Appears nurse is diverting narcs

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Specializes in LTC.

Backstory: We have a pt that is on quite a bit of a particularly strong/addictive narcotic that is an injectible. On the nights this nurse works with this pt, the pt receives the injectible at every possible opportunity, which is q2hrs. The nurse charts "severe pain" for this pt. Fine and dandy, except for no one else, (including myself) ever has to give this med to this pt at that frequency, on any shift. The routine order covers the pts discomfort well, as I assess for pain frequently, and the res is A&O and can tell me if pain relief is effective or not. It has come to light that action has been taken, including suspension of this nurses' license, for diverting the very same drug at another facility. Her license, including actions taken, are posted on the BON website. I can't prove anything, which brings me to, what do I do? I have been told this nurse will "disappear" for awhile and come back in a completely different mood, and has even showed the bruises on her hip to someone. That's all rumor, but I worry my pt is getting NS injections instead of the pain control she desperately needs, or at least less of what is ordered for her. Is there anything I can do? FYI: We drug test on site.

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Go to your supervisor and tell her this exact same thing and hopefully they will go in on her shift and request a drug test and you will find out then if this is true. This is the way we found our nurse who was taking drugs..... Just how long ago did she receive her suspension from the board.??

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Specializes in ER.
Backstory: We have a pt that is on quite a bit of a particularly strong/addictive narcotic that is an injectible. On the nights this nurse works with this pt, the pt receives the injectible at every possible opportunity, which is q2hrs. The nurse charts "severe pain" for this pt. Fine and dandy, except for no one else, (including myself) ever has to give this med to this pt at that frequency, on any shift. The routine order covers the pts discomfort well, as I assess for pain frequently, and the res is A&O and can tell me if pain relief is effective or not. It has come to light that action has been taken, including suspension of this nurses' license, for diverting the very same drug at another facility. Her license, including actions taken, are posted on the BON website. I can't prove anything, which brings me to, what do I do? I have been told this nurse will "disappear" for awhile and come back in a completely different mood, and has even showed the bruises on her hip to someone. That's all rumor, but I worry my pt is getting NS injections instead of the pain control she desperately needs, or at least less of what is ordered for her. Is there anything I can do? FYI: We drug test on site.

I had a similar situation with a coworker, who was also on multiple prescrition narcs, with very strange behavior and getting lost for long periods of time, i contacted managment and they said that they could not do anything because there were not cameras to catch her in the act, and as far as the scripts went therewas nothing they could do because they were prescribed. Well after much research i contacted the BON and there is a state program for addicted nurses, I made a compliant to them and they handled it from there. The nurse had to comply with there program , of drug tests, meetings etc to keep her license from getting suspended. It is you obligation to report any concern you have!!

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This is so frightening to me.

I agree with the previous posters. Don't be afraid to report your concerns. Even if there is no proof, if she is caught at a later date, your conscious will feel better. And I'm sure she WILL get caught eventually.

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Specializes in ICU.

your manager should be made aware of your suspicions.....if the patient is a&o he could verify how often he is getting pain meds during the night........based on his answer.....drug testing :smokin:

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Yep...sounds like something is up. If this person is the only nurse giving the resident these meds and everyone else is assessing for pain and not giving the PRNs...sounds like somehing is up.

be confidential and see your supervisor.

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Specializes in LTC.
Go to your supervisor and tell her this exact same thing and hopefully they will go in on her shift and request a drug test and you will find out then if this is true. This is the way we found our nurse who was taking drugs..... Just how long ago did she receive her suspension from the board.??

She was just released from probation last month.

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Specializes in Gerontology, Med surg, Home Health.

Call your pharmacy consultant and have them come in and look at the narcotic book. They are trained to spot inconsistencies and other less than perfect practices. I had to deal with this at my last job. During one investigation we discovered the nurse was the only one charting she gave pain medication. The DEA finally came in to review my investigation.

Don't try to deal with it yourself. Let your DNS know and make sure she calls the DEA. You don't need proof. You only need suspicion and then the DEA comes in. If I were you, I might alert the BON as well.

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Specializes in Hem/Onc, LTC, AL, Homecare, Mgmt, Psych.

I would contact the supervisor and she can contact the pharmacist or PCP with your concerns, Q 2hrs narc use should be investigated for a couple different reasons. Thats an awful lot to be injecting that poor pt.... why not something noninvasive like subling. roxicodone or roxanol for pain?

So one reason would be abuse of the med by the nurse which is worst case scenario.

Other would be; we do have to consider that maybe the resident actually DOES have more pain at night than the other nurses on days/eves are noticing....

I work all 3 shifts in a LTC/SNF and on nights I really have time to sit and visit with the residents and do a good assessment. On days and sometimes on evenings I have to fly through the shift to get done on time. Lucky if I can ask a resident twice to rate and f/u with pain level on days.

On nights the residents don't have any distractions to their pain/insomnia.

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Specializes in LTC.

The pt does have roxanol, but doesn't like it, and they have a PICC so the frequency of med is not an issue. Anyway, this pt went home today, so I doubt anything will come of my suspicions, but I alerted my supervisor about my concerns anyway.

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Specializes in Gerontology, Med surg, Home Health.
The pt does have roxanol, but doesn't like it, and they have a PICC so the frequency of med is not an issue. Anyway, this pt went home today, so I doubt anything will come of my suspicions, but I alerted my supervisor about my concerns anyway.

You should still report your suspicions. Just because this person went home wouldn't stop the nurse from diverting.

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Specializes in Gerontology, Med surg, Home Health.

As a point of information. I recently got the form for my license renewal. Under the STANDARDS OF CONDUCT section....."A significant new standard of conduct requires any nurse to report three serious violations directly to the Board. Each nurse has a duty to report when he or she directly observes: 1)another nurse's impaired practice; 2) another nurse abusing a patient; and 3) another nurse's diversion of controlled substances. The new regulations are found at 244 CMR 7.00 amd 9.00"

In other words, your obligation is NOT satisfied if you tell someone else. You must report directly to the Board. The language is quite clear.

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