Need Advice... Nurse stealing non-narcotic medication

[JSSCELI]

I am a new nurse and I am not sure exactly what to do regarding this issue. I am about 4 weeks into my first job as an RN and yesterday my preceptor asked me to see if any of my patients had PO Zofran. I asked why and she said that one of the nurses was feeling nauseous. She stated that the nurse she was asking for had asked for PO Phenergan but that she felt better giving her Zofran. I replied by saying "no, none of my patients have PO Zofran". I'm sure I had a funny expression on my face because she followed up with the fact that she frequently took medication like Mucinex or any over the counter medication from patients, reasoning with me by saying "you can get them from the store. So it's okay." And I responded by saying "you can't get Zofran from the store and even if you could the patients are still having to pay for the medication that you're taking from them."

I'm at a loss and I can't get this off my mind. I feel like taking any medication out of the pixis under a patients name is stealing from that patient. I've already had issues with this preceptor and next week I'm going to finish my orientation with another nurse. (This preceptor frequently leaves the floor to talk on other floors or to go outside and smoke. There was one instance when a patient was going into ARF and we had to call a rapid response. She was outside smoking and wouldn't answer her phone when called. Another instance just recently was that one of my patients was having chest pain and I was having to make all of the decisions and call the doctors all by myself. Being new and never having to deal with those things alone are VERY SCARY!)

Anyways... I know what the rules are regarding a nurse stealing/diverting narcotics from a patient. But I don't know what the rules are if it's non-narcotic medication. Also, I did not see this nurse take anything. It was merely a conversation. I don't want to cause a stink over this since I've already had issues with this nurse. But, I just can't get it off my mind. Is this something that I should take to my manager. Or is it something I should file an anonymous incident report over? Or should I just ignore it all together? I don't know what to do and if she does end up in trouble she's going to know it was me that ratted her out. Any advice?

[kbrn2002, ADN, RN]

If you are talking about giving a coworker a couple Tylenol that are stock meds provided by the facility I have no problem with it, as a matter of fact I have done that frequently. If it is any med, prescription or not, that is charged out to a particular pt then that is theft and needs to be reported.

[MunoRN, RN]

Promethazine isn't just any nausea drug and would definitely raise some eyebrows with a BON. Promethazine is a popular potentiator of opiates (it magnifies the euphoric properties of opiates). "Sizzurp", a popular street drug concoction in beverage form, is typically codeine and promethazine, the opiate can vary, but it always contains promethazine. The fact that the Nurse initially asked for promethazine would certainly prompt further investigation by a BON.

[trueblue2000]

It is theft, plain and simple. Narcotic or nonnarcotic, prescription or OTC, patient or hospital supply; does not make an iota of difference. You are stealing. Can't believe some nurses think it is OK! Say you had contractors working at your home and they started helping themselves to your medicine cabinet, would you think that would be OK? This is a police matter more than a BON issue. A nurse in my facility was stopped by security at the parking lot (they were tipped) and found her scrub pockets lined with syringes and small medical supplies. Did they report her to the BON? They called the cops! Handcuffed and taken to jail for stealing hospital property.

[subee, MSN, CRNA]

Anyone can confirm when she steals by asking the patient if he/she just had a Zofran dose or a dose of Whatever. The problem is to whom you report. I would start with the instructor's chain of command, but I'm not even sure of that since she is not stealing from the school but from the patient. Even if it's not a narcotic it's theft. This dirtbag needs to get fired.

[Nurse SMS, MSN, RN]

I am pretty surprised at the nonplussed reaction of many here. I would have expected more of a condemning attitude. Interesting.

At my place of employment, if we need Tylenol we can go to pharmacy and they will give it to us. Anything more than that is denied, including things for congestion, itching, etc etc etc, even if over-the-counter. Obviously the purpose of it being refused is that the hospital can't take on the expense of providing OTC meds to employees. Therefore it is worth assuming that taking anything more than that from a med drawer or the pyxis would be considered diverting and be grounds for termination and BON reporting. There are two issues at stake with diverting. One is the potential for impairment, yes. But the other is an indication of a lack of character and honesty, both core values of any RN and clearly outlined in the Nurse Practice Act of my state and I would wager most others. Taking medications that have not been purchased IS stealing, either from the patient or from one's employer. There is no way to tap dance around that fact. My locker looks like a mini pharmacy with tons of OTC meds in it just in case - meds I purchased and stocked for myself at work. I would be super uncomfortable taking it from the med cart or pyxis for personal use. It just seems to me like termination with potential far reaching repercussions waiting to happen. Call me paranoid. Or honest. Your pick.

