My coworker was high and got away with it

Published

Happy 4/20 I guess?

This particular RN (I'll name him Jon) has been working for our unit for two years. We work in a MedSurg unit at a county hospital. Apparently, we DONT do drug tests at all.

Our morning was going fine, we both took report in the same area and had our breaks at the same time. Nothing seemed out of the ordinary (aside from saying "I'm sleepy/tired," but we all say it). Jon did one discharge and completed one admit. He helped me start an IV for one of my patients and cosigned my insulin.

It wasn't until lunch I noticed Jon's phone Snapchat(?) of him consuming edibles. I also saw Jon's text messages saying "he was still high this morning."

I immediately went to the charge nurse and reported my discovery. Our charge nurse was in disbelief and found it difficult to believe. We confronted Jon and he denied everything.

Our charge nurse discreetly followed up on his patients, and they reported nothing but excellent nursing care. We checked his charting and everything was within policy. We also checked all his pyxis pulls and there were no discrepancies. Lastly, we privately spoke to an MD that Jon was speaking to in the morning who also reported that his behavior was completely normal.

I apologized to Jon as there were no evidence of him being high towards the end of the shift. As we were leaving the hospital, one of Jon's friends (from another unit), came up to him and ask him about his 4/20. I saw Jon winked and nodded. I got upset and just left.

The next day, I reported it to the charge. She said to leave it alone since there wasn't any proof and no patients were harmed. I am not sure what else to do at this point.

I had a coworker and her husband commit suicide over allegations of drug use. Please be careful of accusations. It was a tragic experience for all of us and the daughter they left behind.

The policy at my work when someone is suspected of being under the influence is...

Employee informs the charge

Charge informs the manager

Manager informs nursing supervisor

Employee is taken for immediate bac/urine drug testing.

Nowhere in this process are patients interviewed or the accused person's charting is checked. The op didn't do anything wrong. The charge should have looked up the policy and procedure for handing this situation.

No one has said that a -legitimate- concern should not be reported. In order to get past this idea that the OP "didn't do anything wrong" or "did the right thing" let us pretend for a moment that there was indeed a legitimate concern (Humor me. We all know there wasn't a legitimate concern or else there would've been no need to check charting in order to try to prove it....). Anyway, the "concern" was, correctly, reported to the charge nurse. Everything that happened beyond that was wrong. Why does this matter? Well, to recap points already made, there are at least a couple of serious issues at play: The OP has acted illegally by accessing PHI outside of the guidelines of hospital policy and thus HIPAA. The reason that the records were accessed does not fall under the realm of hospital employees acting according to established policy in order to do the hospital's business. Secondly, the egregious manner in which this was handled in and of itself provides a legitimate defense for the accused. In pursuit of "justice" (or a misplaced concern for patient safety), the OP has opened his/her employer up to additional legal liability.

I don't necessarily fault a newer nurse for making a questionable report. Let's give the benefit of the doubt and assume that naivete and lack of wisdom/experience made this a serious and legitimate concern in the OP's mind. What happened next is not okay, and it is not all on the charge nurse. It would be all on the charge nurse if s/he launched an investigation alone while the OP stayed out of it. We all know that we can't memorize every policy, but we are responsible to know the gist of policies that apply to us. Experience (if not wisdom) should tell us that no where in nursing school or hospital orientation did we learn 'how to properly conduct a peer investigation'. For goodness' sake, LIFE experience should tell us that we aren't usually called upon to launch investigations that don't involve us personally. Someone using your SS#? Okay, great - investigate that, since you personally are being defrauded! Think a fellow shopper has a weird bulge under clothing and therefore may have shoplifted? Report if you must. Or better yet, MYOB. The point is, you don't need 20 years of nursing experience or a photographic memory of hospital policy in order to have known that this type of witch hunt was way out-of-bounds.

The concern with this whole mess is the lack of judgment shown at that particular juncture. And yes, I will extrapolate to say that, in this case, the judgment shown was poor enough to beg the question of overall judgment and competency to hold a position that requires non-judgmental decision-making, prioritizing, and accurate assessments.

