Drug testing in the workplace (remote deployment)

[tniuqs]

Would you do a DOA ... thats: drugs of abuse testing ie urine dip after you taken a History and an done a complete Physical Examination ?

Then requesting the patient to "volunteer" to provide a sample with the understanding that the "worker" would be dismissed and loose his position based on refusal of providing a sample.

This after an EMS professional has obtained verbal consent "post incident" and then to release the sample of urine and "test strip" to an prime contractor's safety person ?

Comments please.

[Richard B the EMT]

When I was hired by the NYC Health and Hospitals Corporation EMS, back in 1985, the department had me sign a paper stating I agreed to unannounced "pee in the cup" urine testing. Even after March of 1996, when we became a part of the FDNY, nobody has approached me to rescind such permission, or to do said unannounced urine testing.

Any drugs I take by prescription or over the counter, I maintain a current listing, should somebody ask. And, even though I have been told the amount is minuscule and negligible on the item, I avoid poppy seed bagels, as not to get false readings.

[tniuqs]

Perhaps I have not been clear, the Paramedic (in this case) would be the tester / sample taker, and this based on an "incident" like as a minor MVC or the like then dictated testing at the whim of a non medical Safety Person judgement.

Besides many OTC's can break the threshold limit, for example here in Canada 222 (these have 8 mgs of codeine) or adult on attention deficit disorder meds as these can turn a positive for Meth-amphetamines, or Benzo like Valium (for muscle spasm) or Ativan for anxiety. Then there is the very serious question of what is "impaired level" as only ETOH has legal standards (just saying)

I could just imagine that loss of a job could resulting in termination, then leading to a court case for wrongful dismissal, then who goes to court ... the Paramedic I highly suspect.

1-Is it an employers right be informed of a persons medications

2-If the worker becomes a patient is it acceptable for a Paramedic to release information ?

cheers

Edited July 17, 2010 by tniuqs

[akflightmedic]

Squint...I smell what ya steppin in but I think this ground has been covered in courts of law previously.

With one of my former employers, we tested all the time. We did 100 randoms and we did post incident/accident testing as well. Every employee knew if they were injured, they would be tested once they were medically treated. So, it is their own fault should they test hot.

However, anyone that tested hot, were immediately informed and they never lost sight of their urine sample. The process was they pee in the cup, they bring it in the room, they watch it get tested and they watch the results. They never leave it unattended. If it was positive, they were informed and then the safety or security rep who was in the hallway was to step in the room while the sample was sealed and secured. The sample after being sealed and signed by the donor, was then placed in a bag and documented by all again. Then the bag was placed in Fed Ex shipping container and again all sealed/witnessed.

The sample was then sent to an independent laboratory for in depth analysis. IF the employee had any reasons for testing hot, he was then given the chance to explain his meds and yes the employer has a right to know at that point in time and the employee should be willing to say so if he values his job.

Based on the employee's story and the lab results, a decision was then made in regards to employment.

However, where I was doing the testing, no employees would be here if they were on any of those meds as they are a dis-qualifier before ever being hired. So if someone was hot, it was always accurate.

[rock_shoes]

1-Is it an employers right be informed of a persons medications

Only if that person’s medications could foreseeably result in an unsafe work environment for either the worker in question or other workers on the site.

2-If the worker becomes a patient is it acceptable for a Paramedic to release information ?

The question here is whether or not the information an employer is seeking is relevant to maintaining health and safety on the job site. If the information being sought is directly related to whether or not a person is fit for duty then the paramedic does have an obligation to indicate whether or not said employee is fit for duty. Disclosure of specifics beyond fit or unfit should be between the employer and employee. Pardon the pun but asking the medical staff to perform random drug screenings is piss poor practice on the part of the company. Random drug tests are “idiot proof” enough the site safety rep should be doing them.

The sample was then sent to an independent laboratory for in depth analysis. IF the employee had any reasons for testing hot, he was then given the chance to explain his meds and yes the employer has a right to know at that point in time and the employee should be willing to say so if he values his job.

