Pre-employment drug testing is a standard step in the hiring process for most healthcare jobs in Florida. For nurses, it’s more than just a formality. A positive drug test can create an issue with your nursing license, mandatory reporting, and possibly a Florida Department of Health (DOH) investigation.
If you’re a nurse in Florida and you failed a pre-employment drug test, it’s natural to feel overwhelmed. Lauren A. Leikam, PLLC, a health care nursing license defense attorney, provides context for state regulations and answers questions about your options if you get a positive result for things like marijuana use, drunk driving, illicit drugs, or other recent prescription drug use. Here’s what you need to know.
Florida’s Licensing Standards for Nurses
In Florida, nurses are licensed and regulated by the Florida Board of Nursing under the Florida DOH. The Board is responsible for ensuring compliance with all nursing legal and professional standards required to practice safely.
Failing a drug test doesn’t automatically mean you’ll lose your license, but it does raise red flags to current and future employers, and formal action from the DOH is hard to navigate without professional legal representation. A positive drug screen can lead to an investigation, especially if it suggests impairment, substance use disorders, or substance misuse of prescription and illicit drugs.
What Happens if a Nurse Fails a Pre-Employment Drug Test?
Here’s what typically happens when a nurse fails a pre-employment drug test in Florida:
1. The Job Offer May Be Withdrawn
Most employers treat failed drug test results as grounds for rescinding a job offer. Even if you have a prescription for a controlled substance, failure to disclose it ahead of time can complicate the situation.
2. Mandatory Reporting May Follow
Certain employers—especially hospitals, clinics, or other licensed healthcare facilities—may be required to report the failed drug test to the Florida DOH. Under Florida Statutes §464.018 and §456.072, impairment, substance misuse, or inability to practice with reasonable skill and safety can trigger disciplinary proceedings and even criminal charges. Additionally, you risk being reported to The Intervention Project for Nurses (IPN) in lieu of DOH.
3. You Could Face a DOH Investigation
If the failed test is reported to the Department of Health, you could receive a letter informing you that you’re under DOH investigation. While this is not the same as being found guilty of wrongdoing, it’s the start of a process that examines whether you are safe to practice and whether disciplinary action is appropriate.
4. You May Be Asked to Participate in IPN
If the DOH believes substance use is an issue, they may refer (or order) you to The Intervention Project for Nurses (IPN) (IPN) for evaluation. Participation is often lengthy and may include monitoring, drug testing, and assistance by an addiction specialist at a treatment facility.
5. Your License Could Be At Risk
If the investigation determines drug abuse and that you violated the Nurse Practice Act or pose a risk to patients, your nursing license could be restricted or suspended until you enter IPN.
What Happens If a Nurse Fails a “For-Cause” Drug Test?
A for-cause drug test is triggered when an employer has reason to believe a nurse may be impaired at work. This could be based on observed behavior, patient complaints, or incidents involving medication errors or safety concerns.
Failing a for-cause drug test is serious because it suggests possible impairment while practicing.
Here are some of the possible consequences:
- Immediate Suspension: Employers may remove you from duty while they investigate further.
- DOH Reporting: Your employer may report you to the DOH and also may report or refer you to IPN.
- Increased Risk of IPN Referral: Because the failed test involves your behavior on the job, you are more likely to be referred to IPN for evaluation.
- Your License May Be in Jeopardy: A failed for-cause test can lead to an investigation into your fitness to practice, and ultimately, disciplinary action.
You have the right to respond to allegations and defend your license. Do not make any statements before seeking legal advice.
What If a Nurse Fails a Random Drug Screen?
Healthcare facilities often conduct random drug testing as part of a compliance or safety program, especially for nurses in high-risk environments like critical care or emergency departments.
If you’re selected for a random drug screen and fail:
- Your Employer May Take Action: This can include administrative leave, mandatory reporting, or termination.
- The DOH May Be Notified: Just like with for-cause or pre-employment tests, a failed random screen gets reported to the Florida Department of Health.
- You Might Still Face IPN Referral: Even if you weren’t impaired at work, the presence of a prohibited substance could prompt a referral.
Failing a random test doesn’t automatically mean you’ll lose your license, but it will likely initiate a review process. Legal guidance can help you respond properly and understand your options.
