"Urine Drug Screams, Part 5" by Troy H. Cheek on Apr 23, 2004

After I butted heads with the staff a few times, my pointy-haired boss promised that he would make it clear to the Emergency Center staff that it was the Security department, and specifically me, which had received the special training and that we, and specifically me, were the final word in UDS procedures, which would resolve all the conflicts.

Yeah, and I'd book a flight on Porcine Air.

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

"Where's the patient?" I asked as nicely and politely as I could. I don't think they noticed my clenched teeth.

"He's in Bed 14," the nurse replied. "I told him about the UDS, but he says he refuses."

"Too bad," I said. "I'll call his company and let them know."

"Oh, don't do that yet. We may not have to."

"And why may we not have to?"

"I told him that he had to give us a urine sample or I'd call the law on him," the nurse told me in a confidential tone. "He thinks you're the police. Just go in there and order him to comply with the UDS."

"You realize that impersonating a law enforcement officer is illegal? And that if I obtain his permission using illegal means, the UDS is invalid?"

The nurse admitted that he had heard something to that effect but didn't think it would be a problem here. All I had to do was not actually say that I was a cop and I was in the clear.

"I don't think it works like that. If I know he's mistaken me for a police officer and don't do anything to correct him, that's the same as making the claim myself."

I eventually got tired of arguing and just spoke with the patient. Once I explained that I'd have to inform his employer that he refused the UDS, he was actually willing to cooperate.

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

Stat is medspeak for PDQ. I despise jargon.

"Where's the patient?" I asked, not even pretending to be nice or polite.

"Bed 7. And hurry!"

"Hello, I'm Troy from Security and I need you to- Yikes! What happened to you?"

One of the small crowd of people with the patient answered. "He fell off the loading dock and got his head caught in the hydraulic lift gate on the back of the truck he was loading," she said. She made a V-shape with her arms and mimed crushing her face. To this day, it still hurts just to consider it.

"I see. Sir, can you sign this consent form?" I asked.

"Mrhplhe gurgle wheeze blurple," he replied.

"Please hurry, sir," his friend pleaded. "They said they had to wait on you before they could give him something for pain."

"I'll be right back." I made a beeline for the nurse.

"Finished already?" he asked. "Good. They're waiting for him in surgery."

"Not doing it right now," I explained. "Send him on up. They can call us any time within 24 hours after the accident and the UDS will still be valid."

"But, he'll be doped up on painkillers by then!" he objected.

"I certainly hope so." I know I'd want to be.

"But, the painkillers will show up on his UDS!" he ojected.

"That can't be helped. His company's staff physician will get the appropriate section of his medical chart. They'll figure it out."

"But, what if he took something similar to that painkiller before the accident? We'll never know!" he really objected.

I snarled at him. Didn't mean to. I just did. "That's the price we pay for never allowing the collection of a UDS sample to delay medical treatment! Now, get your ass in there, give him the damned pain medicine, and document his chart so somebody knows to call us when he gets out of surgery!"

He practically ran to the patient's room. I got another complaint on that, but it was worth it. The patient's friends heard me and one of them wrote a letter to the hospital thanking me for it, so I actually came out ahead.

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

"Where's the patient?" I asked. I was worried. This particular nurse had given me trouble before.

"Bed 3. It's a girl."

"Congratulations, I didn't even know you were expecting," I said, trying a little humor. It fell flat. "What company does she work for?"

"She doesn't work," came the reply. "She's only 13."

"Then why am I here filling out UDS forms?"

"Her parents are divorced and going through a big custody battle. Her father brought her in and wants a drug screen to prove that she didn't take any drugs while in his custody, because he thinks the mother will claim that the kid did."

Believe it or not, this is not the first time I'd heard a story like that. "You don't need me for that. You can do it yourself."

"Oh, I know that. I'm just not comfortable with it. I'm not sure it's entirely legal. And I know if I'm involved in the process, I can get called in to testify about it. It's a horrible feeling, knowing that anything you do can cause legal consequences and tie you up in court for weeks."

"My world, and welcome to it."

I politely but firmly refused to become involved. That earned me another meeting with my pointy-haired boss. I got 30 minutes of talk about teamwork.

"It wasn't work-related, Boss," I tried to explain. "There was no contractual agreement of any kind to go by. I wouldn't have had any lab to send it to or any company to return the results to. It had nothing to do with Occupational Services or the UDS process that I was trained on. The nurse was just trying to get out of some work, or maybe out of some court time."

"Well, if somebody has to be tied up on court all day, it's better that it's a security guard than a much more highly paid nurse."

"Boss, it almost sounds like you're saying that you thing it's more important to have his nurse around here one of your own officers."

The boss looked startled. "Well, of course."

My turn to look startled. "Of course?"

"Of course. Troy, you know that a hospital actually needs nurses."

"And it doesn't need security?"

"Of course not. All a hospital really needs are doctors and nurses to take care of the patients and adminstrators to handle the money. Security and the other support departments are just luxuries."

This coming from the Director of the Security deparment. Suddenly, a great number of things he had said and done over the last few years made a great deal more sense. I didn't argue with him anymore about it.

I didn't do that UDS, either.

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