Nurses Diverting Drugs?

[jfpruitt]

How big is this problem really? Is it bigger than we think? I am graduating in May and started a 3 week preceptorship on Saturday. My preceptor told me that they had 2 RNs last month that just got fired from narcotic drug diversion. She stated that this is a huge problem that no one talks about. I still can't see how this happens so easy when you have to count and recount the narc's.

[OBNURSEHEATHER]

Originally posted by Jay Levan

I always ask myself "What were they thinking?"

They're addicts. The only thing they're thinking about is a fix. It has nothing to do with feeling invinsible or untouchable.

It is not a rational thought process at all.

As for how big of a problem it is and publications of liscense revocations, the Ohio BON publishes a quarterly newsletter. In it are listed all actions against liscenses, and their degree of action. "Narcotics Restriction" is one listed, and your name and liscense number are posted.

[SmilingBluEyes]

Originally posted by OBNURSEHEATHER

They're addicts. The only thing they're thinking about is a fix. It has nothing to do with feeling invinsible or untouchable.

It is not a rational thought process at all.

As for how big of a problem it is and publications of liscense revocations, the Ohio BON publishes a quarterly newsletter. In it are listed all actions against liscenses, and their degree of action. "Narcotics Restriction" is one listed, and your name and liscense number are posted.

EXAAAAAAAAAAACTLY. They are not thinking with RATIONAL minds often. Being addicted, they often cannot help themselves.

[TazziRN, RN]

Why aren't diverting nurses fired instead of rehabed? Because being addicted brings you under the umbrella of the Americans with Disabilities Act. In CA, the time you are in recovery and not allowed to work can be spent on disability as long as you are in a recovery program. As for ways to divert, when you want it bad enough, you will find a way. You will usually get caught, but that's not what's on your mind at the moment. Most of the nurses and docs I know that are in recovery (or still using) are in critical care or the OR, because of accessibility. Ways to divert are not the only things that shouldn't be posted: I have heard ways to beat drug screens that would curl your hair.

[OrthoNutter]

Originally posted by FullMoonMadness

We had a nurse do this. She logged out the prefilled Morhine syringes,withdrew the drugs and refilled with saline.She also had a bad habit of not logging out of the AcuDose.If you have ever been involved in an ivestigation reguarding missing narcs,the experience stays with you forever.Heads up.

Again, I have to ask....how does this happen and people not realise? I'm assuming that these syringes are like the pre-filled Clexane (enoxaparin) ones we have here...but even so, the syringe is enclosed in packaging so people would know if it had been tampered with. I'm assuming that the same precautions would be done with pre-filled narcs or how would you know that you were giving what originally came in the package?

We don't have any narcs in pre-filled syringes in my state. We have to physically go to the DD cupboard and sign the ampoules out, break the suckers and draw the stuff up. It's not all that time-consuming that I would see a need for pre-fills. All our narcs are checked by two nurses and we count each time the cupboard is opened. Maybe we're just more strict in our practice here....but this is just not an issue where I work.

[Scooby365]

Just a note to add to the subject from experience......I had an incident as a supervisor in a LTC facility. Facility had an off site pharmacy so we recieved a month's supply for every Pt. We had a nurse figure out how to replace the Tylenol 3's with regular Tylenol. I happened to be passing meds one morning and discovered it. On further look I found over 600 Tylenol 3's missing throughout the facility!!!! Well after hours answering questions for the DEC they told me I wasn't suspected....Yeah right...what an uneasy feeling. Luckily about 2 months later they caught the nurse doing it. What a nightmare that was.

[New CCU RN]

Originally posted by sbic56

Narc diversion is a big problem. I have been involved in uncovering occurances twice, so have learned some of the tricks used.

It is possible to withdraw the narcotic, replace it with NS and return it to the narcotic stock.

Anything that we get comes either in a vial, a prefilled syringe, or an ampule. The vials must have a cover, if they do not, they are wasted.

The syringes are prefilled but also come in a plastic container that if that seal is broken, they must be wasted.

Ampules, well I don't see how this can be done.

[sbic56, BSN, RN]

Originally posted by New CCU RN

Anything that we get comes either in a vial, a prefilled syringe, or an ampule. The vials must have a cover, if they do not, they are wasted.

The syringes are prefilled but also come in a plastic container that if that seal is broken, they must be wasted.

Ampules, well I don't see how this can be done.

The prefilled syringes sometimes come in pack of ten and can be manipulated with once the fisrt one is used. The packaging you describe ought to be standard, though.

[New CCU RN]

Ours come in a pack of ten... but there is still a plastic casing around it... if that is damaged in anyway, it is wasted.

[Rapheal]

Originally posted by jfpruitt

Wow. I guess it does look like I've posted alot about this subject. Maybe I'm sensitive to criticism and I should have been more detailed in my intent.

And I should have been more tactful in response to your thread. I apologize. It was not my intent to make you feel unwelcome on this board. I too, will be more detailed in the future in getting my point across in a more positive way.

[Tweety, BSN, RN]

Originally posted by jfpruitt

3rdShiftGuy I am appalled you would suggest I was becoming a nurse to divert drugs. Joking or not. The reason I've posted before is one of my assignments was to gather information about a paper on diversion. I would hope people on this board had enough sense NOT to post ways to divert. It sickens me to think that you and others think this was my intent. Maybe I'll discontinue Discussion on this board and just read from now on. Ughh....

Sorry, that was inappropriate. I know you aren't researching how to become a drug addict and I was joking. I guess some things you don't joke about. I also like Fab4's response below yours above.

I do think that in order to know what to look for in an addict, we have to know how they divert.

I heard of a nurse on another unit that actually had a hep lock in her ankle to give herself IV demerol that she stole from the hospital. That's serious addiction there.

[cokie]

please don't stop posting because of negative responses. everyone is entitled to an opinion. maybe if you are doing research you need to be clear, to be fair. as far as pyxis solving the problem of DIVERSION, this is not possible. i believe diversion by definition means that one is diverting something. diverting is still stealing, but at this point it is the pt. who suffers.

[OBNURSEHEATHER]

No, the pyxis does not solve the problem, it just makes every person that gets into it accountable for being in it. Leaves more of a trail.