. Can I join? My name is Ro. I am a RN NP Nurse Educator & DNP student. #RNchat 10/29/2009 21:03 bthenextstep: T1 so yeah or neh to moving on to T2? I'm good w/ either. :) #rnchat 10/29/2009 21:03 EllenRichter: @rnchat Sure, we can fill an hour with this topic (T1) :) #RNchat 10/29/2009 21:03 bthenextstep: T1 so should RN's be drug screened ? yearly? I remember only on hire? #rnchat 10/29/2009 21:04 ocdgirl2000: @nursingpins #rnchat they leverage the meds by selling, buy friends, love,superficial things, distorts reality, gets worse, other addictions 10/29/2009 21:04 OSUMarkRN: @bthenextstep T1: I think all h/c workers should be yearly. #RNchat 10/29/2009 21:05 bthenextstep: T1 it is then #rnchat 10/29/2009 21:05 nursingpins: T1 - Nurses need to be drug tested at least every 2 monts - or we will not change things - sorry to say. #RNchat 10/29/2009 21:05 EllenRichter: Welcome latecomers @rorod101 @anthonyburich @nursekris99 @seergenius #RNchat 10/29/2009 21:05 bthenextstep: @ocdgirl2000 so then we're still on the behavior of addiction. I agree w/ that. #rnchat 10/29/2009 21:05 rnchat: @RoRod101 Welcome, Ro. Here's T1 - http://bit.ly/1VZZNc #RNchat 10/29/2009 21:06 bthenextstep: @OSUMarkRN T1 I do as well. #RNchat 10/29/2009 21:06 EllenRichter: T1 ~For sure, random drug testing of health care professionals would certainly weed out noncompliant people #RNchat 10/29/2009 21:06
  • 6. AnthonyBurich: @bthenextstep My class just got screened pre-clinical rotation. #rnchat 10/29/2009 21:06 ocdgirl2000: #rnchat T1 they have to screen us @ hire Gov is into it! LOL! I would love it! great plus 4 job like ours, hard to find good methadone RN's 10/29/2009 21:06 RoRod101: @rnchat Thx. About to ask that. :) #RNchat 10/29/2009 21:06 InfusionNurse: shld be tested 2 when behaving suspiciously! RT @OSUMarkRN: @bthenextstep T1: I think all h/c workers should be yearly. #rnchat 10/29/2009 21:06 AnthonyBurich: @EllenRichter Thank You!! #rnchat 10/29/2009 21:07 bthenextstep: @bamagirlRN That was my point. LOL I think the behavior is the issue - AND they happen to be RN's. #RNchat 10/29/2009 21:07 EllenRichter: T1 And those health care professionals on legitimate prescription drugs can have results waived with valid rx #RNchat 10/29/2009 21:07 bthenextstep: T1 I believe there is a protocol for testing when suspicion is found. But why not yearly testing - period. #rnchat 10/29/2009 21:08 nursingpins: T1 - Critical care nurses are so strange - would be hard to tell when a behav. is new - ;) #RNchat 10/29/2009 21:08 OSUMarkRN: @EllenRichter T1 agreed. #RNchat 10/29/2009 21:08 chuymatt: so, are we talking someone watching me as I pee? I must say, the feeling with jobs like that is that we are not trusted. #rnchat 10/29/2009 21:08 ocdgirl2000: #rnchat T1 they should also breathalize RN's as well. especially in the AM. 10/29/2009 21:08 bthenextstep: @EllenRichter T1 good point about the valid Rx. #rnchat 10/29/2009 21:08 OSUMarkRN: @nursingpins OUCH! #RNchat 10/29/2009 21:08 bthenextstep: @nursingpins T1 HAH.. you are so right. Sad.. but true. #rnchat 10/29/2009 21:09 EllenRichter: T1 I'm wondering if we would have many staff left to work if there were random drug tests!!! #RNchat 10/29/2009 21:09 nursekris99: T1: Our company has a random testing policy, but has yet to enforce it. #rnchat
  • 7. 10/29/2009 21:09 bthenextstep: @chuymatt T1 so then how do you keep the workplace safe without offending someones trust? (w/ yearly screening) #rnchat 10/29/2009 21:10 ocdgirl2000: #rnchat T1 you would be surprised how high the blood ETOH level is 4 someone who has a tolerance is!people who drink maintenance q day?heh! 10/29/2009 21:10 AnthonyBurich: @EllenRichter Do you think a healthcare pro consuming narcotics on a script is still a danger to patients and coworkers? #rnchat 10/29/2009 21:10 nursingpins: T1 - Drug div. is a much bigger problem with nurses than most know about - I see it! #RNchat 10/29/2009 21:10 chuymatt: "to clock in, swipe your card, pee in the cup and breathe into the mouth piece." #rnchat 10/29/2009 21:10 RoRod101: T1 Have not seen 