Would you report possible diversion?

Fiona59 · Mar 20, 2016

Leave it for management to figure out. He will get caught eventually. Either refuse to consign his waste or take it from him and drop it in the sharps yourself.

Ask him why he's drawing up for your patient. He'll soon leave you alone and become some other nurses problem.

ypu don't want to make an unproven allegation

bagladyrn, RN · Mar 20, 2016

Do I understand correctly that he is asking you to waste with him a narcotic drawn up (not in the original sealed vial)? If so I'd be very wary of putting my name on this as you have no way of verifying what you are wasting.

Yppah · Mar 20, 2016

You must report drug diversion. This nurse is a danger to patients and oneself.

Anonymous865 · Mar 20, 2016

If you had the same level of suspicion that someone was abusing a child or vulnerable adult, what would you do?

Does your state have a "duty to report" law. Many states have laws requiring healthcare professionals to report if they suspect a colleague is impaired or diverting.

Based on your experience with narcotic abusers, without intervention do you think this individual over time will 1) get better or 2) divert more and more narcotics

Hoosier_RN, MSN · Mar 20, 2016

Report your suspicions. Management will investigate. They can't terminate unless they find just cause. Would you want someone who is impaired taking care of you or a loved one? The rest of the public doesn't want this either. If he's clean, no harm. But quit cosigning wastes if you're not sure. You could be held just as liable

dirtyhippiegirl, BSN, RN · Mar 20, 2016

Report your suspicions. Management will investigate. They can't terminate unless they find just cause. Would you want someone who is impaired taking care of you or a loved one? The rest of the public doesn't want this either. If he's clean, no harm. But quit cosigning wastes if you're not sure. You could be held just as liable

This isn't true at all, certainly not in a right to work state. And when the hospital reports him to the BON (this is generally where the legal "mandate to report" is) -- the BON assumes everyone is an addict and sets the bar to prove that you are not very, very, very high.

jadelpn, LPN, EMT-B · Mar 20, 2016

So your pharmacy is not noticing that the medication dispensing machine consistently shows that you pull for your patient narcotic pain med, then a few minutes later the other nurse does the same? There is not a camera pointing to the machine? There is not a giant red box that pops up that says "too soon" or some other thing that requires an over ride with another nurse?

What this nurse chooses to do is on them. With that being said, YOU could be set up on this and here's how: "Nurse Emergent must not have given the med, the patient stated that they never got the med from Nurse Emergent..." YES any number of patients are alert and oriented, some not so much, and when you are in pain things are not always clear. There are some patients who don't care as long as the nurse in questions "bumps up" their dose a tad if they "cover" said nurse.

Addicts/nurses that divert manipulate. It is part of their disease process. And you are being manipulated to waste drugs you don't see being wasted for a nurse who is withdrawing drugs for a patient who has already been medicated. Signing for wastes that you don't see if grounds for termination in some facilities. As is not reporting your suspicions.

"No, I will not waste this with you, as I am unclear on why you withdrew the med on my patient to begin with, and clearly the pyxsis had the times given. This is a habit that I am unable to support. I would seek out charge to deal with this with you". And walk away.

In the meanwhile, to protect yourself, going forward unless you see it a-z, you don't put your name on it for wastes.

You can report this on your parent website for ethical breeches. Let management take it from there. But excuse yourself from this situation pronto.

beckster · Mar 20, 2016

Tell him you appreciate the "help" but you've got it and you won't cosign his waste because it looks suspicious. If he is diverting he'll back off pronto.

ponymom · Mar 20, 2016

I only wasted w my unit manager who was always there (great unit manager BTW) or one of two COBs whom I genuinely trusted.

Over my several years of nursing I was directly responsible for two nurses and one cna being investigated and ultimately being disciplined for drug/alcohol abuse. Two eventually did lose their licenses. The other is still doing time with stips/restrictions.

I also gave a negative opinion when contacted about someone who was applying to work at a ltc facility a few months after I had left it. I knew they were 'in the zone' and I informed management of that fact. They still have not found employment as a nurse, and, and, they are still 'using'.

Been there,done that, ASN, RN · Mar 20, 2016

Are you saying you are signing for a narcotic waste, when you do not know what is in the syringe?

What is the frequency of habitually?

IF he is watching for you to give a narc, then pull this trick... he is using you and deserves anything he gets.

dishes, BSN, RN · Mar 20, 2016

Agree with everyone who is advising not to sign a waste of a narcotic that you did not witness being drawn up. Also, what are the restrictions on his license? Is he allowed to handle narcotics without a RN observing him?