Detection, Reporting, and Testing
Background
The College of Nursing (CON) is committed to the health and wellbeing of patients and of students. As part of this commitment, the CON complies with and upholds all federal, state, and local laws that regulate or prohibit the possession, use, or distribution of alcohol, illicit drugs and/or prescription medications. Students who are impaired by substances endanger patients, themselves, faculty and staff, and other students. The purpose of this policy is to establish a process to facilitate identification and management of student impairment due to substance use with the aim of protecting patients, students, and faculty.
Substance use and impairment shall be defined as:
1) The use or possession of any drug in a manner prohibited by law or by applicable regulatory agencies; and
2) The use of alcohol or any legal drug or other substance in such a way that the user’s judgement and/or performance is compromised.
Policy
All students must adhere to The Ohio State University Code of Student Conduct (Link to conduct). When a student is suspected of substance use or impairment, safety of patients, others, and the student is faculty’s primary concern followed by fair-minded treatment of the involved student. Any faculty member, CON staff member, student, and/or clinical/practicum site staff may report behaviors suggestive of impairment.
College of Nursing students are prohibited from engaging in the use of legal substances which lead to impairment during practice or the use of illegal substances that can affect their judgment/performance. Testing for designated substances will occur per the requirements of the program and/or clinical/practicum agencies.
There are circumstances in which students may need to take over-the-counter (OTC) or prescribed medications that may impair their judgment, performance, and/or behavior. As such, all students are responsible for being aware of the effect these medications may have on their judgment, performance, and/or behavior. If it is likely that the student’s clinical/practicum performance could be affected by OTC/prescribed medication, the student should initiate contact with the Office of Student Life Disability Services (SLDS) for consultation.
Students are encouraged to voluntarily request referral for treatment before their substance use leads to academic or conduct problems as described in the Code of Student Conduct (3335-23-04 Prohibited Conduct) and College of Nursing Professional Standards. The College administration reserves the right to test a student for substances at any time that a student is suspected of impairment or substance use as outlined in the “For Cause” section of this policy.
Whether a student self-reports a substance use issue or is found to have used a substance through other means, such as, but not limited to, drug testing, the student will be referred to the applicable assistant/associate dean for a discussion of program progression issues and review of resources. Academic progression issues will also be reviewed by the Undergraduate and/or Graduate Studies Committee/s as applicable.
At the point that a substance use issue or impairment is validated, the student will be administratively suspended and unable to participate in any College of Nursing clinical/practicum experiences. The appropriate dean will determine whether continued College of Nursing classroom attendance will be allowed.
A student on mandatory academic suspension for substance use/impairment may be considered for reactivation in the program by submitting a petition to the appropriate studies committee (Undergraduate Studies or Graduate Studies Committees).
A second validated instance of impaired practice will result in dismissal from the College of Nursing.
The College of Nursing shall maintain the toxicology reports in a manner that ensures the confidentiality of the results and complies with applicable state and federal requirements.
Procedures
Where a faculty or staff member suspects that a student is under the influence or impaired, the following procedures should be taken:
1. Immediate actions.
Reasonable Suspicion and “for cause” drug/alcohol toxicology testing.
When faculty believes that a student is using or is under the influence of drugs or alcohol in class or during practice, the faculty observing the behaviors will initiate, in consultation with the course lead[1], the “Reasonable Suspicion Checklist”(Appendix A).
If, based on personal observations as documented on the checklist confirms, that reasonable suspicion for substance impairment (e.g. drugs and/or alcohol) exists, the faculty of record and/or the course lead will contact the appropriate assistant/associate dean who will review and determine if “for cause” testing is needed.
“For cause” testing is initiated by the designated administrator after verbal communication with the student, witnesses (e.g., other OSU faculty, students, RN staff or supervisor at the facility) and based on the completed Reasonable Suspicion Testing Checklist data that are submitted by the faculty member/s (Appendix A).
Once testing is ordered, it must be completed within two hours or as feasible based on site location, but within 24 hours. Ordered testing for reasonable suspicion may not be appealed. Failure to complete testing in a timely manner may result in a presumption of positive toxicology result and academic suspension.
If the drug screen is positive or if the student does not complete the required testing within the specified time period, the College of Nursing is required to report students who hold licensure (e.g., R.N. licensure or other licensures) to the appropriate regulatory agency/agencies.
Testing procedure.
Costs for substance tests are the responsibility of the student. To ensure the safety of the student and public, students suspected of impairment will not be allowed to operate a motor vehicle and will be responsible for any transportation costs.
When testing “for cause,” the following substances will be tested through urine toxicology, blood toxicology, or “breathalyzer” testing as appropriate for the substance(s) of concern:
- THC (tetrahydrocannabinol)
- Cocaine and metabolites
- Amphetamine/Methamphetamine
- Benzodiazepines
- Opiates
- Methadone
- Barbiturates
- PCP (phencyclidine)
- Alcohol
- Any other substance(s) deemed necessary to test
2. Follow up actions.
Test results.
