Should drug diverters be prosecuted?

Libby1987 · Mar 2, 2017

What is the reason hospitals avoid reporting to the police, do you all think? Is it just too much trouble to help build a case? Other workers might be called to testify. It might bring bad publicity and cost the hospital money as well.
I doubt it's out of concern and mercy toward the nurse.

If they're terminated and reported to the board, does law enforcement really need to get involved? Like Happygr8ful's story, the BON is probably enough. Would the majority of these nurses be a threat to the public once they are terminated and suspended?

It may not be mercy but I think nurses are sympathetic characters.

twinsmom788 · Mar 2, 2017

Probably because the lay person stealing them from the outpatient pharmacy would have to get INTO the pharmacy to steal them, behind the counter and into where the drugs are kept. They'd have to either break in after hours (illegal) or threaten and intimidate the employees (also illegal) in order to get the drugs. Breaking in and threatening and intimidating -- possibly injuring or killing -- people is seen as much worse behavior than stealing from your employer.

I absolutely cannot wrap my head around this comment. "Injuring or killing" a patient happens when a nurse diverts medications from a patient. I have seen this first hand. Call the police, contact the BON, contact the Board of Health Care Facilities, or what ever it is in your state.

CrunchRN, ADN, RN · Mar 2, 2017

I agree 100% with what HouTX stated.

DeeAngel · Mar 2, 2017

im going to read my nurse practice act more closely. I have never heard of a nurse not being Able to take a prn opioid when he or she is off the clock if it is prescribed and indicated. I know that a nurse mustn't be under the influence of any mind/judgment altering substance while he or she is working under their license and caring for patients. For example- if a nurse has his/ her wisdom teeth removed, she can take ibuprofen and acetaminophen while at work, but when she is home, why shouldn't she be able to control her pain more with an opioid if it is prescribed to her and is indicated? Maybe I misread your post.

I have taken opioid pain medications while working. I had an extraction done and was taking Vicodin and called off work that evening. The House Sup told me that I could take Vicodin and work as long as I had a legal prescription for it. I also informed my charge when I came on duty and she had no problem with it.

dirtyhippiegirl, BSN, RN · Mar 2, 2017

If it is against the law, then it should be prosecuted. I also don't think any licensed healthcare profession should be given a chance to practice again if they have diverted drugs. I believe in second chances, but the second chance can be in a different profession.

Wait, what? So you don't actually believe in second chances because it's not like we take addicts out back and shoot them. What do you think is the alternative to being prosecuted and then having to get a job in another field?

Ruby Vee, BSN · Mar 2, 2017

I absolutely cannot wrap my head around this comment. "Injuring or killing" a patient happens when a nurse diverts medications from a patient. I have seen this first hand. Call the police, contact the BON, contact the Board of Health Care Facilities, or what ever it is in your state.

I've never heard of a patient being killed because a nurse diverted pain medication -- not that it isn't possible, of course. If a nurse being under the influence has caused harm to a patient, it's in a whole other class than simply diverting narcotics. An impaired nurse who harms a patient is subject to all sorts of disciplinary steps both through her employer and the Board of Nursing. I'm not sure it is up to US as bedside nurses to be calling the police, the BON or the Board of Health Care Facilities -- that sort of action should go up the ladder in your facility FIRST. Not because you're trying to cover it up, but because the facilitiy has procedures in place to deal with this sort of thing. You want to protect YOURSELF. If you accuse someone of harming a patient because they were stealing and using drugs on their shift and it turns out that they were having an exacerbation of a mental health issue, extreme low blood sugar or a CVA, you could be sued.

Now if your co-worker is going after patients or colleagues with a machete, calling the police is probably your first option unless you're a ninja who can disarm and subdue him.

klone, MSN, RN · Mar 2, 2017

I absolutely cannot wrap my head around this comment. "Injuring or killing" a patient happens when a nurse diverts medications from a patient. I have seen this first hand. Call the police, contact the BON, contact the Board of Health Care Facilities, or what ever it is in your state.

