How to help coworker with substance abuse

julieanneb · Oct 20, 2011

I don't know if I'm in the right area but I have a coworker (RN) who has lost her license twice for narcotic abuse and her behavior is such that I am sure she is relapsing. She is constantly signing out narcotics for patients who are not in pain. (We are in a small PACU so her patients are very visible). I don't want to report her because if I am wrong it could ruin her reputation. How do I approach her on a personal level? We work in an area where lots of IV narcotics are used. No one has followed up on required drug screens due to change of management.

I was in a similiar situation with a fellow nurse that was also a best friend and my roomate. Approach her on a personal level. Do not report her. And,you do not know if she is relapsing. Nurses that r known on the floor to have had addictions always have others assuming they are using. I say,approach her yourself. U do not know for sure. Are you good friends? I approached my roomate and coworker than drove her to rehab. And,the others never looked at her the same again. They always assumed she was using. Are you worried bout her,are you worried bout the pts.? If she is taking the drugs for herself,when the pt. is not in pain,she is harming herself,not the pt.....So,again,I ask,who is it you are woorried bout?

HouTx, BSN, MSN, EdD · Oct 20, 2011

Wow - major ethical delimma with so many elements to consider. Diversion of narcotics or any other meds always requires falsification of records... somone has to be charged for the meds. If the meds were used for the benefit of the nurse instead of the patient who needed them, there is actual harm to the patient. Although it varies slightly by state, just about every nurse practice act contains a 'duty to report' unprofessional behavior. If this individual is caught, the ensuing investigation will taint bystanders who knew "something was going on" but did nothing about it - thereby making them vulnerable to charges of unprofessional behavior and facilitation (by inaction) of fraud.

As human beings, whenever we ignore a 'wrong' we are in effect condoning it. Everyone has to draw her own line in the sand as to what she is willing to live with. I agree with PP, a good first step would be to speak to your your co-worker about what you have observed and let her know that you are very concerned about her. This confrontation may very well serve as a wake-up call that forces her to take appropriate action.

subee, MSN, CRNA · Oct 20, 2011

There is no "dilemma" here. Multiple relapser and must be relieved IMMEDIATELY for 1. Patient safety and 2. The nurses's personal safety. She has a disease that ends in death in an ugly place. Needs to go straight to ER for drug screen and then not left alone to go home and suicide.

SineQuaNon, MSN, RN, NP · Oct 20, 2011

As an addict myself, she needs to be told to self report to the board. Or to quit or take a leave of absence to deal with her addiction or YOU will report her to the board. Probably the best way to handle it. She could not be using....but she likely is, and she needs to be called on it. Getting caught saved my life and is the best thing that ever happened to me.

jmo1231 · Oct 20, 2011

This is such a difficult situation to be involved in and keep in mind a few pertinent facts. First you are bound by the nurse practice act to report any wrongful acts or potential acts and patient safety comes first. Secondly addiction is a disease that kills and you are not doing her any favors by ignoring the situation. I would give this to the powers to be and let them deal with it. If she is clean it wont be an issue.

jabwrn · Oct 24, 2011

Thank you all for your very helpful replies. We are not good friends but I will try to talk to her. I didn't realize that by doing nothing I was also guilty of unprofessional behavior.

Joyce

subee, MSN, CRNA · Oct 25, 2011

Joyceannw, that's what we're here for. Good luck and let us know how this turns out. This nurse has a long way to go, but first she needs to be removed from the environment where narcotics are easily available for her own safety.