Despite the relaxation of marijuana laws in Louisiana over the past five years, registered nurses still face serious occupational hazards if they use the drug recreationally or, in some cases, for medical purposes.
The Louisiana Employment and Medical Marijuana Task Force heard testimony on Tuesday from Shonda Broom, a former nurse who recounted how her off-hours cannabis use and a single drug test before the jobs effectively destroyed her 12-year career and permanently branded her a criminal.
This was one of a series of meetings the task force has held to influence the creation of laws to protect workers who use marijuana for medical purposes on the recommendation of a doctor.
Broom became a registered nurse in 2005 and spent the second half of her career self-employed, primarily providing home health services for the elderly, until July 2016 when she closed her business and sought employment. work in a hospital. In an interview with the Illuminator, she said she applied for a job in November at the Thibodaux Regional Medical Center and had to take a pre-employment urine test. She said she had not used marijuana recently and expected to pass the test.
Louisiana panel looks at medical marijuana issues in the workplace
The results came back positive for THC, the active ingredient in cannabis. She later learned that the drug can be detected in urine for several weeks after use. The hospital rescinded his job offer, so Broom left and looked for another job.
For Broom, who was 36 at the time, it was the beginning of the end of his career.
Investigation
Before applying for a new job, Broom waited about a month to make sure no traces of marijuana remained in his system. She found a new employer and was hired after passing a separate drug test.
But within five months of his new job, Broom told the task force, news of his initial drug test failure reached the Louisiana State Board of Nursing, which launched an investigation.
At the time of this first drug test, Broom said she had smoked cannabis occasionally to treat depression and high blood pressure, but did not yet have a prescription or referral. doctor.
Although the Louisiana Legislature legalized medical marijuana earlier that year, few if any patients were actually receiving the drug due to a quirk in the law relating to the word “prescribe.” The legislature eventually rewrote the law to state that physicians can “recommend” rather than “prescribe” marijuana, circumventing various regulatory hurdles regarding prescribing a controlled substance. Federal law still designates the plant as a Schedule I drug, meaning it has no recognized medical use, even though several states have legalized medical cannabis.
Following the state nursing board’s investigation, Broom said she gave up her professional license rather than accept an involuntary suspension. Her last day of work as a nurse was April 26, 2017.
“Not only can I not work as a nurse, but the discipline shows up on a background check,” she told the panel. “It makes me unemployable in several industries besides healthcare.”
According to the board’s disciplinary records on the case, Broom could have accepted the suspension and reapplied for her license later, but that process would have required her to undergo a rigorous drug treatment program set out in a consent order. The listed requirements included, among other things, completion of a rehabilitation program and a probationary period that included random drug testing, professional monitoring, and periodic psychiatric or substance abuse evaluations – all for a period of five years at its own costs.
Broom would have been allowed to work only in a restricted environment under the direct supervision of a medical professional and would have been prohibited from dispensing medication to patients. Her supervisors should have submitted quarterly assessment reports to the board of nursing and she should have notified any new employers of the treatment plan. Additionally, the deal would have required Broom to pay various fines and costs to the board of nursing totaling more than $1,200.
Strict discipline considered a success
In a telephone interview, Louisiana State Board of Nursing Executive Director Karen Lyon said such disciplinary action is common for nurses who fail a drug test, whether for marijuana, alcohol or drugs. harder drugs such as opioids. Conditions are generally more stringent for nurses who have used substances while on duty or who have shown signs of impairment in the workplace, she said.
For less serious offenses such as using marijuana outside of work hours, Lyon said, a nurse could seek reinstatement as early as six months after their suspension if all the stipulations of the consent order are met. They would still remain on probation and have to submit to drug testing, monitoring and other conditions for five years, she said.
Lyon admitted that such disciplinary action is strict, but she said the board has seen a successful recovery rate of almost 95% for nurses who agree to such conditions.
“We try to have a therapeutic program that keeps patients safe and helps nurses recover,” she said. “Our program is very successful.”
Nurses who have a legitimate medical marijuana referral can still be investigated by the board if they show signs of impairment or fail a drug test while on duty. If the nurse can produce a medical certificate stating she is fit for duty, the investigation will often end without disciplinary action, she said.
In those cases, the board could issue a “letter of concern,” which Lyon says is an informal reprimand that the board keeps on file.
For a moment, Broom said she was ashamed of what happened and never talked about it. But over time, she became involved with groups that advocated medical marijuana and saw what she called the absurdity of drug testing and the disciplinary standards of the nursing board.
Broom told the task force that the Louisiana Board of Nursing uses outdated disciplinary standards that are much stricter than the National Council of State Boards of Nursing (NCSBN) guidelines.
The NCSBN recommends minimum disciplinary action for situations like Broom’s. Its 2018 guidelines include a variety of case examples for a nurse who tests positive for marijuana. In cases such as Broom’s where there is no allegation of impairment while on duty and in a jurisdiction where recreational marijuana remains illegal, the NCSBN recommends that nursing boards issue a “letter of non-disciplinary concern” – the same disciplinary standard as the Louisiana board. applies to nurses who have a doctor’s referral for the plant.
When asked why the Louisiana Board of Nursing did not adopt the 2018 NCSBN guidelines, Lyon pointed out that the NCSBN is not a regulatory body. The NCSBN is a membership organization that conducts research and recommends regulatory practices for state nursing boards. Her guidelines are not binding, she said.
Broom said she felt the state board was not fully aligned with the state legislature’s position on marijuana.
“They’re choosing to ignore it, and their ignorance has cost me dearly,” Broom said, adding that the board definitely called her an unemployable criminal. ” At first glance [on a background check], it appears that I have committed fraud and abuse and immediately disqualified myself without an employer going any further. So embarrassing.
Drug Testing Gaps
Broom also told the task force that licensing boards should stop using drug tests as evidence of impairment — something the task force has discussed in previous meetings.
At last week’s meeting, Troy Prevot, Task Force Member and Physician’s Assistant for Workplace Drug Testing, said that many government workplace policies and regulations are outdated and still based on the mistaken belief that a positive drug test is an indicator of intoxication.
None of the lab tests available can accurately tell when someone has used drugs, especially cannabis. The NCSBN notes this in its guidelines and also states that “current laboratory testing cannot provide any objective threshold for establishing impairment.”
“Someone could have used [marijuana] for two straight weeks, arrested for two weeks, applied for a job, failed that screening and their lives are destroyed for something that happened over a month ago,” Broom told the panel.
Peter Robins-Brown, task force member and executive director of Louisiana Progress, said he hopes more people like Broom will come forward to share their experiences. The task force hopes to find out how many nurses and other professionals have lost their professional license due to failed drug tests, he said.
Broom now works as a consultant. His company, D4N Consulting, provides training and assistance to companies and other organizations wishing to develop workplace policies regarding drug testing and employees treated with medical marijuana.
“I think the problem is that people are still being punished for out-of-service use,” she told the panel. ” Let’s be realistic. People aren’t sitting on the clock smoking weed… It’s possible, but in reality, they’re not just sticking candy in their boss’ face. Much of the punishment comes from off-duty use.
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