…and the fat lady sings, “Have a fabulous day!”
Ask any nurse in my state’s Diversion Program what they fear most. The ETG test will win…hands down.
This is an indirect measure of a liver enzyme that is elevated in the presence of very small amounts of alcohol and can be detected for several days in the urine. Seems like a boon to disciplinary programs. Unfortunately, there are small amounts of alcohol in thousands of the most common household products. Diversion nurses are directed to a list on the internet of common offenders (makeup, household cleaners, food, hand sanitizer) that contain alcohol and must be avoided AT ANY COST. Memorize the list. Don’t test positive. (The Substance Abuse and Mental Health Services Administration denounces the use of the ETG test for disciplinary purposes, but the company that sells them…SELLS them). If you test positive more than once…you are removed from patient care until the situation is resolved. Plus, 90 meetings in 90 days, don’t miss any. Your job, if you are truly without sin (and you will begin to question this yourself), is to become paranoid about everything you eat, drink, and breathe (hairspray and air freshener can make you test positive). You become the “nurse in the plastic bubble.” You shrink back in horror on the few occasions when you accidently pump hand sanitizer onto your palm instead of soap. You always, always use gloves when handling alcohol swabs…because, if you do not stop testing positive, the board may declare your tests to be “substantive evidence of a relapse.” This will have major repercussions for your Program…your 4-year timer is reset (or worse, your are sent to the disciplinary program, where the Scarlet A is permanently tattooed on your license…and your time starts over). Major repercussions as well for your self-esteem …you pick up a 24-hour chip at a meeting and announce yourself as one day sober. In 12-step culture, this means going back to step one. Whether or not you actually “used” is immaterial.
Every nurse in Diversion wonders if he or she would be able to make it through the experience of being “declared” relapsed incorrectly. With all of the other degrading experiences that go on, one has to wonder…could you, would you, will you, eat green eggs and ham…?” Or will you, shall you…won’t you carry a big “f-word” word for the rest of your life…and we all know what that does don’t we, fellow drunks and addicts…poor me…poor me…poor me a drink!!! The ETG test makes it possible be 100% compliant, absolutely perfect, the mirror image of normal…and still fail.
It is entirely within the realm of possibility that you will test positive on the ETG at least once during your 4 to 5 year contract as a performer for this circus. I had a string of positive tests with less than a year to go in my program, and I was ordered off my clinical floor for two weeks (at three and 1/2 years clean). Every day I waited for the phone to ring, for my case manager to TELL me that I was in relapse. THAT is how crazy it is. THAT is how powerless you are. I really did not know how much more of this I could take. Unfortunately, the list of high-paying careers for UNLICENSED Masters prepared nurses is depressingly short. I was writing my comp exam (on addiction… “can you say I-ro-nee?”) for my Masters Degree in Nursing and waiting for a call from the Board to tell me to take three giant steps back in my Diversion program. It turned out to be a food ingredient (not on the list). Well, it’s on the list now!
Meanwhile, I enjoyed a warm fuzzy scene with my ED nurse manager with whom I had previously had a very professional and respectful relationship…
“…three positive tests actually Jim…well like I said Jim…the test can be positive even with exposure to hand sanitizer…yes three positives. No…I…really haven’t…”
But you stop defending yourself, because you have come to recognize this facial expression.
Jim can’t see you now.
SyckRN, the professional veteran ER nurse who has worked for him for three years has vanished from his vision.
In her place…a lying unreliable drug addict who has left him with a huge staffing problem.
“Steaming hot humiliation being served in the Nurse Manager’s office, complements of the BRN…Come see the incredible shrinking dignity…before it disappears forever…Get it while it’s hot!”
You will call an 800 number 7 days a week, 365 days a year…for the duration. You do not ever, EVER, get a vacation from this. You will miss graduations, your childrens’ sporting events,your classes, and even work…in order to remain compliant to the drug testing portion of the Diversion program (You are willing to travel long distances to test…even though technically you are not required to go farther than a pretedetermined distance, because you are obsessive in your efforts not to cast doubt on your gratitude or your sobriety. There are things are not in the Circus Manual, but you do them just the same). If your urine is too dilute….it counts as a positive. If your doctor prescribes a medication that concerns us…well, we can’t really do anything to stop that…but oh boy…so many other things we CAN do. We might have to test you MORE OFTEN. (10,000 dollars and counting)….
When you call the number and enter the appropriate identifiers, an automated voice gives you your testing status for that day:
You will either get A. “You have been selected for testing…please report to your designated testing site for testing…have a great day.”
or, if the Diversion Gods are smiling that day, you hear message B. “You have NOT been selected for testing today…have a FABULOUS day!”
If ever you pass a nurse in the hall of your workplace, and he or she tells you to have a fabulous day, it is quite likely that you have just been greeted by “One Who Bears the A.” “Fabulous” used to be our mantra and was spoken almost as often, but with much more subversive joy…than the word “grateful.”