NCBON:NEW:Procedure of Urine Drug Testing,WOW
As of Jan 1, 2011 the NORTH CAROLINA BOARD OF NURSING issued this new policy for urine drug screens. Keep in mind, it is not the drug testing or even the observed collections. It is the manner in which the test is performed.
Once again, not the observed collections but the way NCBON is dictating the collection procedure. $50.00 to 76.00 that is a 52% increase.
IS this PROCEDURE done in any other states?
WHAT IS YOUR PROCEDURE, IF ANY?
Can you nurses give me all your feedback and how you feel about this procedure?
NOW, i wish I could upload all the forms that were sent to all nurses in the Alternative Program and the Chemical Dependency Discipline Program in NORTH CAROLINA.
Observed Collection Requirements
Effective January 1, 2011, all specimens collections for the NCBON participants must be directly observed. Directly observed means that you must personally and directly watch the urine go from the participants body into the collection container.
A participant's failure to comply with these requirements will be consider a refusal to test.
1. The observer must be the same gender as the NCBON participant. (The observer may be a different individual than the person serving as the specimen collector.
2. The observer must enter the restroom or facility where the urination occurs.
3. The observer will instruct the participant to RAISE HIS OR HER SHIRT, BLOUSE, OR DRESS/SKIRT, AS APPROPRIATE, ABOVE THE WAIST, JUST ABOVE THE NAVEL: AND LOWER CLOTHING AND UNDERPANTS TO MID-THIGH AND TO SHOW THE OBSERVER, BY TURNING AROUND- THAT THE PARTICIPANT IS NOT IN POSSESSION OF A PROSTHETIC OR OTHER DEVICES DESIGNED TO CARRY URINE SUBSTITUTES.
4. After the observer has determined that the participant does not have such a device, the observer may permit the participant to return clothing to its proper position and then conduct the observed collection.
5. The observer must personally and directly watch the urine pass from the participants body into the collection container.
6. Participants must adhere to all other procedures and guidelines for the Chain of Custody etc. as outlined in the enrollment packet from FirstLab.
:slap:
Sounds like the Job Corp. here in town. The only thing missing is the blue dye in the toilet.
Wow, don't know if I could ever pee like that! I have a hard enough time as it is!!!!
Invasion or not, I personally am grateful for my second chance. I would gladly do it, even if required an I/O cath! Our nature, as an active addict, is to lie, cheat, and steal. But in recovery, the key is ACCEPTANCE. NONE of us got here for being girl scout of the year. We must all accept the consequences of our actions, or we won't make it. Let this experience be a reminder of what our past actions have caused, and strive to never repeat them. Complying with what seem like harsh terms is a SMALL price to pay for the second chance the BON is giving us. I am happy to pay this price, because I want to be a great nurse, and I want to live. Love to all those that struggle, sasto.
The entire urine testing program is predicated on "invading" one's privacy and is part of the price you have to pay to be allowed to rejoin the game of practicing nursing. Some people just decide they can't hack all the requirements so their nursing license is gone.
Thank you for all the comments on this invasive procedure.
Acceptance!!! I have accepted and accepted and accepted with grace and charm. It was a big struggle for the first years but now I try to just go with it.
Just because we are in recovery does not mean we have to be run over like a piece of road kill, talked to like we are less than human and basically be treated like dirt. We have enough shame and quilt that we live with daily.
I find recovery is about CHANGE, changing the whole person, mind, spirit and body. Learning to love ourselves, again. Treating others and ourselves with
respect and love.
I said this morning, if I can not vent and talk about things in a SAFE environment with out be ridiculed, then what are the support groups for????
This blog is about the delivery of the new policy of observed drug screens by the NORTH CAROLINA BOARD OF NURSING not about the doing the observed drugs. I would give them my blood, hair and urine at the same time if they ask me too, and I would do with a sincere smile.
This is about the copy and paste job they (NCBON) did from the DOT; Part 40- Procedure for Transportation Workplace Drug and Alcohol Testing Programs (effective Oct. 1, 2010)
P 40.67 sections g thru k.
