D.o.n addicted to narcs

TreehuggerRN · Nov 23, 2009

Sounds like a bad soap opera. I don't see how he/she gets away with disposing of narcotics alone, usually a pharmacist has to go through a specific process to do this, and in the presence of a nurse.

caliotter3 · Nov 23, 2009

When I was made aware of this type of activity it was part of a police report that was submitted concerning abuse of a patient. Found out two or three years later that absolutely nothing was done about it. Bottom line, you should make the appropriate report to keep yourself clear of any accusations of covering up the illegal activity.

JR816, BSN, RN · Nov 23, 2009

http://nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workplace/ImpairedNurse.aspx

logical_jackieo · Nov 23, 2009

her adon is her best friend of over 10 years and coworker for longer, she says nothing or trusts her to dispose of them alone.

heron, ASN, RN · Nov 23, 2009

May I suggest that you need to step outside the chain of command?

Understand that, if you report and there's a serious investigation by an independent authority, it may not be wise to stay at your current job ... which is probably why others who are equally aware of the situation haven't reported already.

Your state Board of Pharmacy is the agency that enforces federal DEA inventory control regulations. Give them a call and they will tell you what is necessary for them to inspect the facility's handling of controlled drug inventory.

You might want to remind corporate that they can lose the facility license to handle controlled drugs at all ... it also falls back on the doc or docs doing the prescribing, if one wants to be a real PITA.

RobinlynaRN · Nov 23, 2009

I am not sure what state you are from, but in the state of Texas she would be reported to the Texas Peer Assistance program for nurses. (TPAPN) The first step you need to make is to call your board of nursing and report her. They will take it from there, but you certainly have a legal responsibility to do something.

KungFuFtr · Nov 23, 2009

I am a nurse and my current don is clearly addicted to narcotics so badly that she is falling asleep during meetings, and calls sloshed. and is managing to get narcs out of our carts cause she says they are " not being used" often enough and "discarding them. As soon as I started to press the issue she made it clear she was ridding of me. Corporate says there has to be an incident to investigate her. what do I do? can I write the nursing board and ask the to step in? she has a history of being escorted off of last job site for narcs missing. the other nurses are all talkign about it but will do nothing! the admin is sleeping with the don and wont listen to reason at all.
please help
jackie

How do you know she's clearly addicted to narcs? Maybe she takes Benadryl? Do you have proof that she's stealing the narcs or are you assuming she is? I'd be careful about accusations and slander. Do you really know that she has a hx of stealing drugs or is it gossip? If she was escorted off the job for stealing, you still don't have access to her criminal records. You could always show concern for her "erratic behavior" by reporting just that to the next up in command. If she's having a relationship with her boss, maybe his boss might want to know.

It's not what you know, it's what you can prove...

tewdles, RN · Nov 23, 2009

IMHO the biggest issue you should be concerned about is the disposal of controlled substances for which you are responsible. Please be careful to document carefully about the removal of any meds removed from the med cart with your knowledge. Document your offer to witness the disposal and the refusal of that offer. Do not ever sign that you witnessed the proper disposal if you did not. It sounds like this DON is in a nonpatient care role, so her "sleepiness" is not likely going to impact patient safety. You are quite possibly making some assumptions about what is going on, and making reports based upon supposition is not recommended. CYA and try not to stir up trouble would be my recommendation.

pennyaline · Nov 23, 2009

In the places I've worked, in more than one state, narcs had to be removed along with their respective count sheets and co-counted and co-signed by the person removing them and the nurse who held the keys at the time they were removed. It is perfectly appropriate for your DON to take discontinued/outdated narcs and lock them up to await destruction. She cannot destroy them alone, however. A pharmacist and the DON count narcs to be destroyed, sign off the count for each narc on its count sheet, and together assure that the narc is irretrievably discarded.

Whether your DON does patient care or not doesn't matter. She is the facility's second in command and the primary decision maker for your department. If she is working in an impaired state, her decisions and behaviors may be inconsistent, illogical and self-serving.

If you believe that your DON is impaired on duty, report it to your state's professional licensing authority. They will take it from there.

Medic/Nurse, BSN, RN · Nov 23, 2009

gee - this sure sounds like a mess, no doubt. but - i'd really caution you to be very careful. in matters like this, you don't know - what you don't know and some of the issues you raise in the post seem odd.

