On June 4, 2019, a former nurse at Roswell Park Comprehensive Cancer Center in Buffalo, New York was charged with stealing pain medication from cancer patients. Kelsey Mulvey, of Grand Island, was charged with illegally obtaining controlled substances by fraud, tampering, and violation of the Health Insurance Portability and Accountability Act (HIPAA). She is accused of diverting powerful painkillers like Dilaudid, oxycodone, methadone, and lorazepam. She was also allegedly administering water to the patients who legitimately needed those drugs. These charges could find Mulvey in prison for 10 years and fined up to $250,000.
Details of Mulvey's Crimes
In 2018, administrators at Roswell Park Comprehensive Center suspected that a staff member was diverting pain medication from the Pyxis. Between February and June of 2018, it's alleged that Mulvey failed to administer medication to 81 patients, instead of giving them water, that at times was contaminated and resulted in infection. Administration became suspicious after finding a large number of transactions in the Pyxis that were "canceled removed,” indicating that the drawer was accessed, but the operation was never completed.
The complaint filed last week states that she removed and replaced controlled substances with water during these canceled transactions. Mulvey accessed the Pyxis on units she wasn't assigned and even on her days off, including vacations. When the facility started investigating the issue and Mulvey in 2018, she resigned. As of June 16, 2019, there are two Kelsey (Anne) Mulvey's listed in Buffalo, New York on the license verification site. However, both list that the license to practice nursing is inactive.
Nurses and Addiction
Caring for others is a challenging business. Nurses watch as patients endure horrific medical battles. Many times, nurses and other healthcare professionals internalize or suppress their feelings to get by and cope with the stress. However, sometimes, nurses bend under pressure and turn to misuse and abuse of substances they possess or even some they divert from patients who need the medication for pain, anxiety, and other symptoms or conditions.
The American Nurses Association estimates that one of every 10 nurses abuse drugs or alcohol. So, at the next staff meeting you attend, look around and do the math. For every nine nurses, you are sitting with, you or someone else in that small group is or will abuse a substance. Maybe even at the detriment of a patient. Scary, right? Many of us can't fathom being that one in 10. However, when you think about the reasons nurses abuse drugs and alcohol, the picture starts to become a bit clearer.
Let's discuss a few of the reasons experts believe nurses struggle with issues of addiction:
Stress Levels Run High
Results from a study of 120 nurses in the Midwest revealed that more than 90 percent of respondents had moderate, high, or very high levels of work-related stress. To combat work-place stress, 79% of the study participants talked with friends and loved ones, 46% listened to music, 43% watched TV, and 43% used prayer and meditation. Unfortunately, 13% reported that drinking alcohol was a coping mechanism they used to deal with their stress levels. Nurses with the most stress also experienced poor health outcomes and high-risk behaviors.
Stress can make you do things you wouldn't usually do. It can also impact your overall health and well-being. However, when stress gets to the point that deadening the feelings with substances sounds like a good idea, it's time to reach out for help.
Easily Accessed
If you work in a hospital or other care facility, you likely hold the key to some powerful medications. This alone can be problematic for nurses with chemical dependency issues and those who are under more stress than usual.
Psychology Today reports that behaviors that should make you question what's going on with colleagues include volunteering for shifts on holidays, weekends, and overnight because there is less oversight by administration during those shifts. You might also wonder what's up if a coworker constantly has incorrect narcotic counts, reports wasting medications without a witness because no one was around, or they look for opportunities to be alone with pulling narcotics from the dispensing system. It's critical to point out that doing one of these actions or having it happen occasionally isn't reason enough to schedule a meeting with the unit manager to discuss your concerns. However, if you notice a coworker doing these actions consistently or if you have that "nurses intuition,” it might be best to discuss your observations with the manager privately.
High Levels of Fatigue
We're not talking about being tired after a day out and about with family and friends. The fatigue nurses feel is often caused by inadequate staffing, high acuity assignments, and increased clinical responsibilities. Fatigue can cloud a nurse's judgment, placing their patients in danger. The American Nurses Association reports that fatigue is costly because it can increase healthcare needs and worker's compensation costs, disability, recruitment and training efforts, and legal fees.
The remedy to fatigue sounds quite simple - sleep. However, sleep eludes an estimated 1 in 3 people. Older individuals are at a higher than average risk of experiencing insomnia. Women are twice as likely to struggle with sleep than men. And, shift workers have a higher than average risk, too. Since nursing is made up of primarily female workers and sick people don't miraculously get better at night, nurses are prone to experience fatigue.
Resolving the Issue of Addiction in Nurses
Each state and local jurisdiction handles drug-addicted nurses differently. Some walk away with a criminal record, but no jail time and others are fined and locked up. And, of course, there are those who are never charged and walk away completely unscathed. These are simply the criminal ramifications that nurses might face and doesn't address the variations of what might happen to the nurse's license to practice and make a living.
How do you feel about nurses who struggle with addiction and get caught diverting? Do you support programs to help them with the problem and keep their nursing license? Have you or a colleague ever struggled with addiction? Share your thoughts below, we would love to hear what you think about Kelsey Mulvey and other nurses who struggle with addiction.
subee, MSN, CRNA
1 Article; 6,129 Posts
But people are always "shocked" when they discover that someone is suddenly led off rhe floor and not returning to work. They shouldnt be. There were signs all over the place that didn't get picked up. Trying to educate people isn't the same as starting a witch-hunt. Do you even know if your state has a witch hunt clause in your diversion regulations? When people don't know what ti do, they generally dont do anything. Lots of nurses OD every month.