In the first letter from the NCBON, they stated that these changes are being made as a result of changes in government standards for drug testing implemented in 2008. Therefore, consistent with Federal guidelines, effective Jan 1, 2011 all urine drug screens will be performed using direct observation procedures.
If this is a Federal guideline then you nurses in other states would be doing the same thing as North Carolina, right??
I do not mind being observed for drug screens. but you guys try this new procedure the next time you go to the bathroom, keep in mind your pants will be touching the nasty bathroom floor then you are going to put them next to you body?? YUK, YUK.
Thanks for reading this and I still want your feedback.
By the way, I truly love my simple and rewarding life TODAY and I am so grateful for the what recovery has shown me and keeps showing me everyday. I can look in the mirror and love what I see today, just for today.
Got2B (me)
I haven't had to test for a few years and only had to be "Directly Observed" a few times following a +Etg test. I never looked at it as humiliating or invasion of privacy because when I signed the contract for the recovery program I voluntarilly gave up my privacy. I agreed to comply with all rules and regulations currently in place and those that might be put into force at any time during the term of my contract.
I read the section you cut and pasted and nowhere does it say you have to lower your pants to the floor. It says lower clothing and underpants to mid-thigh. If you are worried about pant legs touching the floor wear shorts. I really don't care of someone see's me naked - There's not much to get excited about but if they want to look I'll show them. I feel the same way about airport screenings.
Most of the places where I tested were very professional and did not perform their duty in a manner that demeaned or caused undue embarrassment. At first I was subconscious but after a while it just became a very routine procedure.
As addicts we tend to get very excited about what we preceive to be our rights. The fact is we give up our rights when we enter these recovery programs. Are these contracts and their provisions constitutional? Probably not as no person can be forced to give up their civil liberties, but since these contracts are considered voluntary it becomes a moot point. You either comply or get kicked out of the program and lose your license. You can challange it later with the BON but if you get probation you'll still have to test so what's the point of fighting it.
Sasto mentioned that recovery is about acceptance - but it is also about "SURRENDR" there is a whole section in the Big Book on the concept of surrender. It is not admitting to defeat but rather choosing not to fight so that you can concentrate on what you must do to survive.
At the place where I work someone submitted a pre-employment urine that turn out to be "Not human in origin" we never did find out what species it was, but it goes to show that people will go to great lengths to try to cheat the system.
My advice for what it's worth is to settle in and do what you are told. No matter how much the Boards want to tell you they care about your recovery the truth is they want to see how you respond when they "Yank the leash" my advice is don't give them the chance to yank it in the first place.
Peace and Namaste
Hppy
hppygr8ful,
Please, do not misread me, I am accepting and surrendering, totally, to this new policy the NCBON has established. I will comply with dignity to anything they ask of me.. Keep in mind it was not easy for me for the first couple of years, then I let go and and surrendered, finally!!!
But my brain is still adjusting to being sober and clean, or at least I think it is...
Have any of you tried to this new procedure policy? IF you haven't, please try it the next time you use the bathroom. It is almost funny. I never said I had to lower my pants to the floor, but try holding a shirt up and lower your panties and pants mid-thigh, then turn a 360. I bet your pants will drop to the floor or at least mine did when I tried it.....YUK, YUK
I really do not mind or care if anyone see's my 50 yrs saggy body either.
I know the observer is just doing there job and they will be professional. They do this daily, collect observed urine's.
I am simply talking about this issue, "just what I was instructed to do from my sponsor 3 1/2 yrs ago when I got clean.
You also blogged "It is not admitting to defeat but rather choosing not to fight so that you can concentrate on what you must do to survive. "
I disagree with that part of your blog, This is part of my professional survival, or at least I thought it was. I am not wanting to challenge or fight with the Board or anyone else. I am just blogging about it and wanting to get other nurses insight and find out what other states do. I have learned to get my thoughts out ,ask for help and listen to others idea and thoughts.
