co-worker stealing narcotics

Long Term Care Columnist / Guide · Dec 17, 2006

From a DNS standpoint: Loose lips sink ships. In other words, management CANNOT share confidential information about an employee with other employees, such as what we are doing about someone suspected of drug diversion. It's way too easy anymore to be sued for all sorts of ugly things if one were to contribute to the loss of an employee's livelihood and reputation, so the wise manager keeps their mouth shut.

That said, my own policy at work is to suspend anyone suspected of "funny business" in the med room (with pay) pending further investigation. Of course, I want something a little more concrete than an accusation against an employee by a co-worker who personally dislikes that employee; but even so, I've learned that it's best to always check it out. The one time I didn't was the time my trusted med aide actually WAS diverting.........oh, what a mess that was. That's why I'm so quick now to jump on any 'irregularities' and educate staff about federal law governing narcotics---this is not a game. :nono:

BROOK9960 · Dec 18, 2006

You are absolutely right. there was difference in the MD's order and the MAR after this girl changed it...but still....they said they don't have enough proof to write this girl up for med error.....I had even made copies of that MAR and narcotics sheets and the physician's order..and gave it to DON,,she said she will personally investigate it.....

Maybe the DON is in on it too? :idea:

doingourbest · Dec 18, 2006

I work in a nursing home. I have a patient who is prescribed percocet 1 tab every 6 hours PRN for pain. She generally takes one tab at 9AM and the other at 9PM. One of my collegues, who is a floater and occasionally works on my floor signed 4 percocet in her 8 hours (11PM to 7AM) shift. She was very clever to make the order look like 2 tabs(it was a handwritten order in the MAR, she channged it by adding I to the order which then looked like II tab), however, even if the patient was supposed to get 2 tabs she had her last dose at 9PM and the nurse who worked 11PM to 7AM can not give more than one dose during her shift. The same night she signed for 6 percocets on another patient who was supposed to get 2tabs every 6 hours, and had her last dose at 10PM. The nurse does not sign the the MAR for the PRN medicine but just signs the narcotics sheet.
We complained to the supervisor and it was even relayed to the DON but no action was taken............
After a week, a whole pack of percocet (20 Tabs) was lost along with its paper during her shift from my floor again. Everybody knew about it including the DON but she is still hanging in the building. Today, she was again on my floor....Eventhough I counted the narcotics with her,,,,, i was very much scared to give my keys to her..i have just ordered percocet for my patient, it will be delivered tonight. I don't wanna loose that but i wonder if I will see it in the narcotics box tommorow. To keep myself in the safer side, i had all the narcotic sheets copied for myself.....

I have been in a similar situation. I was the night supervisor and had a nurse on my shift stealing medication from the patients. He was not only stealing it for himself, but for the DON and ADON. And they were sisters. Everyone knew this was happening. The adon would come in at night and stand there by the med cart all night long waiting for her drugs and the don would come in shaking and stammering until he gave her her share. He was also getting six dollars an hour more than I was despite the fact that I was his supervisor. He Tried to offer me Percocet and when they found out I had reported it to state I was fired. You don't need a reason to fire someone in Kansas because it is a "right to work" state. And they couldn't even make up a reason. It was just "we just have to let you go." Thus is life in nursing I guess.

TrudyRN · Dec 18, 2006

What a freakin' mess!!! I have never heard such lunacy before. The one about the DOn and ADON being hooked is only slightly worse than the DON in the OP who seems to be doing nothing.

I think you should notify the DON again and ask her what steps are being taken. I think it would be wise, also, to talk to the Administrator or owner. Or, you could notify the state inspectors and/or CMS (Medicare). Don't forget the patients' doctors, either. I just can hardly believe this stuff is happening but I guess I should not be so naive.

RN BSN 2009 · Dec 18, 2006

I have been in a similar situation. I was the night supervisor and had a nurse on my shift stealing medication from the patients. He was not only stealing it for himself, but for the DON and ADON. And they were sisters. Everyone knew this was happening. The adon would come in at night and stand there by the med cart all night long waiting for her drugs and the don would come in shaking and stammering until he gave her her share. He was also getting six dollars an hour more than I was despite the fact that I was his supervisor. He Tried to offer me Percocet and when they found out I had reported it to state I was fired. You don't need a reason to fire someone in Kansas because it is a "right to work" state. And they couldn't even make up a reason. It was just "we just have to let you go." Thus is life in nursing I guess.

Unbelievable! (Not that I don't believe you, but it's such a shame!)

gentle · Dec 18, 2006

Wow. We have absolutely no tolerance for this sort of thing. We immediately watch, document and within a few shifts the person is caught drug tested and GONE.

