CoWorker using a patient's medication

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My RN coworker took prescription ointment from a patient diagnosed with scabies and used it on herself, fearing she would be exposed and did not want to take scabies home to her family. She had no signs/symptoms of scabies, just very nervous. Am I mandated to report this to the BON? Management and pharmacy staff are aware, but because she is well-liked (and they often socialize/party together outside of work), there has been no discipline. Seems like this is a case of diversion and working outside the scope of practice, as this was a prescription medication. Management recently reported a different coworker to BON accusing her of "neglect" because she accessed internet on work computer . Doesnt seem fair to me. Your thoughts, please?

JadedCPN, BSN, RN

1,476 Posts

Specializes in Pediatrics, Pediatric Float, PICU, NICU. Has 17 years experience.

By definition, it is diversion - the medication does not need to be an opioid/controlled substance in order for it to be diversion, but most people get in trouble for diverting opioids or controlled substances rather than, for instance, tylenol or blood pressure meds.

In terms of you being mandated, I doubt it but that is up to each individual BON. For instance, California's BON specifically states "To ensure safe quality nursing care, it is critical to immediately address nurses suspected of diverting drugs or using drugs. While filing a complaint with the BRN is not mandated by law, health professionals do have an ethical responsibility."

ETA: I agree with the below poster. I do not think you should automatically report a situation like this to your BON. I've known many nurses who were under the impression that if it wasn't a narcotic, it wasn't diversion. Better to give someone the benefit of the doubt rather than potentially jeopardize their license.

RNNPICU, BSN, RN

1,261 Posts

Specializes in PICU. Has 17 years experience.

Before you go off reporting this coworker, why not talk to your coworker and remind her that this could be viewed as diverting a medication. ALthough it was a topical medication, perhaps she felt it was okay? I would first speak to your coworker.

Also, unless your coworker told you directly that she had no discipline, you do not know that for a fact. If the hospital was aware, then there really isn't a need to do more.

amoLucia

7,735 Posts

Specializes in retired LTC.

OP - what is it that you WANT to happen? That the nurse somehow be punished for all the world to see?!? Burned at the stake?!? To be tarred & feathered?!?

A PP commented that the issue may have been addressed by mgt. It is NOT a requirement that they announce it to all.

Just a question - did you have ACTUAL knowledge of that nurse using the med? Or was it just something you learned of heresay?

As long as the chain of command has been informed, the act has been addressed.

BlondieRN19

6 Posts

I witnessed the taking of and the use of the prescription medication. This coworker has been telling everyone what she did, there is no discretion. Pharmacy had a question regarding the proper billing of this medication which is how management became aware. What I was concerned about is the question about my being mandated to report this to the BON. Following my post here, I telephoned the BON with a general "what if" scenario and was told that I would be required to report this. I wish I hadnt of been working with her when she did something so stupid.

MunoRN, RN

8,058 Posts

Specializes in Critical Care. Has 10 years experience.

Not that it makes a huge difference, but the commonly used topical cream for scabies is permethrin which is not actually a prescription medication, it's widely available over-the-counter in the form of bug sprays, lice treatments, etc.

Regardless of whether the medication is a "legend drug" over an OTC, it's still diversion if your taking a medication meant for a patient for yourself. And in this case particularly dumb since any corner drugstore stocks shelves full of it.

RNNPICU, BSN, RN

1,261 Posts

Specializes in PICU. Has 17 years experience.

OP if you witnessed and observed her using, why did you not stop her? The BOD could very well ask you why you did nothing except stand by. All of us have done bonehead move at some point and regret it, not usually worth a call to the BON. How do you know with absolute certainty that the hospital may have done something.

Your strong desire to contact the BON for this nurse makes it seem like there is an ulterior motive behind it. While I agree this nurse should not have done something like that, I would much rather have the hospital handle it. You too are complicit in this event as a bystander and you did not intervene.

Just me.

85 Posts

Has 23 years experience.

I am fairly new to this site, and there is a disturbing trend. This need for some responders to accuse the OPs of this and that. In this case the OP may have a strong sense of what is right and wrong.

If management is aware, leave it with them.

JadedCPN, BSN, RN

1,476 Posts

Specializes in Pediatrics, Pediatric Float, PICU, NICU. Has 17 years experience.
54 minutes ago, Just me. said:

I am fairly new to this site, and there is a disturbing trend. This need for some responders to accuse the OPs of this and that. In this case the OP may have a strong sense of what is right and wrong.

If management is aware, leave it with them.

I had to go back and reread the reponses to make sure I didn't miss something. Where did a responder accuse the OP of anything?

I definitely agree with your last statement.

Wuzzie

4,895 Posts

If it was reported to your superiors it is on them to contact the BON. Not your job to police what management does or does not do. You can feel safe to remove yourself from the situation and no longer let it rent space in your head.

JKL33

6,465 Posts

5 minutes ago, Wuzzie said:

If it was reported to your superiors it is on them to contact the BON. Not your job to police what management does or does not do. You can feel safe to remove yourself from the situation and no longer let it rent space in your head.

Precisely. I thought I posted this (below) but I guess not:

In regard to what you (OP) have written, there's a problem: Whether you do or don't have an ethical obligation has absolutely nothing to do with who this woman parties with or whether or not your manager's treatment of a differently employee was fair or not.

Personally I would use my company's incident reporting system to report what I witnessed (if I felt burdened to do so), and my conscience would be completely relieved.

Wuzzie

4,895 Posts

1 hour ago, Just me. said:

I am fairly new to this site, and there is a disturbing trend. This need for some responders to accuse the OPs of this and that.

This is patently untrue. What is true is that we don't sugar coat things. People ask for honest responses/opinions and they get them. Sometimes they don't like what they hear and they clap back. It's the nature of the beast. For example you took issue with me telling another poster that she asked for opinions but if she didn't want to listen to well-intentioned advice (AEB her arguing against the advice) that was "no skin off my nose" which is a very mild way of saying I'm not going to get too upset about it. I never passed judgement about her or flayed her for what she did. I was hardly accusatory and certainly not mean. I simply told her she needed to consult an attorney and she really does. We are not meant to be a support group for bad behavior and I can tell you this, when someone who has screwed up comes here and takes full responsibility we are more than happy to help them through the situation but if they make excuses for what they did the response is entirely different. Trust me, we are much easier on them the any BON would ever be.