Nurses must conduct health care and educational activities fully in control of their manual dexterity and skills, mental faculties, and judgment. The presence or use of drugs or alcohol, lawful or otherwise, which interferes with the judgment or motor coordination of nursing students in a health care setting poses an unacceptable health and safety risk for patients and health care colleagues and undermines the public’s trust in the nursing profession. Preventing and/or detecting substance abuse is particularly critical for undergraduate students in the upper divisions and for graduate students in all programs, where students spend a considerable amount of time learning patient care in a variety of clinical settings.
Protect the health and safety of patients and health care colleagues;
Preserve the public’s trust in the nursing profession;
Comply with the University’s agreements with affiliating clinical agencies; and
Maintain a drug-free workplace and academic environment and complement the University’s Drug-Free Campus and Workplace Policy and the University’s Student Code of Conduct.
CON
The term CON means the University of Tennessee, Knoxville’s College of Nursing.
Drug Testing / Drug Test
The term drug testing or drug test means the scientific analysis of urine, blood, breath, saliva, hair, tissue, and other specimens of the human body for the purpose of detecting a drug or alcohol.
Health Compliance Officer
The term Health Compliance Officer means the Health Compliance Officer for the University of Tennessee, Knoxville’s College of Nursing.
Health Care Provider
The term Health Care Provider means a licensed Medical Doctor (MD), Doctor of Osteopathic Medicine (DO), Nurse Practitioner (NP), or Physician’s Assistant (PA).
Illegal Drug
The term illegal drug means any drug which is not legally obtainable; any drug which is legally obtainable but has not been legally obtained; any prescribed drug not legally obtained; any prescribed drug not being used for the prescribed purpose or by the person for whom it was prescribed; any over-the-counter drug being used at a dosage level other than that recommended by the manufacturer, or being used for a purpose other than the purpose intended by the manufacturer; and any drug being used for a purpose or by a person not in accordance with prescribed medical therapy. Examples of illegal drugs include, but are not limited to, stimulants, depressants, narcotic or hallucinogenic drugs, cannabis substances, such as marijuana and hashish, cocaine, heroin, methamphetamine, phencyclidine (PCP), and so-called designer drugs and look-alike drugs.
Impaired
The term impaired means that a person's mental or physical capabilities are reduced below their normal levels (with or without any reasonable accommodation for a disability). An impaired nursing student manifests deterioration in the level of function as compared to that previously observed, or the nursing student does not function at a level normally expected under the prevailing circumstances. Impairment may exist in one or more multiple domains, including psychomotor activity and skills, conceptual or factual recall, integrative or synthetic thought processes, judgment, attentiveness, demeanor and attitudes as manifested in speech or actions. Impairment will include addiction to and/or physical dependence upon chemical substances.
Nursing Student(s) / Student
The term nursing student(s) or student means any individual enrolled in the CON in pursuit of the BSN, MSN, DNP, or PhD in Nursing degree, including registered nurses (RN) and students taking courses via distance education, special students, or in post-graduate study, either alone or in combination with any other degree, regardless of the specific location of the student.
Positive
The term positive, with respect to drug testing, means the level identified by the Medical Review Officer in accordance with guidelines established for healthcare workers.
Reasonable Suspicion
The term reasonable suspicion means that evidence which forms a reasonable basis for concluding that it is more likely than not that a person has engaged in substance abuse. Facts which could give rise to reasonable suspicion include, but are not limited to: the odor of alcohol or drugs, impaired behavior such as slurred speech, decreased motor coordination, difficulty in maintaining balance, marked changes in personality or job performance, and unexplained accidents. Such evidence may come from a professional or expert opinion, layperson opinion, scientific tests, or other sources or methods.
Substance Abuse
The term substance abuse means (i) the manufacture, use, sale, purchase, distribution, transfer, or possession of an illegal drug by any nursing student while on University or affiliated clinical agency premises or while participating in any University or affiliated clinical agency-sponsored or related activity, including any nursing-related course or clinical training activity; (ii) the illegal use of a legal drug; (iii) the consumption, possession, or distribution of alcohol, unless approved by the University or clinical agency, by any nursing student while: on University-controlled property; on the property of an affiliated clinical agency; and/or while participating in any University-sponsored or affiliated clinical agency-sponsored or related activity, including any nursing-related course or clinical training activity; and/or (iv) a nursing student's use of alcohol or any drug in such a way that the student's performance in any nursing course, including activities at any clinical agency, is impaired.
Substance abuse by nursing students is strictly prohibited and will result in disciplinary action, up to and including permanent dismissal from the CON.
In addition, a violation by any nursing student of any state or federal statute, or regulation established pursuant to such statute, pertaining to the manufacture, improper possession, sale, use, or distribution of a drug or alcohol is strictly prohibited. Such a violation may result in the student's dismissal from the CON. A nursing student who fails to notify the Health Compliance Officer about any such violation within five (5) days of a legal conviction, guilty plea, or plea of no contest for any such violation may be subject to dismissal from the CON.