I think it is because, some of us have have been adversely affected/scarred by someone elses risky behaviors. As a result, people who steal narcs don't last too long on our unit.

jill48, ASN, RN · Dec 18, 2006

Wow do you not have the correct info here. Check your state BON site and inquire of thier IPN programs if they are offered. Granted it's wrong and I'm not defending diverters in any such way. But to state they just "get away with thier jobs intact" is very very false. Once caught they most likely will have to endure a legal arrest by law enforcement, jail time, court hearings, then presenting before the BON. Hearings after hearings. Most IPN programs require up to 5 years or more of continous monitoring to include daily AA/NA meetings, peer support group meetings, in-patient addictionologist workups, up to 7 randomly ua's a week if they want etc. Dont forget the very flawed ETG. Many of these nurses jump through hoops to get thier license re-instated then have to fight to even find a job after they get that license back. So please dont stereotype them as some crack head in the street as thats just not how it works. Not to mention all this is out of that nurses pocket while they have no job to pay for it. Sometimes the stress of all the hoops is enough to make on consider relapse due to the stress. These nurses fight hard to get back and when they do take a lesson from them and I bet they have some great advice when you find these type situations. Most of these nurses arent doing it just because it's fun.
Now as far as the admin ignoring? Again they cant and usually wont tell you what they are doing regarding the monitoring of the situation. But you can bet sooner or later this person will be caught. When she does get caught she will suffer the consequences and rightfully so. Document, document, document. Dont make assumptions but have concrete statements. It's not your job to investigate but to report it. If you feel at anytime this nurse is working while in an "impaired" state then you report it right then and hope they jump to drug test her immediately. It could be the facility wants to be sure they have all thier ducks in a row if diversion is an issue. If you arent satisfied with that most every bon has an anonymous reporting area on thier websites. This happens more than you realize.

Lacie, sometimes I think we share a brain or we were separated at birth. I agree with you completely.:bowingpur

rehab nurse · Dec 18, 2006

can't they get a pharmacy report about the percocet that were to be delivered? i work in a ltc, i know it's a much different world than acute. i actually work subacute/rehab side so there's narcotics galore. however, there's a sheet from pharmacy that the nurse who receives has to sign with all the narcotics on it.

in our facility, we actually have another "count" sheet of ingoing and outgoing cassettes. like we received 3 new cassettes of meds, and we emptied one, and the cassette and completed signed sheet goes to DON.

we have a ADON who takes the old narcs out nearly three times a week, otherwise the drawers get too full. we don't have a pyxis.

but i would think you could get in with pharmacy about how much percocet they've been sending out for a single pt. i know our pharmacy would call on any narcotic that was being reordered too soon.

good luck, let us know what happens.

report her yourself!! i'm sorry you're caught up in this mess. the others are right. document your facts, and give the BON a call.

jetscreamer101 · Dec 18, 2006

When I used to work one unit all the time, I started to notice narcotics counts decreasing at a more rapid rate, pts who normally only took tylenol starting to use vicodin pretty frequently, etc.

I did report it to my DON. They kept my name out of it, and it took awhile, but they finally tracked it down to one nurse. They did bring the law in, not really sure all that happened after, but she was fired for diversion.

Ruby Vee, BSN · Dec 19, 2006

i once worked in an icu with disappearing drug problems. the investigation went on for months, and in the end the nurse manager was found with drawers full of morphine 10 mg. syringes in his office.

my best advice is to document. report the facts and the facts only; no speculation or drawing of conclusions. turn in your report to the don, and keep a copy for yourself. if it comes down to an external investigation, you'll want records of what exactly you saw, when you saw it, what you did about it and when you did it.

your don may already be investigating things, but if not, it doesn't hurt to protect yourself!

banditrn · Dec 19, 2006

I learned at the last LTC that you also have to watch HOW you count narcs.

When I was coming on, I would count the cassettes, and the other nurse would have the book - one morning the count was off, and it looked like it was off on MY shift. The next nite, when I counted with this same nurse, I decided to also watch the book, and what I counted in the cassettes wasn't what was written in the book, and she didn't say a word until I pointed it out.

The other nite when I came on at the new place I work, the count was off - the evening nurse was a new LPN, and she was very upset, because she couldn't figure out what had happened to it. I questioned her about how the count had been done, and she said the nurse going off had counted the actual pills. I instructed her to ALWAYS be the one to count the pills when she comes on, especially if the other nurse is insistent that SHE do it. And to keep an eye on the narc book at the same time. It doesn't mean you assume the other nurse is diverting - but sometimes at the end of a shift, I'm a little brain dead.

starbin, BSN, RN · Dec 20, 2006

Found out that the case is being investigated and I was told that they might need our (me and the other nurses who had witnessed this disappearance of narcs) help .........good to know that something is happening....