You are so RIGHT about either comply with the board conditions or get kicked out and lose your license. And the North Carolina Board has NO problem removing your privilege to practice. I also loved and AGREE with your theory on the "Yank your Leash".
Thank you all for your opinions and feedback, Keep them coming.
We all have opinions about things unless you are an ANDROID.
I am smiling and laughing at some of the responses and sad about others, but i enjoy reading all of them!!!
Keep it simple and respond not react!!
Got2B
BRN Diversion programs
Hi Got2Be,
It is good to see one accept the consequences. I did than in the CA BRN diversion program for 4 years until my DEC consultant called me a retard. Now I have my own blog slamming the BRN.
However, I do accept the consequences of my actions...I just don't accept stigmatizing behavior from those who should know better.
I failed 3 ETGs and even though my CM said she KNEW I was sober, I got removed from patient care for two weeks. They finally realized it was the low carb (sugar alcohol) that I was newly eating. What a horrendous experience. Did you know that SAMHSA warns against using the ETG (alone) for deciding a professional has relapsed? It's not a reliable test.
Sorry, got excited when I saw the topic and went on a rant. I hope that's ok in this forum.
Honey, this whole SITE is a virtual venting board, TRUST me! That is what our Head Honcho/Fearless Leader, Aaron C. has in mind. Figuring we are all responsible adults (within reason!), there have only been a handful of times when anyone has been really nailed for being a jerk. :moosekick:
We may get crazy during any given sports season, the Holi-daze, etc., but.....have at it if/when you must. In fact, I encourage it.
SyckRN wrote:Hi Got2Be,
It is good to see one accept the consequences. I did than in the CA BRN diversion program for 4 years until my DEC consultant called me a retard. Now I have my own blog slamming the BRN.
However, I do accept the consequences of my actions...I just don't accept stigmatizing behavior from those who should know better.
I failed 3 ETGs and even though my CM said she KNEW I was sober, I got removed from patient care for two weeks. They finally realized it was the low carb (sugar alcohol) that I was newly eating. What a horrendous experience. Did you know that SAMHSA warns against using the ETG (alone) for deciding a professional has relapsed? It's not a reliable test.
Sorry, got excited when I saw the topic and went on a rant. I hope that's ok in this forum.
Hi!! We are all here for the same reason. You can blog with me. Yes , I know about the ETG, and I also have information on why some of use have diluted or undetectable urine's ,this is for those who are TRULY honest and are not drinking or using. I hate to see another nurse ridiculed and treated like crap by a case manager or monitoring coordinator. I still have a hard time swallowing the idea of someone monitoring me that has no substance abuse background and/or is NOT a nurse. How can you dictate to me when they do not know the "stages of change" or Active Process etc..... Come on and VENT!!! get it out before it eats your breakfast, lunch and dinner. Thanks for listening to me....
GOT2B
Well okay then, I am going to post an essay I wrote for my philosophy course about MY trip through the diversion program. It's pertinent to the ETG especially:
Ask any nurse in California’s Diversion Program what they fear most. The ETG test will win…hands down.
This is an indirect measure of a liver enzyme that is elevated in the presence of very small amounts of alcohol and can be detected for several days in the urine. Seems like a boon to disciplinary programs. Unfortunately, there are small amounts of alcohol in thousands of the most common household products. Diversion nurses are directed to a list on the internet of common offenders (makeup, household cleaners, food, hand sanitizer) that contain alcohol and must be avoided AT ANY COST. Memorize the list. Don’t test positive. (The Substance Abuse and Mental Health Services Administration denounces the use of the ETG test for disciplinary purposes, but the company that sells them…SELLS them).