1st hand. But one thing I keep in mind is nurse are human first, therefore susceptible to human afflictions. #RNchat 10/29/2009 21:10 OSUMarkRN: @nursekris99 T1: that's the prob with most random test P&P - it is never enforced. #RNchat 10/29/2009 21:10 RoRod101: @EllenRichter Thanks for the welcoming party. :) #RNchat 10/29/2009 21:11 chuymatt: @bthenextstep keep a random drug testing policy that is signed off with hire. Ed. on s/sx of diversion. Test those who seem it. #rnchat 10/29/2009 21:11 bthenextstep: @AnthonyBurich @EllenRichter w/ that in mind.. aren't we all a pot threat to the patients? (mere safety - not just nard use)#rnchat 10/29/2009 21:12 nursingpins: T1 -nurses are human - same addict. personalities as gen. pop - but WE have more axcess. #RNchat 10/29/2009 21:12 nursekris99: @OSUMarkRN They DON'T test the ones who need it, and threaten people they just don't like. But no one pees in a cup. #RNchat 10/29/2009 21:12 EllenRichter: T1 @anthonyburich Yes, working with patients' lives requires a sharp mind, not a drug- induced state. But I know there R exceptions #RNchat 10/29/2009 21:12 ocdgirl2000: @RoRod101 #rnchat howdy! this is a fun chat!LOL! welcome! 10/29/2009 21:12 Geek2Nurse: Hopping in late - Psych RN working toward PMHNP. My super power is insight into *other* people's problems (not so easy with my own!) #rnchat 10/29/2009 21:13
  • 8. false2scams: T1 @ocdgirl2000 No, tell us what opiate withdrawl symptoms are #RNchat http://tinyurl.com/yjrrqck 10/29/2009 21:13 chuymatt: @bthenextstep T1 on further thought, yearly testing does not seem like a horrible thing to do. #rnchat 10/29/2009 21:13 philbaumann: I worked in one facility that had random tests. No biggie - unless you didn't drink fluids for an entire 12-hour shift. :) #RNchat 10/29/2009 21:13 bthenextstep: @philbaumann what.. a nurse not drink fluids for a 12hr shift? never heard of such a thing? ;) #rnchat 10/29/2009 21:14 AbbieCitron: T1 So I'm curious, how and when is drug testing done at your hospital? or is it done? #RNChat 10/29/2009 21:14 chuymatt: I think that there might need to be further policies in place to address addiction as a disease too. For those who are, Tx. #rnchat 10/29/2009 21:14 ocdgirl2000: #rnchat T1 you go in room w-out anything to hide stuff, they don't stare so close, not so bad!we do this to patients 2x/wk! get levels of RX 10/29/2009 21:14 EllenRichter: T1 I know that firefighters, pilots, & many other professions require mandatory testing & there are urine kits used to taint results #RNchat 10/29/2009 21:14 RoRod101: @ocdgirl2000 Hey there! #RNchat 10/29/2009 21:15 nursingpins: You are right Ellen - some nur are still the best - even when imp! - It is the tail end when they get sloppy that does them in. #RNchat 10/29/2009 21:15 bthenextstep: @chuymatt but it would still have to be done randomly.. so that no one could prepare ahead. #rnchat 10/29/2009 21:15 chuymatt: @bthenextstep I have a timer set on my watch for q2h to drink some water. So sad. #rnchat 10/29/2009 21:15 bthenextstep: @AbbieCitron i only know of the initial hire screening.. then only when suspected will they drug screen. #rnchat 10/29/2009 21:16 AnthonyBurich: @bthenextstep Agreed! Random prevents any detox attempts or other shenanigans. #rnchat 10/29/2009 21:17 RoRod101: @bthenextstep That's how I know it too. #RNchat 10/29/2009 21:17
  • 9. bthenextstep: @EllenRichter I think we all could agree - regardless of what can/could be implemented: someone will always find a way around it. #RNchat 10/29/2009 21:17 nursingpins: YES - Randon tests are needed. #RNchat 10/29/2009 21:17 ocdgirl2000: #rnchat T1 @chuymatt addiction IS a disease.