New York Nurse Steals Narcotics from Cancer Patients

Nurses have several risk factors that place them at a higher than average risk. However, diverting medications from cancer patients seems a bit out of the ordinary. Find out the details of Kelsey Mulvey, a Buffalo, New York Nurse who was charged last week.

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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.

Specializes in Mental Health, Gerontology, Palliative.
On 6/24/2019 at 9:32 AM, LockportRN said:

So, you need 2 nurses to give out meds? Sounds like a luxury.

Not really, something to do with the law, policy etc when it comes to controlled medications

On 6/20/2019 at 8:51 AM, 2BS Nurse said:

Thanks for sharing goodnightopus4. We work in a high stress environment where PTSD is not recognized or treated. The work is piled on until we reach our breaking point. A patient dies and we internalize our feelings and take them home with us. I'm so glad you sought out and received help.

I have chosen to remain in the outpatient setting because it allows self care and a good work/life balance. As nurses, we are taught to feel guilty about caring for ourselves. I have learned to set boundaries and say "no" to picking up extra hours.

I am still recovering from a job I resigned from because of the traumatic experiences and the disillusionment I suffered. Honestly, I have all the symptoms. I wish there were more nurses that shared openly and truthfully. I commend those who do.

I would expect 1in 10 to be a low number. I am sure many nurses drink because of the job. However, If it is appealing to have an alcoholic beverage to deal with stress then that does not automatically mean you need to go running for help. Now then, if you find yourself turning to alcohol more than just occasionally then I would say that is the time to get some assistance.

K. Mulvey got away with a lot, seems administration were focusing too much attention on the wrong things. The Pyxis should be monitored every couple of days at least, it would have been easy to set up a trace on her activity. They caught her too late and the patients suffered for it. I suppose they will be made to compensate patients for the pain. I would like to know if patients have filed suit against the hospital for neglecting to monitor the pyxis activity.

As far as antianxiety medications, I know a lot of nurses who see their doctors for these prescriptions because of job stress. I wonder, is there something wrong with the nurse? OR is there something wrong with nursing? We should ponder that.

I was thinking the same thing. There is some responsibility there as well.

On 6/23/2019 at 6:22 PM, K+MgSO4 said:

Yes, according to hospital policy and the Posions Act I do. It's not luxury its law...

I understand that drugs and alcohol are a problem, but putting more burden on every working nurse does not sound like a good solution to me. Why don't they monitor better? At a place I worked they required 2 nurses for insulin, 2 nurses for urinary catheter placement, 2 nurses for disposal and other things. It won't be long till two nurses will be required for everything from charting to blood pressures. So they double the nurses work, will they double the staff. Nope. How does this make things better? I don't know it just seems to be getting more of a mess all the time. I don't know what the answer is.

Specializes in Critical Care.
On 6/23/2019 at 5:22 PM, K+MgSO4 said:

Yes, according to hospital policy and the Posions Act I do. It's not luxury its law...

Is this a state thing? I've never heard of needing 2 nurses to witness pain meds given. Where would people have the time given the crappy staffing on a daily basis! What about those working in home care where there is no other nurse to witness?

When I was a new nurse a well-liked and respected nurse was caught diverting meds, not by coworkers, but by the new PIXUS and pharmacy. She was married with children and had hep C from work exposure in the past and then got cancer. She admitted she was having pain from both and started pulling meds out of the ADU. Almost two decades later she was in the news for diverting once again, this time at a doctors office where she was forging scripts for patients and picking them up at the local Walgreens. They were the ones who finally blew the whistle.

Specializes in OR, Nursing Professional Development.
19 hours ago, brandy1017 said:

Is this a state thing?

The poster you quoted is from either New Zealand or Australia.

Specializes in Med-Surg, Geriatrics, Wound Care.
On 6/24/2019 at 7:25 PM, SobreRN said:

In 1980s IVDA had such a bad rep due to emergence HIV. I never smoked or shot up cocaine for that reason (and I feared a worse crash than the ones I already had, brutal come down.) The article here says 1 of 10 RNs but it is estimated on about 1 of 10 drinkers in any walk of life drink alcoholically so why wouldn't 10% of RNs have issues? 

Then you add all the other things alcoholics are more willing to try. I still believe that cigarettes were the 'gateway' drug in my generation. Anyone who was unwilling to even try cigarettes was not going to try cocaine, LSD or magic mushrooms. 

I actually had a friend that did not smoke cigarettes. I think a parent died of lung cancer. But did other things.

I always wonder about the 1 in 10 who drink "alcoholically" or "abuse drugs". I think it has to be too open ended. Like, anyone who's gotten drunk. Anyone who has drank to relieve stress. And I'm sure some of those suspected of drug problems are the people that have an old pill bottle and take the occasional pill for pain (but no current prescription). The descriptors are pretty vague and are often once=positive.

Then, there was the girl I worked with that always had "cat scratches" on her hands...

On 6/20/2019 at 5:51 AM, 2BS Nurse said:

Thanks for sharing goodnightopus4. We work in a high stress environment where PTSD is not recognized or treated. The work is piled on until we reach our breaking point. A patient dies and we internalize our feelings and take them home with us. I'm so glad you sought out and received help.

I have chosen to remain in the outpatient setting because it allows self care and a good work/life balance. As nurses, we are taught to feel guilty about caring for ourselves. I have learned to set boundaries and say "no" to picking up extra hours.

I also did not pick up extra shifts; irony is among the handful I have known over the years they managers loved the nurses with diversion going on as long (as) they did not have to outright know of it.

Those were the RNs picking up extra shifts, holidays, nocs, overtime and never took more than a couple of days off.

On 6/21/2019 at 8:00 PM, SobreRN said:

Good for you! No, we do not hear enough from 'other side', I have been clean and sober since 3/28/1989; I was a young waitress when I got clean from ETOH and cocaine to be honest until I saw you post I do not think I even had enough 'huevos' to admit to cocaine part of sobriety. BRN does NOT help, Good Lord anyone I have seen on here or known personally is just thrown under the bus under the guise of diversion.