HAMILTON DRUG TESTS UNDERMINE NURSE-PATIENT TRUST

I read with interest the story about the student drug testing in
"Drug test angers family" (Feb. 9). My concern was the nurse's
involvement in this school administrator-ordered test.

I was involved with some of the first urine drug testing among in
mates in the New Jersey Department of Corrections (NJDOC) when I
worked as a nurse in a juvenile facility in the mid-1980s. At that
time, nurses were required to collect the urine, sign as witness to
the collection, label the containers, complete the
"chain-of-evidence" form, store the containers in a locked
refrigerator, and send them off for analysis. We nurses protested
that these were inappropriate actions since:

a) These were not medical tests that were being done for the health
of the inmate/patient; they were evidence-collection tests that
resulted in some disciplinary sanction for a positive result, and

b) Requiring nurses to carry out non-nursing, disciplinary tests on
inmates was a corruption of the nurse-patient relationship.

The nurse-patient relationship is a precious and fragile thing that
is based on the trust that all of the nurses' actions are
therapeutic, i.e., for the health and well-being of the patient, and
not part of some disciplinary program. This is true whether the
disciplinary program is removal from extracurricular activities, up
to and including capital punishment.

After a short time, the nurses' arguments prevailed and the NJDOC
stopped requiring nurses to be involved in the urine drug screening
of inmates. No nurse has been involved in the collection of urine for
drug screens in the juvenile or adult sections of the NJDOC for more
than 10 years. Custody officers perform this function.

Obviously, it is just as important for students as it is for inmates
to be treated in a way that is respectful of the nurse-patient
relationship. Moreover, drug testing typically requires the
inappropriate release of confidential medical information to
administrators, usually by nurses, as some prescribed drugs may
produce false positive results in urine drug screening.

KEN WOLSKI, RN, MPA