"Urine Drug Screams, Part 3" by Troy H. Cheek on Apr 21, 2004

In our previous installments, I explained how a hospital I once worked for tried to save money by getting rid of their Occupational Services department, moving such services to our Walk-in Clinic and later to our Emergency Center. Somehow, the several full-time employees who were trained to perform the urine drug screens and negotiate the contracts and fill out the paperwork didn't the transition with the services. The highly-trained professionals in our state of the art Emergency Center turned out to not have the proper training to provide this service.

All of this eventually culminated in my getting called in to talk to my pointy-haired boss. "Troy, step into my office."

I did so, closing the door behind me. If I don't, he waits until I sit down, then asks me to please close it. "What's up, Boss?"

"I need you to do a urine drug screen," he stated.

"Sorry, boss. I just went. But let me finish my coffee and give me half an hour..."

"No, it's nothing like that," the boss interupted. "I need the whole department to do a urine drug screen."

"Okay, give me an hour or two to call all the guys in and..."

"No, it's nothing like that," the boss interupted. "Why do you always make things so difficult?" I think that part was supposed to be to himself. I suspect that he never realized how loud his mutterings were. "I need the department to start performing urine drug screens on other people."

"Boss, that sounds like something medical, and you know that Security is not allowed to participate in any medical procedures..."

"No, it's nothing like that," the boss interupted. "You're not doing any of the actual drug screen. You're just collecting the samples and shipping them off to the lab. All you need is the right training."

I started to open my mouth, but he answered my objection before I could raise it. "We'll schedule the training."

We soon got the training. The instructor explained exactly why security officers were suddenly acting as lab techs. I explained most of the reasons in my last two columms, but there were a few more factors to consider.

Our Emergency Center was one of the largest in the area. Still is, probably. I don't know, I don't work there anymore. But at the time, they had a huge number of full-time, part-time, call-in, contract, and student nurses. So many, working so many different schedules, in fact, that it would take literally months to train them all in the proper procedures and paperwork necessary for performing the urine drug screens we had contractually agreed to provide. There was a very good chance that there would be occasions when there would be nobody available who was trained to perform a proper urine drug screen should the need arise. For maybe the next year or so.

We needed a temporary solution until the permanent one could be applied. We needed a small force of trained people who would always be available. We needed someone who had job duties which could allow them to occasionally help out the Emergency Center when needed. We needed...

"Troy, step into my office."

Me. Or, rather, all the officers in our Security department. Since we were relatively few in number, we could all receive a quickie training course in a couple of weeks. We could perform the urine drug screens during the months necessary to fully train all the full-time, part-time, call-in, contract, and student nurses in the Emergency Center. As more of those were trained, more would likely be available when needed, so Security would be called less and less.

Eventually, we'd go back to leaving such things to the highly-trained professionals who were supposed to be doing them in the first place, which is why Security didn't get the crosstraining pay they would normally receive for learning a new job skill.

Please read the previous sentence with a hint of sarcasm. That never happened during the time I was working there. What actually happened was that the nursing staff took offense at the suggestion that they were not qualified to pick the proper form and fill it out correctly. A big power struggle ensued and, somewhere along the way, it was decided that Security had the job permanently. Only we were trusted enough to perform this vital function.

Also, our boss was the only person who spoke up during the meeting and volunteered. "I had to volunteer, Troy. Only we can do it."

"What about the Emergency Center staff?"

"Well, there are other considerations..."

"What about our in-house Lab?"

"Well, there are other considerations..."

"What about those Occupational Services people who were laid off?"

"Well, there are other considerations..."

Eventually, we ended up with an extra dime or so an hour due to our crosstraining. This was less than the usual crosstraining pay, but that was justified by how seldom we would be using such skills in actual practice.

Brother, we got a lot of practice.

"Security, please come to the Emergency Center for a UDS."

"UDS?" I asked.

"Urine Drug Screen," one of my fellow officers guessed.

"You mean we've been saying and writing 'urine drug screen' through weeks of training when we could have been using three little letters?"

"Apparently."

Sigh. I sauntered off to the Emergency Center. My first urine drug... Well, my first UDS. "Where's the patient?" I asked, nicely.

"Oh, he just left," answered a nurse. "But we got this for you earlier."

"That appears to be a half-filled portable urinal," I stated flatly. I didn't make any effort to reach for it.

"Yeah. Is there enough in there for your UDS?"

I explained that while there was enough sample, I couldn't use it. The sample was obtained outside of my presence. I couldn't even properly swear in court that it even came from the patient in question, let alone that it had not been tampered with in any way. With the patient gone, I couldn't explain and get him to sign a consent form, either. "Sorry, can't do it."

"But you have to!"

"Sorry."

"I'll talk to your boss about this!" she screeched. "I'll have your job!"

"You won't like it," I answered. "You'd have to deal with assholes all day."

Strangely enough, the boss wanted a word with me later that day. "I have a complaint that you rudely refused to do a UDS earlier."

I explained the circumstances. And if I downplayed my sarcastic parting shot in the version of the story I told my boss, I'm sure the reader will forgive me.

I got a 10 minute lecture anyway. "...and legalities aside," the boss finished, "you have to remember that we're part of a team here. You have to play nice and be polite and at least try to get along with people. Please keep that in mind in the future."

I assured him that I would. Nice and polite all the way next time. No problem. And I was. But that's a tale for tomorrow.

Copyright 2004 by Troy H. Cheek. Reprint with prior written permission only. Comments and questions to $mail:theview$