If you test positive more than once…you are removed from patient care until the situation is resolved. Plus, 90 meetings in 90 days, don’t miss any. Your job, if you are truly without sin (and you will begin to question this yourself), is to become paranoid about everything you eat, drink, and breathe (hairspray and air freshener can make you test positive). You become the “nurse in the plastic bubble.” You shrink back in horror on the few occasions when you accidently pump hand sanitizer onto your palm instead of soap. You always, always use gloves when handling alcohol swabs…because, if you do not stop testing positive, the board may declare your tests to be “substantive evidence of a relapse.” This will have major repercussions for your Program…your 4-year timer is reset (or worse, your are sent to the disciplinary program, where the Scarlet A is permanently tattooed on your license…and your time starts over). Major repercussions as well for your self-esteem …you pick up a 24-hour chip at a meeting and announce yourself as one day sober. In 12-step culture, this means going back to step one. Whether or not you actually “used” is immaterial.
Every nurse in Diversion wonders if he or she would be able to make it through the experience of being “declared” relapsed incorrectly. With all of the other degrading experiences that go on, one has to wonder…could you, would you, will you, eat green eggs and ham…?” Or will you, shall you…won’t you carry a big “f-word (translated to resentment in the BRN language)” word for the rest of your life…and we all know what that does don’t we, fellow drunks and addicts…poor me…poor me…poor me a f'ing drink!!!
My own clinical case manager (very wonderful person who does not work for the BRN, has confirmed that participants she believed to have been compliant have in fact been declared “relapsed”). The ETG test makes it possible be 100% compliant, absolutely perfect, the mirror image of normal…and still fail.
It is entirely within the realm of possibility that you will test positive on the ETG at least once during your 4 to 5 year contract as a performer for this circus. I had a string of positive tests with less than a year to go in my program, and I was ordered off my clinical floor for two weeks (at three and 1/2 years clean).Every day I waited for the phone to ring, for my case manager to TELL me that I was in relapse.
THAT is how crazy it is. THAT is how powerless you are. I really did not know how much more of this I could take. Unfortunately, the list of high-paying careers for UNLICENSED Masters prepared nurses is depressingly short (did you know that you cannot teach RNs without an RN?) I was writing my comp exam (on addiction… “can you say I-ro-nee?”) for my Masters Degree in Nursing and waiting for a call from the Board to tell me to take three giant steps back in my Diversion program. It turned out to be a food ingredient (not on the list). Well, it’s on the list now!
Meanwhile, I enjoyed a warm fuzzy scene with my ED nurse manager with whom I had previously had a very professional and respectful relationship…
“…three positive tests actually…well like I said…the test can be positive even with exposure to hand sanitizer…yes three positives…no…I…really haven’t…”
But you stop defending yourself, because you have come to recognize this facial expression.
Your supervisor can’t see you now.
SyckRN, the professional veteran ER nurse who has worked for him for three years has vanished from his vision.
In her place…a lying unreliable drug addict who has left him with a huge staffing problem.
“Steaming hot humiliation being served in the Nurse Manager’s office, complements of the BRN…Come see the incredible shrinking dignity…before it disappears forever…Get it while it’s hot!”
You will call an 800 number 7 days a week, 365 days a year…for the duration. You do not ever, EVER, get a vacation from this. You will miss graduations, your childrens’ sporting events,your classes, and even work…in order to remain compliant to the drug testing portion of the Diversion program (going long distances to test…even though technically you are not required to go farther than a pretedetermined distance, you are obsessive in your efforts not to cast doubt on your gratitude or your sobriety…these things are not in the Circus Manual, but you know them just the same.) If your urine is too dilute….it counts as a positive. If your doctor prescribes a medication that concerns us, well, we can’t really do anything to stop that…but oh boy…so many other things we CAN do…we might have to test you MORE OFTEN. (10,000 dollars and counting)….
When you call the number, and enter the appropriate identifiers, an automated voice gives you your testing status for that day.
You will either get A. “You have been selected for testing…please report to your designated testing site for testing…have a great day.”
or
If the Diversion Gods are smiling that day, you hear message B. “You have NOT been selected for testing today…have a FABULOUS day!”
If ever you pass a nurse in the hall of your workplace, and he or she tells you to have a fabulous day, it is quite likely that you have just been greeted by “One Who Bears the A.”
“Fabulous” used to be our mantra and was spoken almost as often, but with much more subversive joy…than the word “grateful.”