& it is treatable,or we would not be in business!bless addiction treatment & funding 4 doing it 10/29/2009 21:18 EllenRichter: @bthenextstep T1 Yes!! Anyone who is cunning & manipulative can find a way to beat ANY system #RNchat 10/29/2009 21:18 AbbieCitron: RT @bthenextstep: I think we all could agree-regardless of what can/could be implemented: someone will always find a way around it. #RNChat 10/29/2009 21:18 bthenextstep: So then - is there such a thing as a foolproof method? #rnchat 10/29/2009 21:19 ocdgirl2000: #rnchat T1 there is no way around the spit tests, sorry! they are expensive as all heck! 10/29/2009 21:19 Geek2Nurse: Darnit, I keep forgetting the tag. #rnchat 10/29/2009 21:19 InfusionNurse: I agree..RT @nursingpins: YES - Randon tests are needed. #rnchat 10/29/2009 21:19 Geek2Nurse: T1 I'm not against random testing, tho it's a pain for me, since Adderall makes me show positive for amphetamines. #rnchat 10/29/2009 21:19 nursekris99: We had an alcoholic on staff;her busting meant no alcohol even at office social functions. #RNchat 10/29/2009 21:20 Geek2Nurse: T1 Also take occasional Valium for Meniere's symptoms, & it sticks around for a few days in the bloodstream. #rnchat 10/29/2009 21:20 bthenextstep: @Geek2Nurse try using tweetchat- that's what helped me. or tweetdeck #rnchat 10/29/2009 21:20 chuymatt: @Geek2Nurse As long as you have the Rx, it should not be an issue. #rnchat 10/29/2009 21:21 Geek2Nurse: T1 So I worry about perceptions. Even tho my Rxs are on file with HR, anyone looking at lab results doesn't know that. #rnchat 10/29/2009 21:21 RoRod101: @Geek2Nurse U bring up something interesting what would happen with false positives? #RNchat 10/29/2009 21:21
  • 10. bthenextstep: @Geek2Nurse but I think these are all s/s that would be accounted for as long as they are known ahead. #rnchat 10/29/2009 21:21 EllenRichter: T1 @rorod101 I didnt know there could be false positive drug tests...what causes that? #RNchat 10/29/2009 21:22 OSUMarkRN: Ok. Need to sign off. Good night. #RNchat 10/29/2009 21:22 bthenextstep: Join me for a #rnchat TweetChat at: http://tweetchat.com/room/rnchat - drug diversion is the topic of discussion #rnchat 10/29/2009 21:22 nursingpins: The long term imp nurses are the ones that are the most destructive in the end - and the ones that need the most help. #RNchat 10/29/2009 21:22 AnthonyBurich: @bthenextstep Nothing foolproof. It's a vicious cycle - just look at all of the sports doping scandals. Constant oneupmanship. #rnchat 10/29/2009 21:22 Geek2Nurse: T1 And I can assure you, they wouldn't want me doing patient care *off* my Adderall. :) I absolutely won't pass meds without it! #rnchat 10/29/2009 21:22 chuymatt: @RoRod101 usually there is a 2° check. They should also check your teeth for poppy seeds... #rnchat 10/29/2009 21:23 ocdgirl2000: #rnchat T1 what we do is send out our pos n patients 2 the lab for LEVELS & break down to consituents of exact drug content!falses eliminate 10/29/2009 21:23 bthenextstep: @Geek2Nurse only the ones who need to know should be looking at the results anyway. #rnchat 10/29/2009 21:23 AnthonyBurich: @nursekris99 That sucks! The action of one ruins for all. #rnchat 10/29/2009 21:23 RoRod101: @EllenRichter False in the sense someone taking therapeutic meds #RNchat 10/29/2009 21:23 rnchat: T1 Follow-up: So what the noblest way for facilities to approach nurses caught diverting? #RNchat 10/29/2009 21:23 ocdgirl2000: #rnchat T1 sorry for typos, we are like lab rats where we work!LOL! 10/29/2009 21:23 bthenextstep: @EllenRichter isn't that like the poppyseed false positive? #rnchat 10/29/2009 21:24 AnthonyBurich: @OSUMarkRN Good night. #rnchat 10/29/2009 21:24
  • 11. bthenextstep: @chuymatt hah! beat me to the poppyseed punch. LOL #rnchat 10/29/2009 21:24 bthenextstep: @AnthonyBurich night! thanks for the input! #rnchat 10/29/2009 21:25 AnthonyBurich: RT @chuymatt: @RoRod101 usually there is a 2° check. They should also check your teeth for poppy seeds... LOL #rnchat 10/29/2009 21:25 nursingpins: T1 - need to be confront. - they know when they are caught. - Phil #RNchat 10/29/2009 21:25 AbbieCitron: Good Night All. Enjoyed the informative chat! #RNChat 10/29/2009 21:25 nursekris99: @rnchat A hospital I worked at removed narc privileges for a certain time. Then rehab, testing, etc. #RNchat 10/29/2009 21:26 EllenRichter: T1 The noblest way to deal with nurses (or any other health care professionals) is to offer help #RNchat 10/29/2009 21:26 nursingpins: Good noct all - Thanks Phill #RNchat 10/29/2009 21:26 bthenextstep: @OSUMarkRN night. thanks for playing! LOL #rnchat 10/29/2009 21:26 chuymatt: @bthenextstep for those who have not seen the Mythbusters episode, it was a wonderful, forgone conclusion. Very entertaining. #rnchat 10/29/2009 21:26 bthenextstep: RT @EllenRichter: T1 The noblest way to deal with nurses (or any other health care professionals) is to offer help. well said #rnchat 10/29/2009 21:26 rnchat: Holy Cow! We're coming up on another fast hour of #RNchat - feel free to continue, but we'll be wrapping up soon. See next few tweets. 