unfortunately I was put in the position where I had to tell my manager about someone I though was diverting.. I feel horrible like I have betrayed, she is a good nurse MSN we all look up to her. She was an instructor at a couple of nursing schools
and taught some of the girls on my floor. over the past couple of months I noticed that she "gave" pain meds to pts that were not hers. most of them disoriented, however one time I went to the pyxis to get a med out for a pt in pain and I saw she had taken it out 30 min ago, the pt denied getting anything. I thought that was a fluke and sometimes when you go in and give an IVP med and strike up a conversation the pt may not be paying any attention to what you are doing, so I gave her the benefit of the doubt. I then saw where she started taking narcs on pt's that were to be discharged (like within minutes) these pt's were not even hers either. I had a chest pain pt that was getting dc'd and had denied any chest pain since the stent was put in and I saw where she took out ivp morphine twice for this pt and I had taken out the IV several minutes prior. she took out 2 doses 15 min apart when it was ordered q 4 hrs.
sometimes on my ward I start discussing topics in nursing, I started to discuss diversion and what we should do about it, in a generic. after report, 2 of these nurses came up to me and said, they noticed the same thing. well we all knew that all of us knew and HAD to report this because last week the diversion was so obvious we all couldnt help but notice.
since we all knew we were obligated to report because of Bon policy. We all did report to the manager and since I am the sr RN I had to go first... I had hoped it was a test by administration to see of any one would notice, I told the mgr my suspicions and told him to please tell me that I am wrong, I really wanted to be wrong and maybe her pain mgmt skills were so much better than the rest of us. He said he would look into it.
The next day when I saw the mgr I said please tell me I was wrong or it was just a test, he said we were probably right.
I feel horrible, I feel like I have betrayed a friend and co-worker, On the other hand I would also feel horrible if she overdosed as well. I havent slept in the past few days (at least not for more than an hour or so at a time) I am the one that feels guilty. She is supposed to start a new position this week being the director of palliative care, she said she would be in a different division and wouldnt have access to the pyxis when she left the ward position. so in theory she wouldnt have had any more access to the pyxis. there are 6 others that reported after I did, they all feel just as bad as I do. She was so careless the last week she was there it was just so obvious, most of us take out 4-8 narcs off per shift, she takes out 25-30 and most are not even her pts.
Was I right in turning her in? What can I do to be supportive of her without her hating me or the rest of us. We are a federal facility and have a union, maybe she can do rehab and keep her job? I really want the best for her, yet I am also angry with her for putting us in this position. What can I do to keep from feeling like such a *itch?
May 1, '09
The reason you feel so horrible, cptluciejensen, is that you have your priorities out of whack. You
are not causing the consequences that will be suffered by the diverting nurse. She has caused her own consequences. You would be doing her and her patients no favor by turning a blind eye because you don't want to face dealing with this situation.
More than one diverting nurse has ended up dead because his/her coworkers didn't have the intestinal fortitude to report them.
You did the right thing. Get ahold of yourself & stop the hand- wringing already, okay?
Last edit by catmom1 on May 1, '09
: Reason: typo