The Struggle: When A Nurse Diverts - Page 2

We just had a nurse on our floor who was found diverting narcotics. Her behavior was interesting. She was just sort of spaced out, like she had something else on her mind. Even when reminded she would forget to do something. She worked 7am-7pm and rarely got out of there until 9pm because she had to finish her charting. As the charge nurse on 3-11 I told my manager that she might want to check her clock out times. She was getting an a lot of overtime. She was always in everyone's business so at first we thought she was just doing so much socializing that she could not get out on time. Then one night the night charge nurse looked at the Pyxis and saw a couple of discrepancies. She printed out a list of every narcotic that had been given and looked at the MAR to see if it had been given. The errors occurred with this particular nurse. The narcotics were not documented. She got so sloppy. So the charge on nights wrote the report and gave her copies of everything she had discovered to the our manager. The manager called this nurse in and she immediately admitted that she had been taking narcotics. They sent her out to a program offered by the BNE (State of Washington). It was very sad. Now she is out of work and her boyfriend was already out of work so they have no income right now. She told some of the other nurses that is did not matter if they put her through a program, she still had sources to get narcotics. I doubt very seriously that she will make it. I doubt that she will ever be successful at coming back into nursing.

I struggle with the rationale of rehiring a person who has diverted, into a position where they may be tempted again. If a person stole money fron the bank would they get rehired I wonder?

The job can be very stressful and if the patient is very sick, it can be hard to "forget" or get it out of my mind. Obviously, there are other diverts such as reading or hanging out with friends, family or loved ones that are much better!

I have recently known two great RN's who fell into this dark side of nursing. One was a young nurse who presumably didn't have the deep professional training and experience to overcome the temptation. The other was older and very experienced who should have known better. As someone noted in the blog, it was a sad situation. My concern is that if it can happen to these two nurses who I considered very professional and trusworthy, then can it happen to anyone, given the same circumstances? If we are all at risk then how do we eliminate this risk?
-ED

This is so sad. It hurts patients and reflects poorly on all of us as professionals in the health care field. I had a traveling nurse drunk on the job and it took all of 1 week to figure it out and find bottles in her locker and kick her butt out.

Unfortunately this is not a new issue. The first job I had as a new grad was working the NOC shift in a LTC Facility. In 1995 we had very few job opportunities. To make this short , when I came on my shift I did drug counts with the off going staff. It consumed a great deal of time as we did actual hand counts. I found a controlled substance short 2 tabs. I gave the staff member the benefit of the doubt, giving her time to review her shift and account for the shortage. Unable to account for the 2 tabs, I made a notation of the count shortage. Without assigning blame i.e. " Medication count off by two tabs of vicodin, staff nurse Jane Doe and I rechecked and count remains short as noted above". We both signed as required. This was done two times, after that the drug count was never short.

The risk of deverting pain medication to ones self is only as great as the selfishness required to medicate themselves AND allow the pt. to suffer in pain. There is no excuse for it.

In the 80's I worked steady nights with a group of several young mothers with little children; there were about 6 of us who worked part time steady nights. We had to stay one morning as our charge nurse lit into everyone about narcs going missing. This was on a tele unit and I am talking BOXES of valiums going missing. It seemed like they didn't even know what shift it was because the whole box would disappear along with the med sheet that came with the box. We never suspected anyone from "our group" we were all part time and not there all the time. However, one of us, it turned out was the culprit. She would always be sleepy and blamed it on her kids not letting her get any rest. She would nod off during charting and we all felt so sorry for her, I remember us all dimming the lights in the chart room and talking quietly so she could get a little rest. She always preferred the far end of the hall, too. I remember that. She would switch assignments just to get that end of the hall. So they planted a fake patient unbeknownst to us whose job it was to order pain meds and lots of them to see who was diverting. Turns out it was her. The feds escorted her out the building one night that I was off. I was shocked. Even more shocked about 6 months later when I heard she was working as an OR tech. Say what? Guess the hospital wanted to keep it quiet.

I had another good friend in nursing school who ended up diverting years after we graduated. I was working managed care doing chart reviews in my neighborhood hospital working for an insurance company. She was an agency nurse and I was so happy to see her after so many years. I saw her that one day and then I learned after only a couple of days they caught her messing with a PCA to get the morphine out. I saw in our state bulletin that she had her license suspended. Then a couple of later I saw in the bulletin that her license was revoked for refusal to follow the rules outlined in her program.

Another good friend (one of the part time mothers I worked steady nights with) years later I got her to come with me to the managed care side of the business. Steady daylight weekends off, wearing nice clothes to work, she loved it. But she had a drinking problem. One too many DUI's and she requested to be put in the program. She is working in LTC now, having gone through the program . Our friendship is long over however, because her drinking clouded her judgement and after I stuck my neck out for her once again, she ticked off a medical director after being on the job 2 weeks. She was fired.

Only one more story: Talking about "weed" reminded me of a nurse I met who used to work hospice in Florida back in the early 80's. She remembers rolling her patients' joints for them!!!

We had a nurse who was diverting Diprivan....REALLY!!! She had a respirtatory arrest (go figure) in a patients room in the ICU. She ended up with a perm pacemaker b/c the cards thought she had sick sinus syndrome. Come to find out, she was starting her own IV's in her upper arm and shooting up at work. It was even thought she was taking the drug from hanging bottles in patient's rooms. All we could say was WOW!! How stupid!

Gosh these stories are shocking. Why ruin your career especially since you have worked so hard for it. Very sad