A student’s admission to the following CON programs is conditioned on the student taking a drug test and receiving results that are negative for the presence of illegal drugs:
Upper division of the BSN;
MSN;
DNP;
PhD;
RN to BSN; and
Certificate Programs
Upon receiving an offer of admission to one of the programs described above, a student shall submit a written authorization to the CON allowing CON vendor designated laboratory to conduct a drug test for the presence of illegal drugs and verify results through CertifiedBackground.com. The student shall agree to submit the drug test results to the Health Compliance Officer.
In addition, until graduation, students in all clinical degrees and certificate programs shall submit to an annual drug screen using CON vendor for screenings. The CON reserves the right to random drug screen students for cause.
In addition to the drug testing required by the CON, nursing students shall comply with an affiliating clinical agency's drug/alcohol testing policies (including but not limited to pre-employment or pre-clinical placement testing or when there is reasonable suspicion to believe that a student has engaged in substance abuse). The cost of all drug/alcohol testing required by affiliating clinical agencies shall be borne by the student or affiliating clinical agency, as determined by the affiliating clinical agency. Affiliated clinical agencies have the right to refuse any student for clinical placement based on concerns about that student’s ability to deliver safe treatment or care to patients.
A nursing student who demonstrates behavioral changes reasonably suspected to be related to substance abuse may be required to submit to drug testing. A decision to drug test based on reasonable suspicion of substance abuse may be made by a faculty member and/or a clinical agency. The nursing faculty member's/clinical agency’s request to drug test shall be documented (see Appendix) and may be based on a variety of factors, including but not limited to:
Observable phenomena such as direct observation of drug use and or physical symptoms or manifestations of being under the influence of a drug;
Erratic behavior, slurred speech, staggered gait, flushed face, dilated/pinpoint pupils, wide mood swings, or deterioration of work or academic performance;
Information that a student has caused or contributed to an accident that resulted in injury requiring treatment by a licensed health care professional;
Substance abuse-related conviction by a court, or being found guilty of a substance abuse-related offense in another administrative or quasi-legal proceeding.
A request to drug test a nursing student shall be submitted to the Health Compliance Officer, who will determine whether there is a reasonable suspicion of the nursing student engaging in substance abuse.
The following procedures will be followed if the Health Compliance Officer determines that there is a reasonable suspicion of substance abuse:
As soon as practicable, a drug test will be arranged by the CON, unless done in cooperation with the affiliating clinical agency. The test shall screen for the use of illegal drugs and/or for the use of any drugs which are reasonably suspected of being abused by the student.
The cost of reasonable suspicion drug testing will be borne by CON student.
The Health Compliance Officer will be notified of all test results.
Until the Health Compliance Officer receives the drug test results, the student will not be allowed to participate in clinical activities.
Nothing in this section shall be construed to prohibit an affiliating clinical agency from conducting or ordering a drug test in accordance with the affiliating clinical agency’s policies and procedures.
If a student tests positive for a prescribed drug, then the student must obtain a written statement from a qualified health care provider that the medication is prescribed and will not interfere with safe clinical practice.
If a student tests positive for an illegal drug or prescribed drug without a valid prescription then the nursing student will be deemed unable to meet the essential qualifications/functions of the nursing curriculum, will be dismissed from the CON (or not admitted to the CON), and will not be eligible for readmission if the student:
Tests positive for substance abuse;
Refuses or otherwise fails to submit to a drug test required under this policy; or
Tampers with, contaminates, or switches a sample (or attempts to do any of those things).
The Health Compliance Officer will notify a student who has a drug test that is positive for substance abuse.
If a drug test is negative, that fact will be noted in the student's record. Unless there is compelling evidence to do otherwise, the preliminary investigation will cease, the student will be released from further action, and the student will be permitted to make up clinical work, if any, that the student missed during the pendency of the drug test.
If, after receiving a drug test that is positive for substance abuse, a student denies having engaged in substance abuse, then the student will be given the option of taking another drug test within 24 hours of the notification to the student about the positive drug test. The student will be responsible for the cost of the repeat drug lab test. If the second drug test is also positive, then the student will be dismissed from the CON and will not be eligible for readmission to the CON. If the second drug test is negative, then the student will be permitted to continue in the CON.
If a student is dismissed from the CON because of a positive drug test, then the student may appeal that decision to the Dean of the College of Nursing. The student must submit a written appeal within three (3) working days. The Dean of the CON will appoint a task force made up of the Student’s Program Chair and two (2) additional faculty members to hear the appeal.
All drug testing results will be treated by the CON as information that is received in confidence and shall not be disclosed to third parties unless disclosure is required by law, the information is needed by appropriate CON officials to perform their job functions (e.g., the CON’s Health Compliance Officer, appropriate CON program directors, the CON’s Director of Student Services, and course coordinators of the student’s clinical courses), disclosure is needed to protect the health and safety of others, or the student has consented in writing to the release of the information.
The CON and the University shall have the right to use and disclose the results of drug testing required by this policy in connection with internal academic and disciplinary purposes and in connection with the defense of any student grievance and any claims filed by a student, or by his/her personal representative, in any court of law or with any state or federal administrative agency.