Suspecting Co-worker of taking drugs

  1. What would you do if you suspected a co-worker was taking narcotics? What if your NM did not believe you? Would you confront the nurse? Just curious how others would deal with this situation.
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  2. 14 Comments

  3. by   TazziRN
    If my suspicions were strong and the NM did not believe me, I would make a call to the BON. I've done that.
  4. by   RN_student2006
    We actually just talked about this in class the other night, because some nurses will do this (sad, but true). She told us to document it when we think it is happening (if it's not documented, it didn't happen). Then take that to whoever your boss is.
  5. by   fgoff
    Does you place of employment have a Risk Manager or an Employee Health Department or EAP?

    One of these departments may be helpful if nursing does not feel strongly about it.

    Good luck! Your co-worker should be glad to have a friend willing to help if there is a problem.
    Last edit by fgoff on Aug 25, '06 : Reason: Should say EAP not EPA Sorry
  6. by   mtdnk
    Another resource is your state nurses association. The NYSNA (New York State Nurses's Association) has a program called SPAN (statewide peer assistance for nurses) which is a great resource. Best of luck.
  7. by   hogan4736
    Quote from TazziRN
    If my suspicions were strong and the NM did not believe me, I would make a call to the BON. I've done that.
    No offense Taz, but that seems awful harsh going from the NM right to the board...Plus it now could make you intimately involved...You could be wrong (remember, hospital pharmacies can track Pyxis usage - info that you do not have)...You could damage a career and a reputation based on suspicions...Besides, many hospitals, once they find out someone is using on the job, can refer to EAP, or allow the nurse to SELF-report, keeping the situation confidential...
  8. by   LuvMyGamecocks
    Good question, but can you clarify something for me? You said taking narcotics...do you mean you think they're stealing them or do you think they're consuming them on the job? Do they have any physical signs of being under the influence of narcotics?

    If they're stealing...can't that be verified with Pyxis? Can an RN obtain verification from the pharmacy? If so, you can take that to the NM, right? (Still a student...feel free to correct me.)

    If they're consuming on the job....I would go to that person with an approach like, "Your eyes have been blah, blah, your speech blah, blah. It appears that you're under the influence of something and I'm concerned for the safety of your patients. If you are willing to stop, I will be willing to let this be an issue for you to handle on your own. But, I can't ignore the compromise of patient safety."

    No direct threats, but a strong message that you know something's going on.
    Last edit by LuvMyGamecocks on Aug 25, '06
  9. by   TazziRN
    Quote from hogan4736
    No offense Taz, but that seems awful harsh going from the NM right to the board...Plus it now could make you intimately involved...You could be wrong (remember, hospital pharmacies can track Pyxis usage - info that you do not have)...You could damage a career and a reputation based on suspicions...Besides, many hospitals, once they find out someone is using on the job, can refer to EAP, or allow the nurse to SELF-report, keeping the situation confidential...
    Not familiar with EAP, I've never worked someplace that has it. The only choices my two places of work have is the NM, and HR. That's why I suggested the BON. If the NM does nothing then the hospital probably wouldn't. Yes, we allow self-reporting here but it has to be offered by HR. And in CA, the investigation would be dropped if it's unsubstantiated. I stand by my opinion.
  10. by   hogan4736
    an argument could be made for just pulling the nurse aside and talking to him/her, before going to the board...in AZ, if a board complaint is made, there is no more self-reporting for that nurse...
  11. by   sister--*
    Quote from TazziRN
    Not familiar with EAP, I've never worked someplace that has it. The only choices my two places of work have is the NM, and HR. That's why I suggested the BON. If the NM does nothing then the hospital probably wouldn't. Yes, we allow self-reporting here but it has to be offered by HR. And in CA, the investigation would be dropped if it's unsubstantiated. I stand by my opinion.
    In my facility, EAP stands for Employee Assistance Program. It allows three confidential visits per calendar year to a facility contracted counseling group. This is at no cost to the employee. Heaven knows that in our profession it's easy to loose perspective amidst the chaos!
  12. by   Ruby Vee
    Quote from zumalong
    what would you do if you suspected a co-worker was taking narcotics? what if your nm did not believe you? would you confront the nurse? just curious how others would deal with this situation.
    [font="comic sans ms"]document, document, document.