10/29/2009 21:26 ocdgirl2000: RT @rnchat: T1 Follow-up: So what the noblest way for facilities to approach nurses caught diverting? #RNchat REFER 2 TREATMENT!!! 10/29/2009 21:27 bthenextstep: @rnchat noblest way is open and honest communication toward helping those who need it. period. #rnchat 10/29/2009 21:27 RoRod101: RT @ocdgirl2000: #rnchat T1 sorry for typos, LOL! ~ I'm not at work :0 #RNchat 10/29/2009 21:27 chuymatt: @EllenRichter suspension? laying off? I have no clue. Tx must be in the plan or we will be out much needed RNs. #rnchat 10/29/2009 21:27
  • 12. AnthonyBurich: Does the ANA or some other governing board have protocol regarding diversion? #rnchat 10/29/2009 21:28 Geek2Nurse: @RoRod101 T1 In my case, it's not really a "false" positive. Adderall is an amphetamine; Valium is a benzo. #rnchat 10/29/2009 21:28 EllenRichter: T1 We let a staff nurse leave an hour early once a week to make her AA meetings. Thats what I mean by help & support, too! Very impt #RNchat 10/29/2009 21:28 bthenextstep: @rnchat i forgot how fun these chats are Phil. You DA-MAN #rnchat 10/29/2009 21:28 ocdgirl2000: #rnchat T1 well, what did you expect me to say? I get paid to say that!LMAO!! 10/29/2009 21:28 bthenextstep: @EllenRichter that's awesome. #rnchat 10/29/2009 21:29 RoRod101: @Geek2Nurse Got it :) #RNchat 10/29/2009 21:29 chuymatt: RT @bthenextstep: "@EllenRichter thats awesome." Indeed. #rnchat 10/29/2009 21:30 InfusionNurse: Thanks Phil! Good chatting with everyone! Good night, till next chat! #rnchat 10/29/2009 21:30 rnchat: Thank you everyone! Wonderful chat tonight! Transcript will be up in a bit. Next tweet will tell you when the next #RNchat will be. 10/29/2009 21:30 RoRod101: Great chat all! Nice to chat with fellow nurses. #RNchat 10/29/2009 21:30 Geek2Nurse: T1 Ironically, @RoRod101, I've never done any kind of illicit drugs, don't even drink alcohol. :) #rnchat 10/29/2009 21:31 ocdgirl2000: @RoRod101 #rnchat I'm not at work either, lol!although sometimes it's hard to leave there!typos I'm sooo tired get up at 4 am.. 10/29/2009 21:31 bthenextstep: RT @nursingpins: Good noct all - now that there's funny. LOL #rnchat 10/29/2009 21:31 AnthonyBurich: @rnchat Thanks Phil for hosting another awesome chat. Really fun with so many great participants! Thank you all - and good night! #rnchat 10/29/2009 21:31 EllenRichter: T1 Very interesting topic. Thanks for all the great conversation, people! :) #RNchat 10/29/2009 21:32 bthenextstep: FYI I hope I didn't miss anyone - I tried to add all the new faces to my Twitter acct. #rnchat 10/29/2009 21:32
  • 13. rnchat: Next #RNchat - 11:30 EST (15:30 UTC) Wednesday 11/4 10/29/2009 21:32 EllenRichter: @ocdgirl2000 you were our specialist tonight! Thanks for your thoughts on this subject! #RNchat 10/29/2009 21:32 bthenextstep: have a great night everyone #rnchat 10/29/2009 21:33 RoRod101: RT @AnthonyBurich @rnchat Thanks Phil for hosting another awesome chat. Really fun with so many great participants! Thx all! #rnchat 10/29/2009 21:33 chuymatt: goede nacht, all. #rnchat 10/29/2009 21:33 ocdgirl2000: #rnchat @AnthonyBurich: Does the ANA or some other governing board have protocol regarding diversion? prob suspension! report to AADA 10/29/2009 21:33 EllenRichter: RT @AnthonyBurich @rnchat Thanks Phil 4 hosting another awesome chat. Really fun with so many great participants! TY & good night! #RNchat 10/29/2009 21:34 ocdgirl2000: #rnchat here's a good link http://www.samhsa.gov/ 10/29/2009 21:37