A Nurses Responsibility: Report Possible Narcotic Diversion

Chemical dependency and narcotic diversion from the workplace has become more common. Nurses need to know their responsibility if there is an alcohol and/or drug problem on their unit. Education is needed for all staff members. Nurses General Nursing Article

Drug diversion from the workplace, specifically a hospital or surgery center, is becoming more common every day. The specialty of nurse anesthesia has a near 10% of practitioners who may face a chemical dependency. It is important to know that every nurse has a responsibility to report any suspicion of drug diversion. If the drug count is always incorrect after a certain nurse works, it should be reported.

Drug addiction and alcoholism are true diseases, and these individuals are sick. Don't be afraid to report possible drug diversion. In the long run, this will help the individual get help.

Most facilities have a policy regarding the intervention of an employee, but many employees do not want to get involved. Fear of retaliation, from the employee or other co-workers, they look the other way. Properly planned interventions, which may include a counselor from a treatment center, will facility a road to wellness.

If the employee agrees to go to treatment and follows the recommendations of the licensing and/or rehabilitation board, the job may be secure. Once the employee returns to the unit, it is important for all co-workers to provide support and assist with accommodations that must be made. Standard accommodations that may be implemented for a variable time period are:

  • The impaired nurse cannot administer any controlled substance or carry narcotic keys.
  • The impaired nurse may not be allowed to work 12-hour shifts or overtime.
  • The impaired nurse will attend an assigned support group which may require other coworkers to cover part of a shift.

The staff should be educated regarding the restrictions of the impaired nurse and notified of any additional responsibilities the staff will need to cover. It can be helpful if a coworker volunteers to cover the assignments that are restricted.

The returning nurse will be afraid regarding what their peers may think about their disease. The staff should be educated that chemical dependency is not about morals, it is a disease.

Many specialty associations have members within the state that are available to answer questions and assist with helping a person find appropriate treatment.

The American Association of Nurse Anesthetists has a Peer Assistance Advisor for each state and a Wellness Committee. There is an abundant amount of information on the website with a variety of useful links. More information regarding how to deal with drug addiction, alcoholism, and other topics can be found at http://www.AANA.com.

Connie Whitesides MSN, RN, CRNA

Actually drug addiction as well as alcoholism takes a great damage to human body and attitude images. Thanks to explore your insight thought. it will help to prompt all of us to avoid drug addiction and other narcotic substances.

Specializes in Med surg, LTC, Administration.
But if the hearsay is circulating, shouldn't management be made aware, if for no other reason than they will then be able to investigate and clear the wronged individual and put an end to the gossip? Because let's face it, once that rumor mill gets to churning out its garbage, it's not going to stop until SOMEthing forces it to stop. If nobody tells mgmt about it, it's going to keep getting worse...

I think we are capable using good judgment. The post I was responding to, used, if you hear from a second or third party. The problem with this, you don't know the truth and could destroy a life, because of it. Also, when you have a suspicion, you should go immediately to your superior, not to another coworker or friend. This is how the rumor mill starts. If everyone followed policy, then you would not be hearing it from a twice removed source. Management would have taken care of it, and hopeful the person doing this, will be helped. I am in management and hear all kinds of things all the time. I take every accusation seriously, but make sure a full investigation confirms or denies such allegation. No one ever knows what we are doing and why. Only those who need to know. This way, if an allegation is false, which most are, no one got hurt in the process. Of course those guilty need to be stopped immediately. But your right to due process is greater than a "maybe this is true." Peace!

Specializes in med/surg, AIDS, trauma.

i was one of those drug addicted alcoholic nurses who also diverted, but i made sure my patients were also comfortable. i never used at work and became addicted after an injury and my dr. wrote rx's for over 11/2 yrs., i do not blame her, i take full responsibilty, but addiction is a cunning disease with regards for no one. absolutely yes you should report any one you know of, suspect, or even her about in gossip because it is more than likely true, nurses have that special 6th sense and can see things others can't. yes, the offender will be extremely furious, deny everything, lie and then lie some more, but trust me in the end he/she will be grateful she was reported. i now have 2 years clean and sober and am free of my demons, and the thing i was most afraid of never happened which was facing my coworkers when i went back to work. they were understanding and helpful and never talked about me as i had feared. in closing i will leave you with this. all addiction does is hide and wait and wish you death and suffering it is always present just waiting for you to become weak so it can take over your life. we must be ever vigilant.

Just wondering: Recently I had an issue with Pharmacy sending my supervisor a Pyxis log and stated that there was a vial of Fentanyl and a vial of Versed missing from our return drawer. I have a hard rule with my nurses that after a sedation case, as soon as the patient is settled back in recovery, the drugs MUST BE IMMEDIATELY wasted/returned. I don't want any questions to come up as to our control of these drugs. When Pharmacy recovered the returned vials, there were these two missing. After three hours or so of me pulling charts, reconcilling the charts against the return logs, talking with my nurses, I gave up. Nothing found, except for those two vials, and I couldn't find where they would be missing from. I told the Pharmacy that I would be doing an Esrm and leaving it up to the powers that be to find what was going on. Imagine my surprise when I was told the next day that the vials had been found...in the return bin....go figure!! We have to have a witness to waste, but are allowed to return solo....but, who witnesses the Pharmacy Tech? They don't have anyone to monitor them, but if something is missing, the oness is on us to find it....not a good system, if you ask me! Are there just NOT Pharmacists who would divert meds? I don't think so!!

Specializes in Med surg, LTC, Administration.
Just wondering: Recently I had an issue with Pharmacy sending my supervisor a Pyxis log and stated that there was a vial of Fentanyl and a vial of Versed missing from our return drawer. I have a hard rule with my nurses that after a sedation case, as soon as the patient is settled back in recovery, the drugs MUST BE IMMEDIATELY wasted/returned. I don't want any questions to come up as to our control of these drugs. When Pharmacy recovered the returned vials, there were these two missing. After three hours or so of me pulling charts, reconcilling the charts against the return logs, talking with my nurses, I gave up. Nothing found, except for those two vials, and I couldn't find where they would be missing from. I told the Pharmacy that I would be doing an Esrm and leaving it up to the powers that be to find what was going on. Imagine my surprise when I was told the next day that the vials had been found...in the return bin....go figure!! We have to have a witness to waste, but are allowed to return solo....but, who witnesses the Pharmacy Tech? They don't have anyone to monitor them, but if something is missing, the oness is on us to find it....not a good system, if you ask me! Are there just NOT Pharmacists who would divert meds? I don't think so!!

Absolutely! And why, we count all narcs when ekit is opened for any reason. I don't know your system, but with ours, if a vial of versed were needed, two nurses would take that time to count and log everything with quantities in our kit. Many, many times, we have found a narcotic or two missing. Immediately we notify administration and they take it from there. As you stated, pharmacist divert meds too, but they also make plain ole mistakes. Which again points to, being certain drugs have been diverted, before you accuse a co worker. I am not saying this to you, but other post which seem to want to report hearsay. We need to be sure, not just hear it or think it, we must then tell management and not our coworkers, and we must let the process take place unhindered, before we tar and lynch someone. Peoples lives are never the same, once a serious allegation of diversion is reported. Especially the innocent, never seem to be able to get over it or are never looked at the same. Thanks for sharing. Peace!