The Medical Review Officer (MRO) will receive all toxicology reports from the laboratory. The MRO will review lab reports and interpret test results. The MRO will report final toxicology results to the Associate Dean for Academic Affairs and Educational Innovation or his/her designee. The Associate Dean for Academic Affairs and Educational Innovation will inform the applicable members of the College of Nursing administrative leadership team of the results of the testing on a need-to-know basis.
Records Disposition
Incident documentation is stored in a firewall-secure, password protected electronic folder on a College of Nursing server accessible only by the Associate Dean for Academic Affairs and Educational Innovation and his/her designees. Incident records are stored separately from student academic records and are retained as consistent with OSU Records Management Policy.
Appendix A
Reasonable Suspicion Testing Checklist
Physical Indicators:
| WALKING | FACE | SPEECH | BREATH/ODOR | ||||||||||||||||||
| Holding on | Red/flushed | Whispering | No alcohol odor | ||||||||||||||||||
| Stumbling | Pale | Slurred | Faint alcohol odor | ||||||||||||||||||
| Unable to walk | Sweaty | Shouting | Strong alcohol odor | ||||||||||||||||||
| Unsteady | Appears normal | Incoherent | Sweet/pungent tobacco odor | ||||||||||||||||||
| Staggering | Slobbering | Silent | Chemical odor | ||||||||||||||||||
| Swaying | Grinding teeth | Rambling | Marijuana odor | ||||||||||||||||||
| Falling | Dry mouth | Slow | Breath spray/mouthwash | ||||||||||||||||||
| Other | Runny nose | Other | ____None ____Gum | ||||||||||||||||||
| Other | ____Mints ____Candy | ||||||||||||||||||||
| ____Other______________ | |||||||||||||||||||||
| STANDING | EYES | MOVEMENTS | APPEARANCE | ||||||||||||||||||
| Swaying | Watery | Fumbling | Messy | ||||||||||||||||||
| Feet wide apart | Bloodshot | Jerky | Dirty/stained clothing | ||||||||||||||||||
| Rigid | Glassy | Nervous | Burns on person/clothing | ||||||||||||||||||
| Staggering | Dilated | Slow | Ripped/torn clothing | ||||||||||||||||||
| Sagging at knees | Closed | Hyperactive | Partially dressed | ||||||||||||||||||
| Other | Droopy eye lids | Other | Puncture marks/needle tracks | ||||||||||||||||||
| Appear normal | Appears normal | ||||||||||||||||||||
| Behavioral Indicators: | |||||||||||||||||||||
| DEMEANOR | ACTIONS | ||||||||||||||||||||
| Cooperative | Polite | Calm | Fighting | Profanity | |||||||||||||||||
| Talkative | Silent | Resisting communication | Erratic | Hostile | |||||||||||||||||
| Sarcastic | Belligerent | Tearful/crying | Threatening | Hyperactive | |||||||||||||||||
| Anxious | Excited | Mood changes | Non-communicative | Sleeping | |||||||||||||||||
| Disoriented | Inattentive | Appears normal | Argumentative | Other ___________________ | |||||||||||||||||
| Sleepy | Drowsy | Other | |||||||||||||||||||
| Comments and other observations: | |||||||||||||||||||||
| Additional facts: | |||||||||||||||||||||
| Presence of alcohol and/or drugs in individual’s possession or vicinity | |||||||||||||||||||||
| Misconduct by individual (specify) | |||||||||||||||||||||
| Individual admission concerning alcohol use and/or drug use or possession | |||||||||||||||||||||
| List other witnesses to individual’s conduct and summarize what they say they witnessed: | |||||||||||||||||||||
| Individual declined to comment OR Individual’s explanation for behavior: | |||||||||||||||||||||
| Is individual at least 18 years of age? Yes/No If no, name of parent/guardian contacted: ___________________________ | |||||||||||||||||||||
| Completed by (signature) | Date: | Time: | a.m. p.m. | ||||||||||||||||||
| Printed Name: |
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Title: |
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References
American Association for College of Nursing. (1998). Policy and guidelines for prevention and management of substance abuse in the nursing education community. Retrieved from https://www.aacnnursing.org/News-Information/Position-Statements-White-Papers/Substance-Abuse
The Ohio State University. (2018). Drug-free workplace policy 7.30. Retrieved from https://hr.osu.edu/public/documents/policy/resources/730rstprocess.pdf
The Ohio State University. (2018). OSU records management policy. Retrieved from https://library.osu.edu/osu-records-management/policy.
The Ohio State University. (2016). Student conduct. Retrieved from https://studentconduct.osu.edu/
[1] If the course lead is not available, the course faculty or faculty of record will initiate the reasonable suspicion checklist and notify the applicable assistant/associate dean directly.