Dear List,

I saw a young patient (working in the Avionics industry as a machinist – all work considered Safety Critical) in November who had had a relationship breakdown a few months previous and taken some Cannabis to help get over it….

They denied any recent / current use, as they were not dependant and abstinence was not a problem.

Being of a suspicious mind (more that innate feeling something was not quite right) I sought permission from the company to perform a Chain of Custody drug test in December (I only do one clinic there a month).  Immediately before the test he disclosed use the previous Friday (6 days previous). They were placed on Gardening Leave pending the result and I referred to our local Drug rehab team (19Dec), results were positive as expected. They remained on Gardening leave over the Christmas break.

They were reviewed in a case conference in early January – where use over Christmas was disclosed. They were put on leave (A/L) for a week to allow excretion of the drug from their system. And a test carried out one week later (initially a in clinic test) then a Chain of Custody test – both showed Cannabis & Cocaine (Cocaine use was denied).

Results came in this Monday when I phoned them to advise the results, I was advised that they were resigning as they had another job.

THE QUESTION: Their new job is likely to be very similar doing Safety Critical Work, do I have a duty of care to his new employer? Should I disclose the suspension under the previous companies Drug and Alcohol policy for providing a ‘Non-Negative’ sample. I have spoken to the NMC (who were so on the fence they have splinters up their ****), and it took 10 minutes to explain what an OH nurse does. The RCN were a bit more constructive, but the process remains a little unclear, we agreed that the best solution was to write to the patient to encourage them to complete their drug rehabilitation, and to be open and honest with their new employer, and not to work if there is likely to be residual drugs in there system.

I would be grateful for your thoughts.

Many Thanks

Campbell