Though I agree an employee with let’s say ADHD should be willing to explain why he/she tested positive for amphetamines, I disagree that it’s any of the employers business. The only time a person’s medical history becomes a company’s business is when that person’s medical condition or medication poses a threat to employee safety. IE can this person perform his or her assigned task without putting anyone at undue risk?

[tniuqs]

Squint...I smell what ya steppin in but I think this ground has been covered in courts of law previously.

Where in Canada ? .. no way jack and I ain't going to be the "Paramedic poster boy"

With one of my former employers, we tested all the time. We did 100 randoms and we did post incident/accident testing as well. Every employee knew if they were injured, they would be tested once they were medically treated. So, it is their own fault should they test hot.

AK: This is not a matter of random or pre job screening (no drug and ETOH program if an employee tests positive)

Only if an "incident" occurs (btw a sunburned nose and request for sunscreen was deemed an incident) for cripes sake.

Another point in in human rights crazy Canada, ie "the job and supervisors cause me undue stress and I resorted to _____ to relieve the stress" YOUR HONOUR

!

However, anyone that tested hot, were immediately informed and they never lost sight of their urine sample. The process was they pee in the cup, they bring it in the room, they watch it get tested and they watch the results. They never leave it unattended. If it was positive, they were informed and then the safety or security rep who was in the hallway was to step in the room while the sample was sealed and secured. The sample after being sealed and signed by the donor, was then placed in a bag and documented by all again. Then the bag was placed in Fed Ex shipping container and again all sealed/witnessed.

Bhwaa Haa Ha .. no Fed Ex where I work .. maybe Raven Express.. LOL. The carriers ie "hot shot companies" are not bonded with a reputation "Lost Samples" the continuity of evidence is non-existent, this in-of-itself could be grounds for "dismissal" at the court level, wasting the Paramedics time in court, you can bet your bottom dollar that the Paramedic (if brought to court is on his own dime and his own Lawyer)

The sample was then sent to an independent laboratory for in depth analysis. IF the employee had any reasons for testing hot, he was then given the chance to explain his meds and yes the employer has a right to know at that point in time and the employee should be willing to say so if he values his job.

Closest in-depth lab is over 700 kms away (mass spec)... factor in WHERE I work "BC" the BUD producer of western hemisphere and the somewhat relaxed THC laws .. my bet if tested the entire work force for breaking the threshold in dip test would be cut in half ! The test strips for THC do not prove or disprove "impaired" just catabolytes of THC ... then theres the "prescribed" THC in Canada for a multitude on reasons.

Based on the employee's story and the lab results, a decision was then made in regards to employment.

Who is the JUDGE of the Patients story ?

Nope not here a positive (and very possibly false positive) results in immediate termination and transport (by a supervisor)OUT which in passing results in more "Damages" in tort/civil law.

However, where I was doing the testing, no employees would be here if they were on any of those meds as they are a dis-qualifier before ever being hired. So if someone was hot, it was always accurate.

I ain't in sandbox dude .. I am in human rights crazy Kanukisan this dauwg just ain't going to hunt go to court over a safety man silly power trip, with the previso that I will test if a worker is unconscious and urinary cath is needed and urine test strip to assist to identify DOA in OD or maybe a poisoning (a whole different deal and never disclosed unless to an MD for patient care ONLY a warrant or writ of assist is issued by a Court of Law here in Kanukistan)

The most serious possibility of an incident of someone being Roofie(d) Good God I don't want to be the "tester" in that case !

1-This "mandated" bedside testing for DOA was not a pre-hire condition in job for the Paramedic in question.

2-It truly affects good reporting as the "workers" being apprised of the ability of the site Paramedic to test ...well they just will not report...get sicker...loss of trust +++

3- Also reporting any incident is the workers responsibility .. reporting to Employer is a breach of Patient/Paramedic confidentiality bottom line.