i am a nurse and my current don is clearly addicted to narcotics so badly that she is falling asleep during meetings, and calls sloshed.
this is a loaded statement - i am not sure what indicated clearly addicted to you - but generally it is difficult to determine "clearly addicted" and that is a powerful accusation to make against anyone. you need more that falling asleep in meetings and calls sloshed (not sure what that means). no not make assumptions or jump to any conclusion.
and is managing to get narcs out of our carts cause she says they are " not being used" often enough and "discarding them.
this statement really alarms me. usually getting the narcs out and discarding them is a fairly straightforward process and tends to be regulated (records must be kept, witnessed and audited by whoever handles pharmacy at your facility - either wasted or returned for credit for outdate/expired). my take on this - if you are not being asked to witness anything other that the don taking them and then assuring that your remaining count is correct, i'd not leap to the conclusion that she is doing anything other than what she says. period. now, if she is asking that you are to sign that she is wasting - then draw 'em up and squirt 'em down the sharps box or crush the pills and destroy in sharps box. otherwise, just witnessing that she is removing them from a cart is one thing - actually co-signing for actual waste or as witness in a return to supplier (these packages are usually done by pharm or sealed with tamper proof seals as part of a witnessed process) is another matter. i would not state anything about this act other than the facts - do not draw any conclusion or incite others to draw a conclusion from this action unless you have directly seen her do something improper.
as soon as i started to press the issue she made it clear she was ridding of me.
i am wondering how you "press the issue" and did you confront her directly or join in on a gossip circle? it is one thing if you directly confronted her and said "i saw you take narcotics ..." vs. her hearing through the grapevine that there was conjecture brewing that was she was stealing/using narcs and that you were stoking the fires of ugly rumors. in the case of any method of "press the issue" other than direct confrontation to her face-to-face/just the facts then you were just a part of some very dangerous rumor and i'd make it clear that i would be getting rid of you too. not because you "have the knowledge of my theft and diversion" but because you are engaging in unprofessional and possible untrue conduct and creating workplace problems, ruining reputations and spreading rumors.
corporate says there has to be an incident to investigate her.
did you report her to corporate because of the facts of diversion and impaired performance and what you know for certain or because you have gotten caught stirring in a mess (that may or not be true) and she caught you and the others yakking it up? i have generally seen corporate step in when a legitimate and properly detailed problem of this type is brought to their attention. the fact that they do not want to get involved and asks for an "incident" makes me think that your complaint to them had little substance. of course they could just ignore it or not want to deal with it or not care or figure it is not big deal - but, since they know that the cost of doing nothing about a true narc diversion is really high - i'd think that if you took then something that was legit they would be on it. not saying that a blind eye is never turned - but, just what did you tell 'em?
what do i do? can i write the nursing board and ask the to step in?
well sure you can. we all have a duty to police our profession and take action in the case of truly impaired or dangerous nurses - the public depends on us and we are all accountable for professional practice. i just want to add a caution that i have seen some engage in bon complaints due to some motivations that were not as interested in protecting the "public" as they were in "getting the nurse" that one has some "issue" with or whatever. if you are not certain that your motivations have no direct link to her prior decision to be "ridding of you" for whatever role you had in the "pressing of the issue" over her drug use - i'd advise you to just stop. some battles create lots of losers. if this is not you and you are sure of the "danger" that she creates - proceed.
be prepared to give your info - anonymous complaints of this type are not well received. but, you are getting ready to jump into the abyss - just be certain that you have dates, facts and no assumptions/rumors/agendas. do not deal in circumstantial or rumor or that she is sleeping with the administrator - really, just the diversion and impaired nurse fact. period. also, be prepared to stand up be accountable for your participation in the complaint. accountability is everything. this is a big deal - short of seeing someone with a needle in their arm passed out in a work bathroom would i make a leap to accuse one of drug use on the job. but that is me. and in the case of something that can really damage the career of another even if ultimately unproven - i'd have to make certain of my "facts".
she has a history of being escorted off of last job site for narcs missing.
are you certain? or is this just a rumor that feeds other rumors? this industry is small and word travels - if this were true and certain then you can bet that this knowledge is enjoyed by corporate and administration and likely the bon. for that reason alone - it sure makes the inaction of folks around you seem curious if there was any legitimacy to that part of her obviously well known history.
the other nurses are all talkign about it but will do nothing!
this is the part of your post that really bothers me. "the other nurses are all talking about it but will do nothing" - this is not an issue that, if legit and true and proven, is to be ignored. likewise, that fact that all are talking may be the bigger problem.
the admin is sleeping with the don and wont listen to reason at all.
no real surprise there is it? i'm just really troubled that here is another person (professional, may even be licensed - most all states require licenses to be administrators in certain places like ecf's) that knows about this and like the nurses that are all talking just ignores any idea of mandatory reporting of this don that per your post is impaired and diverting. even if he is "sleeping" with her - then he is sleeping with a narc addict that cannot stay awake in meetings because she is so impaired. the administrator is accountable for this don to corporate. if you are correct about the don being an addict/thief he is really risking it all - in essence he is playing with a fire that will burn his world down too. wow.
please help
jackie
jackie - i really am trying to help and you may be the lone voice of reason and if you stand up and do whatever the right thing is it may save many. i'm just really concerned that this may have gotten out of hard for you (possible very innocently on your part). i'm worried that you either have become so vested in having to be right or you are in some freak reality where everyone else is unwilling/unable to report/take a stand/complain against this addicted don. tough spots.
i really do hope that this works out for you and you are able to get to the right thing. i have had to take a stand on a few issues and i often stood alone and only had my internal compass to guide me that i was charting the right path. it can be difficult to do the right thing. but as difficult as it is - when it is really the right thing - it always feels right. does it feel right? just reverse you and the don - consider that you would be the "target" - with all that you know, only you now know if what you "know" would be fair and just.

good luck.

practice safe and be certain