The Legal Side: What You Should Know
If you’re under investigation due to a positive test for drugs, here’s a general overview of what happens during the DOH investigation process:
- Notice of Investigation: You receive written notice from the DOH.
- Request for Records/Response: You may be asked for documentation or a written explanation.
- Emergency Suspension/Restriction Orders (ESO/ERO) or Orders Compelling Examination (OCE): You receive an immediate suspension or restriction on practicing medicine, and/or the Department of Health orders you to submit to an evaluation.
- Investigative File and Response: This is where you are able to respond to the Department of Health’s evidence or allegations.
- Probable Cause Panel: A panel may review your case to determine if probable cause exists for disciplinary action.
- Formal Complaint: If probable cause is found, a formal complaint is filed.
- Hearing or Settlement: You may resolve the case through a hearing or a settlement agreement.
At each step, what you say and do matters. Having legal guidance from someone familiar with healthcare licensing is critical.
What If You’re Asked to Enter IPN?
IPN is an alternative for nurses dealing with substance abuse or mental health concerns. It can be a lifeline for some, but it may feel overwhelming for others. Here’s what to expect:
- Comprehensive evaluation by a medical review officer or approved providers
- Random drug testing, which can include blood alcohol level (PEth), hair drug, and urine tests
- Treatment or counseling from an addiction specialist
- Workplace monitoring
- Long-term commitment (usually 5 years, and sometimes a lifetime contract)
In some cases, entering IPN can help protect your license. However, you are not required to enter IPN unless it is Board-ordered. Before agreeing, it’s best to speak with Lauren A. Leikam, PLLC, to understand your options.
What to Do If You Failed a Drug Test
- Do Not Panic: Failing a drug test doesn’t necessarily end your career.
- Gather Documentation: If you have a valid prescription, collect medical records and pharmacy information.
- Avoid Admitting Fault: Refrain from making written or verbal admissions without consulting Lauren first.
- Respond to DOH Promptly: Ignoring notices won’t make the problem go away.
- Get a Free Case Review: Lauren can help you understand your rights, respond strategically, and avoid unnecessary consequences.
You Have the Right to Legal Representation
If you’re contacted by the DOH or referred to IPN, it’s essential to consult with an experienced health care licensing defense attorney before responding. Signing documents or agreeing to participation without legal advice can affect your rights and career.
Nurses facing drug test issues need more than just general legal help. They need someone who knows the rules, understands the healthcare system, and takes a no-nonsense approach to defending their license. Lauren A. Leikam, PLLC, represents healthcare professionals facing DOH licensing issues in Florida. As a former DOH prosecutor, Lauren understands both sides of the process. Her legal experience helps her clients navigate investigations and form the best possible strategy to try to protect their licenses with clarity and confidence.
Lauren A. Leikam, PLLC, focuses on helping:
- RNs, LPNs, and APRNs facing DOH investigations
- Nurses referred to IPN or dealing with related compliance issues
- Professionals worried about disclosure, licensing renewal, or discipline
With her years of previous experience as a former prosecutor for the Florida Department of Health, Lauren offers informed, practical legal advice tailored to the unique challenges healthcare professionals face.
Don’t Wait—Schedule a Free Consultation with Lauren A. Leikam, PLLC, Today
If you’re a nurse in Florida who failed a pre-employment drug test, you may think you’re out of options, but you won’t know until you speak to a lawyer. The process ahead can be confusing, but your license and career are worth protecting.
As a longtime health care nursing license defense attorney, Lauren A. Leikam, PLLC, offers clear, professional legal support to nurses and other healthcare providers across Florida. While a failed drug test is serious, it doesn’t have to define your future.
Schedule a free consultation with Lauren today to understand your options and protect your nursing license.
Disclaimer: A free consultation does not constitute legal advice.
FAQs About Failing a Drug Test as a Nurse
What if I Have a Prescription?
If you tested positive due to a legally prescribed, currently valid medication, and you disclosed it properly during the drug screening process, you likely will not face professional consequences. However, failure to disclose or use a valid prescription in a manner inconsistent with the prescription could still be an issue.
Will This Show Up on My License Record?
If disciplinary action is taken, it becomes part of your public license record on the Florida Department of Health’s website. Employers and the public can see these records.
Can I Continue Working as a Nurse?
That depends on the outcome of the investigation or IPN referral. If your license is restricted or you’re placed in a monitoring program, your ability to work could be limited.