[tniuqs]

The question here is whether or not the information an employer is seeking is relevant to maintaining health and safety on the job site. If the information being sought is directly related to whether or not a person is fit for duty then the paramedic does have an obligation to indicate whether or not said employee is fit for duty. Disclosure of specifics beyond fit or unfit should be between the employer and employee. Pardon the pun but asking the medical staff to perform random drug screenings is piss poor practice on the part of the company. Random drug tests are “idiot proof” enough the site safety rep should be doing them.

BRAVO !

AGREED Third Party testing like the rest of the "FREE WORLD" I have enough "liability issues" unless they are going to DOUBLE my wage.

Now:

In the situation of the Patient possibly being impaired with S/S of paranoia, delusions, uncontrolled violent behavior. And quote Canadian Law Mental Health Act: ie A person presents a danger to "Themselves or Others" the Paramedic defiantly has the responsibility to intervene and use medications to chemically restrain ie Zyprexia/Halodol/Versed/Valium/ or Sux if it gets that bad with excited delirium, do we as health care professionals want to touch this "employer liability" question AT ALL?

Though I agree an employee with let’s say ADHD should be willing to explain why he/she tested positive for amphetamines, I disagree that it’s any of the employers business. The only time a person’s medical history becomes a company’s business is when that person’s medical condition or medication poses a threat to employee safety. IE can this person perform his or her assigned task without putting anyone at undue risk?

Agreed .. ADHD controlled is not the Employers Call its an MDs and in passing it is estimated that 25% of Canadian Workers Have or will require TCAs ... do we run someone off for Prozac ? and dependant on the type of bedside testing strip this is included, the safety persons are instructing only "hot" or not "hot" not type as they believe in this scenario that disclosure of type of little red line on the strip is a breach ... good grief misinformation is beyond belief <sheesh>

Where is the line drawn ?

A controlled Diabetic ?

A controlled Epileptic ?

Just who is the judge ?

Remember this a sub contracted Safety person with absolutely no medical background and many times looking to protect the employer ?

So if one is up the feeding chain say for example the "Consultant" you know the guy that signs your paycheck, then that ditches his truck in mud or snow ?

What then ?

Let look at what the experts say:

http://www.heretohelp.bc.ca/publications/workplaces/alt/3

cheers thanks for the reply s.

Edited July 17, 2010 by tniuqs

[Richard B the EMT]

I am requesting a clarification, here. Are we talking about a blood and/or urine sample taken from:

A) an EMS personnel involved in either an accident or incident,

a civilian involved in either an accident or incident,

C) any and all persons involved in either an accident or incident

D) an EMS personnel as a random sampling of EMS personnel for alcohol and/or drug abuse,

E) some combination of 2 or more of the above?

Edited July 17, 2010 by Richard B the EMT

[tniuqs]

I am requesting a clarification, here. Are we talking about a blood and/or urine sample taken from:

Urine, voluntary permission from the "accused" refusal to provide results in immediate dismissal.

A) an EMS personnel involved in either an accident or incident,

Maybe I guess maybe I could be asked wtf who would take the sample then (good point)

Primarily targets are just a worker, in a minor incident at the request of a "safety person"

a civilian involved in either an accident or incident,

Yes and no..... see (a)or(eh)

C) any and all persons involved in either an accident or incident

Just a sub contracted worker for the Prime Contractor ... many Prime Contractors in area with other projects and good point if buddy from another company has an MVC with a worker from my company ...its getting just silly ain't it ?

D) an EMS personnel as a random sampling of EMS personnel for alcohol and/or drug abuse,

No random, not EMS workers persay and no pre-hire, just on a whim and not ALL incidents.

E) some combination of 2 or more of the above?

This is not an easy answer .. the combinations are like trying to staple jello to the wall, no written guidelines, no MD protocol.

Clear as MUD ... sheesh.

[Lone Star]

The issue I have is this:

If the Paramedic (or other EMS personnel) is the 'tester', then the 'testee' becomes the patient. Wouldn't the findings be then considered privileged under HIPAA guidelines?

If they are, then the only way that they could be released is with the patient's consent or a court order