I personally react pretty strongly to Zofran by getting very, very sleepy. When I have an Rx for it, I don't take it on days I am working. It would cause me impairment. I wouldn't consider Zofran a completely harmless drug when mental acuity is important.

Would I report it if I saw someone diverting nonnarcotic meds? I am on the fence to be honest. And that bothers me. I probably shouldn't be on the fence on this issue. It seems clearly right/wrong in my mind. I will have to think this over.

[monkeybug]

I have worked at one facility where it was okay for the nurse to take meds. If we needed a Tylenol or other OTC, we signed it out with our names, date, time, and amount, and pharmacy kept track of this is in some way. It was okay as long as procedure was followed. That's the only way I see this as being acceptable. At every other facility I've worked at, this would be considered theft, and I have seen nurses get in trouble for it. We handled it by taking turns buying a huge bottle of generic ibuprofen and keeping it in the breakroom. Many of us had Claritin or the like in our bags, and would share. But we purchased it, we didn't just commandeer it.

[SouthernPoint]

The patient is only charged with whatever medication that you documented was actually given to them. Just because it is in their med drawer pyxis, or somehow available for them, does not mean they are charged for it. They can only be charged with what was actually administered to them, otherwise, that would be fraud. (This is not to condone stealing, but it is stealing from the facility, not the patient.)[/quote']

Just an FYI. Your statement is not correct in every place. There are still many places that charge the patient up front. Yes, it is fraud no matter how it is done, but saying that a patient is not charged is wrong.

I have seen Nurse's and Doctor's get in major trouble over situations like what happen to this nurse and her co-worker, not only with their employer, but with the FED's. Every heard of the OIG list? What this nurse's co-worker is doing can basically land them on this List.

[SouthernPoint]

Here is my question to those whom see nothing wrong with taking med's from their work place.

How would you feel if a co-worker was taking a roll of toilet paper every now and then?

Some say taking a med from work is no big deal, but I bet they find taking a roll of toilet paper a big deal and consider it stealing.

So my point. Stop stealing from your work place and think about how those without insurance just got charged $25.00 for a Tylenol, because you seen nothing wrong with taking one or two.

[HeatherGurl84]

You were right to say no when asked. Like was mentioned, avoid it unless she is witnessed stealing medication.

[llg, PhD, RN]

It's stealing, plain and simple. Somebody is paying for those medications -- and whoever that is (patient or facility) probably does not want the staff stealing from them. I would be reporting the practice to someone I trusted within the institution (educator, manager, HR, Rish Manager, whoever ...). I wouldn't want to be seen as condoning theft.

Edit for clarification: When I say "report it," ... I don't mean that I would report it to the BON or Police that meds were being stolen. I would be reporting the conversation to someone at my facility so that they could investigate to see if meds were actually being stolen and/or whether or not this nurse was using this conversation as some sort of sick personality test. Whether or not meds are actually being stolen, the conversation was inappropriate and should be reported. The fact that the conversation took place is not "hearsay" and not every circumstance can/should be made a court case. The conversation was inappropriate and disturbing. The institution should be made aware of it so that they can investigate and follow-up appropriately.

The key is to choose an appropriate person to confide in ... and to express yourself in an appropriate way. Don't accuse the person of stealing. But rather, report that you were concerned by this conversation. It left you with questions and concerns that you need to follow-up on, but are not sure how. Let your confidante share the burden of follow-up.

[Meriwhen, ASN, BSN, MSN, RN]

Theft is theft, whether it's a box of band-aids or a Schedule II med.

As far as reporting her...unless you caught her with her hand in the Pyxis, all you have to go on is hearsay and speculation. You may want to tell your manager that you think that medication may be going missing, but I'd not name names unless you have hard proof that she did take it.

Asking for Zofran is in itself not an act of theft. Not entirely ethical, but not theft. No more than saying, "I'm going to kill you!" when you're angry at someone is an act of premeditated murder. When the pill is in her hand, then it's theft.

So watch how you word it if you decide to report her to your manager.

Best of luck.

[mkell]

It may not help you with your ultimate decision, but know that in the Administrative Code from each BON addresses this. Specifically, it states under "Unprofessional Conduct" that "Nursing behaviors (acts, knowledge, and practices) Diverting prescription drugs for own or another person's use." Any prescription drug, not just narcotics.