I've read through the whole thread to this point and even if the picture of him eating a brownie/gummy/cookie/whatever other food was captioned "Happy 4/20" or whatever it said, that still isn't actually evidence that the food was made with marijuana.

If someone is concerned yes, report it, but everything else the OP did after reporting is completely inappropriate.

Betty Crocker? More like Betty CRACKHEAD! You mean to tell me that woman wasn't high 24/7? And don't get me started on Drunken Hines.

lol since Betty Crocker was never a living person but rather a product of advertising genius I guess we can assume whatever we like about her! :)

Drunken Hines, do they make rum cake mix?

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
No one has said that a -legitimate- concern should not be reported. In order to get past this idea that the OP "didn't do anything wrong" or "did the right thing" let us pretend for a moment that there was indeed a legitimate concern (Humor me. We all know there wasn't a legitimate concern or else there would've been no need to check charting in order to try to prove it....). Anyway, the "concern" was, correctly, reported to the charge nurse. Everything that happened beyond that was wrong. Why does this matter? Well, to recap points already made, there are at least a couple of serious issues at play: The OP has acted illegally by accessing PHI outside of the guidelines of hospital policy and thus HIPAA. The reason that the records were accessed does not fall under the realm of hospital employees acting according to established policy in order to do the hospital's business. Secondly, the egregious manner in which this was handled in and of itself provides a legitimate defense for the accused. In pursuit of "justice" (or a misplaced concern for patient safety), the OP has opened his/her employer up to additional legal liability.

I don't necessarily fault a newer nurse for making a questionable report. Let's give the benefit of the doubt and assume that naivete and lack of wisdom/experience made this a serious and legitimate concern in the OP's mind. What happened next is not okay, and it is not all on the charge nurse. It would be all on the charge nurse if s/he launched an investigation alone while the OP stayed out of it. We all know that we can't memorize every policy, but we are responsible to know the gist of policies that apply to us. Experience (if not wisdom) should tell us that no where in nursing school or hospital orientation did we learn 'how to properly conduct a peer investigation'. For goodness' sake, LIFE experience should tell us that we aren't usually called upon to launch investigations that don't involve us personally. Someone using your SS#? Okay, great - investigate that, since you personally are being defrauded! Think a fellow shopper has a weird bulge under clothing and therefore may have shoplifted? Report if you must. Or better yet, MYOB. The point is, you don't need 20 years of nursing experience or a photographic memory of hospital policy in order to have known that this type of witch hunt was way out-of-bounds.

The concern with this whole mess is the lack of judgment shown at that particular juncture. And yes, I will extrapolate to say that, in this case, the judgment shown was poor enough to beg the question of overall judgment and competency to hold a position that requires non-judgmental decision-making, prioritizing, and accurate assessments.

All. of. this. The OP is like a dog with a bone. She reported it. That is as far as she should have gone. Sorry---- I would never want to work with her. It almost feels nefarious the way she went after this. Report and then MYOB for heaven's sake. Stuff like this is why morale goes down the toilet. Busy-body people who feel they have the right to investigate people like they are the police. So wrong. Management needs to step in and tell her to back off; they have got this.

It sounds as if you are stalking him. If I were him I would press charges against you for stalking then obtain a restraining order against you, you have issues...

I did once joke around with an RT. Around 22 years ago @ 0300. Patients all snug as bugs in rugs, medicated, sleeping and we were all caught up (it was possible to be all caught up 22 years-ago when appys & choles spent 3 nights in the hospital.) Anyhoo I took Sweet & Low out and made it into lines; don't ask why, just being silly. RT friend was sitting next to me & knew it was Sweet & Low, we were both being silly but we were not attempting to pass it off as Cocaine. As I recall we just wanted to see if Sweet & Low resembled the real thing and wow, it bore a striking resemblance! I was just exhausted all of the time being new to nights, apparently RT was as well because I took a look at hime and he was staring at that Sweet & Low line, fixated on it with an "if only it were real" expression on his face, I knew on the spot he had a history as well. I found myself staring at it also fixated. At the time I thought of it as innocuous fooling around but it truly scared and made it real for me how close relapse can be. I had been clean and sober for 7 years by this time, I did not embark on parenthood, marriage or college until I got my act together getting clean & sober in 1989, as a waitress in a small town I did a lot of drunk walking & never was arrested; God looks out for fools and drunks, He sure looked out for me! Reading your post on making a line out of flour reminded me, I hadn't thought of that in awhile and while I thought of it as just being silly I never did anything like that again, that was too close for comfort.