    keep a record of what behavior leads you to suspect your co-worker. make sure it is factual and does not contain extrapolations or suppositions. does he/she check out a lot more pain medications than other nurses on the shift? document that. do patients that he/she has medicated complain of pain even after being medicated? document that. but do not say that you know the nurse is taking the meds out of pyxis for his/her private use unless you have actually witnessed the nurse slipping narcotics into his/her bag -- and then document exactly what you've witnessed.

    we all have learned that excessive time spent in the bathroom is one indication of possible narcotic use. it could also be a nurse whose ulcerative colitis or ibs is flaring up. we've learned to suspect our co-workers who are unnaturally sleepy. could it be someone who's been up all night caring for a sick parent, child or dog? or someone whose new allergy prescription is way too much for them? make sure you document facts, not suppositions or assumptions. is it that narcotics are disappearing when only the two of you are on shift? still may not be the coworker you suspect. years ago, i was in a situation like that. the other nurse and i suspected each other, but it turned out that the pharmacy was actually sneaking onto our unit while we were busy and making off with our narcotics! at another job, there was a brand new nurse manager when i started -- the previous one had been caught with hundreds of boxes of morphine carpujects in his office filing cabinets. (after months of investigation by the dea!) if your nurse manager doesn't take your worries seriously, go to her manager. if you've gone all the way up the line, then perhaps consider going to the bon. i don't think you'll have to go that far.
  13. by   CaseManager1947
    Others have asked good questions about the scenario you initially provided.
    Each facility has policies/procedures to direct employees in matters such as these. If the NM will not listen, then I recommend a sit down with yourself, the NM, and perhaps the DON or VP of nursing. EAP is a great option in some places to get folks the help they need. I know, in our facility, its automatic termination using on the job. If the issue is under influence of recreational drugs (pot, etc.) which in most states is a misdemeanor, its still termination. As others have said, kinda depends on whether it's diverting or something else.
  14. by   ZASHAGALKA
    You have a legal obligation to report such suspicions to the board. If you work in a bigger hospital, you can accomplish the same by reporting it to your peer review committee. They are considered local 'agents' for the board, for purposes of well, peer review.

    If your boss doesn't take you seriously, that DOES NOT relieve you of your obligation to report. She is merely the FIRST link in a CHAIN OF COMMAND.

    Also, you might report it to the ethics committee.

    With the advent of pyxis, etc., there is no reason for hospitals not to be on top of this. It's merely a matter of two statistical reviews: 1. How many total narcs a nurse gives in relationship to other nurses on similar units. 2. The percentage of total narcs an individual's group of pts is allowed to have compared to how many are actually being signed out, and a comparison of THAT relationship to other nurses and THEIR group of pts on similar units.

    Even the most conscientious pain control nurse should fall within the standard deviations for sign outs.

    Any nurse that falls significantly outside the standard deviation (say more then 1.5 standard deviations) should be subject to a drug test EVERYTIME for EVERY shift they fall outside the standard deviation. On the other side, a nurse that signs out signficantly LESS then the standard deviation should be counselled on effective pain control management. With their push for adequate pain control, I'm surprised JCAHO doesn't already mandate this.

    That might not solve drug diversion for uses other then personal, but it WOULD significantly reduce the number of 'impaired' nurses due to diversion.

    I don't think hospitals do this because 1. they subscribe to the 'any warm body' philosophy, and 2. they don't want to know about such liabilities (See no evil . . .)

    But, I think this WILL ultimately become a standard. And, when it does, those hospitals will almost certainly backdate their analysis for the entire employment history of nurses (really, it's just a matter of pushing a few more buttons). You ARE being monitored in this as we speak, even if it's nothing more then a passive collection of records for later analysis at this point.

    And let me say this, one of the things I do BEFORE I leave any shift is to check my diebold reports on my pts to see to it that EVERY narc signed out on my pts were either signed out by me, or at my request. If not, that is an incident report. The TWO times I've filed such an incident report: 1 was a diverter that was fired that night (but, he had diverter narcs on 9 pts not his that night), one signed out a xanax on my patient accidentally as his pt was right next to mine on the list AND had the same med ordered, and he had charted he had given it earlier in his shift and there was no record it was signed out on his pt: a simple and correctable accounting error.

    ~faith,
    Timothy.

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