Not all diversion is a result of taking from a patient. And I'm sorry, but giving a patient one Percocet and keeping one for yourself is not on the same league as what Ruby Vee described.

NotAllWhoWandeRN, ASN, RN · Mar 2, 2017

Not all diversion is a result of taking from a patient. And I'm sorry, but giving a patient one Percocet and keeping one for yourself is not on the same league as what Ruby Vee described.

I know there are different degrees of both risk and actual harm inflicted on a case by case basis, but the original article's link included a case where a patient did actually die.

klone, MSN, RN · Mar 2, 2017

I know there are different degrees of both risk and actual harm inflicted on a case by case basis, but the original article's link included a case where a patient did actually die.

I was under the impression we were having a more generalized, global discussion about narcotic diversion, and not talking about one specific case only.

rntracy1, BSN, RN · Mar 2, 2017

Morte, I am in agreement with you. It is absolutely, complete, unequivocally untrue that nurses cannot be prescribed opiates. In fact, I am an RN, in a pain management program, and both my BON and my job, are WELL AWARE of my condition and my use of opiates. I have been drug tested for my job, list all of the medication I am taking and always pass my drug screenings. I am not sure where this individual is getting his information, but I can assure it is untrue. I know plenty of nurses who take prescribed pain medication.

As far as diversion goes, if someone was embezzling from their job, they would most likely be prosecuted, however, I feel drug addiction is a different issue. If it is a constant thing, then yes, they should be prosecuted. But for a first time offense, no, they should not be prosecuted. They should be offered help and a chance at recovery. If they refuse, then yes, prosecute.

rntracy1, BSN, RN · Mar 2, 2017

This is from from the CA Nurse Practice Act for those under a treatment plan:
http://www.rn.ca.gov/pdfs/enforcement/discguide.pdf
(16) ABSTAIN FROM USE OF PSYCHOTROPIC (MOOD-ALTERING) DRUGS -
Respondent shall completely abstain from the possession, injection or consumption by any route ofall psychotropic (mood altering) drugs, including alcohol, except when the same are ordered by ahealth care professional legally authorized to do so as part of documented medical treatment.Respondent shall have sent to the Board, in writing and within fourteen (14) days, by the prescribinghealth professional, a report identifying the medication, dosage, the date the medication wasprescribed, the respondent's prognosis, the date the medication will no longer be required, and theeffect on the recovery plan, if appropriate.

Your quotation from the CA nurse practice act is for those who have ALREADY offended and are currently under a treatment plan. In my state and probably most others it is the same way, if you have diverted narcotics/opiates, were caught, and placed into the board's treatment program, then yes, you HAVE TO abstain from ANY and ALL mind altering/psychoactive substances. (That is how all substance abuse programs work). That is, for any healthcare professional, just common sense. But we are talking about nurses in general. Nurses who practice every day, who have not committed diversion. Nurses are allowed to take opiate medication, as long as it does not impair their ability to practice. Just like you can take a vicodin and drive, as long as it does not impair your ability to drive. Some people can take two vicodin and drive, work, operate machinery, or whatever just fine, while someone else could take half of a vicodin and it knocks them right out. Nurses need to use good judgment when it comes to their practice, their license, and patient safety. The nurse practice act and the BON gives us that discretion as professionals, however if we cross the line, they are there to protect the safety of the public, not to represent nurses.

Double-Helix, BSN, RN · Mar 2, 2017

I wonder if the stigma associated with an indicted employee plays a factor in a hospital's decision not to prosecute drug diversion. Since hospitals are often competing for business, I imagine there's a lot of incentive to portray their facility as safe, professional, and competent. Prosecutions are public record, while referrals to diversion programs can remain confidential. A hospital may choose to forego criminal charges in order to save themselves the potential reputation damage and lost revenue associated with the public knowing that their staff have been stealing drugs.