Specializes in critical care.
That's horrible! I am so sorry this happened to you. I sincerely wish you the best in righting this wrong done to you.

Ixchel, there are no words. I'm so sorry.

Ixchel I am so sorry you are going through this.

Thank you. I really appreciate it. This is actually why I haven't been around in ages. Life seems to be hitting an upward trajectory, hopefully.

ACTUALLY UM NO

I'd like to give some advice that you may take as an insult, but I promise it isn't.

When you use "um" in written conversation, everything you write after it comes across as childish and ignorant. Think about it: when a person emphasizes "um" in a verbal argument, do they tend to make a well-reasoned, mature argument? Personally, I find they tend to be rude and ridiculous.

I'm not saying you are any of those things, because frankly, I have no idea who you are or what you're like. But, know you are judged by writing it out in an argument.

That is terrible :-(

"Partying" doesn't mean someone is incapable of providing care, and people joke about still being drunk/high the morning after a night out all the time. Doesn't mean they actually are. Also, the "high" from marijuana doesn't last that long. The Snapchat you saw was probably just a joke.

Specializes in Emergency Nursing.
"Partying" doesn't mean someone is incapable of providing care, and people joke about still being drunk/high the morning after a night out all the time. Doesn't mean they actually are. Also, the "high" from marijuana doesn't last that long. The Snapchat you saw was probably just a joke.

I agree that partying doesn't mean that someone is incapable of providing care. I also agree that people tend to joke about still being drunk or high the next morning. I just wanted to add to what you said about the high from marijuana, and offer some extra information to clarify about the effects of edibles vs inhaled THC.

Excluding factors such as prescription medications, hydration level, how much food there is in the stomach, frequency of use, personal tolerance, etc... Typically, a high from smoking can last between 4-6 hours. In contrast, a high from edibles can last up to a day, if not more. Granted, this is not the same for everyone.

This is because when THC (or delta-9-THC) is inhaled it simply enters into the bloodstream via the blood vessels in the lungs, and crosses the blood brain barrier. It's fairly standard and can wear off in 4-6 hours.

In contrast, when ingested, the delta-9-THC is metabolized and breaks down to 11-hydroxy-THC which is a significantly more potent and powerful psychotropic form of the drug. It gives stronger highs, and can even produce hallucinations. Also, unlike the delta-9 version, 11-hydroxy-THC can stay in the body for up to an entire day. This, of course, can depend on many things, an important one being dosages. The standard single starting dose is 10 mg THC, with the recommended starting dosage range between 10-25 mg for beginners. When people buy or make edibles, however, it can be very difficult to standardize the dosages and that's why you get people who talk about being incredibly high for up to several days after ingesting edibles.

This is important because, hypothetically speaking, if someone was to smoke and their friend that they were partying with ingested edibles the night before a shift and then they both showed up to work the next morning, the one that ingested edibles is a much higher risk for coming in impaired.

But I agree that speculation aside, it comes down to how the coworker is acting in the morning. The OP said that the coworker seemed to be fine, was providing safe care, and was on top of his game. Therefore, the OP should let it go.

Also, disclaimer, I know these things because I really want to be an ER nurse and want to have a better understanding of recreational drug processes. Therefore I study it. I had a patient come in high on Meth one day and I discovered that I didn't know a single thing about the drug or what he was going through. I wanted to be able to understand different drugs, drug dosages, and what the type/duration of the high for common drugs is so I can understand patient needs and behaviors better!

-HermioneG

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