Doc just put me on this prescription Captain.....

[crotchitymedic1986]

You have an EMT who reports to duty and asks to see you (the supervisor). He has been out "sick" for several shifts, and is returning to duty. He tells you that he has been depressed and has an anxiety disorder, and his doctor put him on "Xanax". He shows you the prescription so that you will know if he later tests positive for anything in a random drug screen, that he is supposed to be on this medication. The medication label clearly states "do not drive while on this medication". What do you do ?

If you dont like that scenario, as you go through the bunk room to get to the bathroom. You see an employee taking a dose of Nyquil (which contains alcohol and diphenhydramine), because he is sick, but didnt want to call-out on you. What do you do ?

[spenac]

He would be sent home. He would have to present with a form stating he can do the job and as EMS is sadly a good part driving he would have to be able to be on medicine that would allow driving otherwise he is not capable of doing the job he was hired for.

[itku2er]

I am with spenac though He would have to have medical clearance to state he could do the job. But look at all the people out that in the community that drive on xanax they do it everyday. Meet with the board of directors on that one and the OMD. That way the company has someone to blame lol.

The nyquil thing I would send him home for that shift. No personal ramifications just send him home. You can buy Nyquil over the counter so its not like he is breaking any law or anything. But I wouldnt want him to drive or work on a critical patient while taking it.

[Doczilla]

There are many folks who do quite well on Xanax are are capable of performing their job functions despite the effect of the medication. In order to determine this, I recommend a driving test, skills test in a simulated environment with scenarios, and quiz the employee after on aspects of the scenario (Xanax affects short term memory). If they pass, they should be allowed to continue their job functions. It's important to understand under what circumstances they take the Xanax. At night to prevent insomnia? Twice or 3 times daily for anxiety on a schedule regimen, or as needed anytime when they feel stressed ("I'm stressed. *pops pill*). I list these from least to most worrisome from an employer's perspective.

As far as the Nyquil goes, there is the alcohol and the benadryl, either of which render a team member unfit to continue the mission on my SWAT team by policy. That employee should be educated on this and sent home.

'zilla

[crotchitymedic1986]

OK, so you send him home and then his lawyer calls you and tells you that you are violating the EMT's rights under the Americans with Disabilities Act. Now what would you do ?

[spenac]

OK, so you send him home and then his lawyer calls you and tells you that you are violating the EMT's rights under the Americans with Disabilities Act. Now what would you do ?

Actually it does not violate his rights. As mentioned cold and alergy medicine impairs. Zanax he had to get a medical release to return to work. No disability being violated.

[Richard B the EMT]

Does the service that sent the "scripts" med taking person home have paid sick days or not? Non chargeable time?

If the individual loses pay, then most definitely, the Americans with Disabilities Act will be used.

On the other hand, if the employee has exhausted their sick days bank, I now don't have a clue.

[crotchitymedic1986]

Actually it does not violate his rights. As mentioned cold and alergy medicine impairs. Zanax he had to get a medical release to return to work. No disability being violated.

Barring him from work because he has a mental disability and has to take medication could be an issue. But to make it even more difficult, the employee decides that it is his "job" that has created the depression and anxiety in his life, and wants to file workers comp

[spenac]

Barring him from work because he has a mental disability and has to take medication could be an issue. But to make it even more difficult, the employee decides that it is his "job" that has created the depression and anxiety in his life, and wants to file workers comp

Wrong. He was out of work and to return has to bring doctors release to full duty. No violation of his rights. Many services have that in writing.

As to workers comp that is a tough one to get approved.

[fireflymedic]

There is actually a loophole within the ADA to protect emergency services if they deem a person unfit to carry on the duties within the profession of police/fire/ems. Depending upon the service and if there are pre established protocols you may or may not be required to maintain the person on the service. General rule of thumb is does it present a potential threat to the person or the patients and does an accomodation place undue stress or hardship on the service. I think in general (especially for paramedics with a basic partner) the elimination of driving is not a major issue provided their doctor is willing to certify they are competent to provide patient care. However, for a basic, the situation may be more difficult. Basics (unless a transfer BLS only) primary job is driving unless partnered with a first responder and/or driver depending upon the service configuration. If it is a short term issue (ie less than 3-6 months) I feel accomodations should be made in general to move to a non care position (ie dispatch, office work, etc) if possible, and if not, the ability to qualify for short term disability. Many people, once they adjust to the medication, have no problem working on it and I think that applies to any medication. As mentioned many times before people work on a variety of medications for a variety of problems. If going through a medication change, yes, bring the person out of a driving/patient care position until they are cleared by a physician then allow them to return on or off medication so long as they can do the job competently. That being said however, I am a strong advocate of NOT having drivers under the influence of narcotic medications and if they are on any sort of medication similar, they should not be driving. In the instance of an accident, not only are they compromising the potential outcome of the patient and their partner, but also the service they work for. In a supervisory position, I wouldn't want to be responsible for dealing with that because the first question was "why did you let someone under the influence drive?" We wouldn't let you drive with alcohol in your system - so why narcotic medications or ones that severely impair you? I dont see the difference here.