Nurses Diverting Narcotics.

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Today I caught a fellow coworker diverting narcotics.... she's an RN with a past history of doing this, but it couldn't be proven, not even with a pop up Urine screening. She had patients complaining about not being given the correct pain pill.... she's basically busted now.... so my question is, have you ever turned a fellow Nurse in for diversion of narcotics and how did it all turn out?

Specializes in Mental Health, Gerontology, Palliative.
Statistically, the addiction rate among nurses is the same as the regular population - 10%. And this includes nurses like myself who never diverted but are alcoholics.

Anecdotally, most of the nurses in my monthly monitoring meeting, the rehab I attended, and in an AA for healthcare professionals meeting I like who got nabbed for diverting were diverting wastes. Folks who divert from patients get caught pretty fast.

Not everyone who diverts also uses which can make UAs useless -- or they are diverting because the legitimate script they have isn't enough.

We dont have the opportunity fortunately. If its liquid preparation its counted down to the last ml and there are only so many times one could spll a few mls without it becoming obviously

If its sub cut or IV, I draw up the whole ampule and waste the extra down the sink with the water running while being witnessed.

I know I'm not going to steal the extra, its way easier just to do everything with a second check and have my bottom protected

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Specializes in MICU, SICU, CICU.

You won't. You won't suspect a thing until the level of addiction is so great that they stop caring about anything else. We both know how easy it would be to divert. It is always the last person that you would ever suspect. Some of the diverters who fooled me were a Sunday school teacher, a cop's wife, an organic farmer, two nursing supervisors, and a volunteer fireman.

Diversion is a lot more obvious with coherent patients . About four years ago I was pulled to tele and 5, yes 5, of my 6 patients had call lights on at once and wanted their pain meds now. The nurse I followed never even mentioned pain meds in report although they were signed off. It was pretty obvious that something was off. I heard she was terminated after a few shifts for diversion.

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Specializes in Geriatrics, Dialysis.

Count me among the wow am I naive bunch! I don't doubt that all these stories are true, I just can't wrap my brain around the desperation of addiction that would lead a nurse to these lengths. So very sad. I did work with a couple of nurses at different times that later lost their licences for diversion, I never suspected either of them of diverting at the time and still don't know if they were diverting when they worked with me. I can say they never seemed impaired in any way on the job. Both nurses ended up being fired, but if that had anything to do with diversion word of that never got out.

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I must admit I rarely watch wasting, I sign my name on the pyxis and jet out because I have other things to do. Then again I never sensed my coworkers diverted.

It's funny, you're the first person I've seen on this board admit to doing that. I don't know if the places I've worked and had clinical were anomalies, but nobody ever insists on watching someone waste meds. Not once that I've seen.

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It's funny, you're the first person I've seen on this board admit to doing that. I don't know if the places I've worked and had clinical were anomalies, but nobody ever insists on watching someone waste meds. Not once that I've seen.

I insist on telling the truth and not blowing smoke like I am some "perfect" nurse lol

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A lot of nurses don't watch lol. But I try to.

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In the 4 years I have been on my unit, 4 people have "left" for diverting or being impaired. Two of them I was there when they were escorted out. I never suspected any of them, and I am aware of the so-called symptoms. We also had a tech get fired for stealing from patients, but that is another story. You just never know...

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Specializes in Trauma/Tele/Surgery/SICU.
Most recently, I worked with one who would enter an order in the EMR for a Fentanyl drip. He would have a coworker sign for it. Then he would d/c the order in the EMR and keep the Fentanyl drip for his personal use.

Do not sign for receiving narcotics from pharmacy for any patients other than your own.

Wow! icuRNmaggie my stomach fell to the floor when I read this. I do this all the time. I always figure since I am going to pharmacy I might as well get whatever they have waiting to save others the trip. This NEVER occurred to me! Thank you for posting this. I will be changing this practice immediately.

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Specializes in Trauma/Tele/Surgery/SICU.
If hospitals would provide the necessary support, nurses might actually be able to witness waste when the med was withdrawn from the pyxis. A charge nurse should be available for witnessing narcotic waste. It is also really inconvenient when the med room is located far from the nurses station in a large ICU or ED.

I don't know how many times I have had no choice but to remove a 2mg dilaudid carpuject when all the patient needed was 1mg because no one was available to witness narcotic waste. Then I would have to ask a coworker to witness the waste at a later time, or vice versa, I am witnessing the waste of something in a syringe for a total stranger who may have easily diverted the medication. If audited, it would look suspicious that we did not waste the drug when it was removed from the pyxis.

Rather than stock 1mg doses of dilaudid and versed, hospitals stock 2 mg doses. The lower doses are available from the manufacturer. I have asked about this and I was told that "there isn't enough room in the pyxis to stock both." Having to waste narcotics constantly is not an efficient use of a nurse's time, especially in very busy understaffed units.

These are systems problems that lead to nurses becoming lax about witnessing narcotic waste and that make it very easy for a diverter.

These are excellent points! I did not realize dilaudid and others narcs were available in 1 mg vials. I also routinely pull out a full vial because no one is available to waste. 1mg vials would really be convenient.

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Specializes in ninja nursing.
Tacomaster has answered my question. I guess it's good that I've never heard of that in almost 23 years of nursing. And here I thought I've heard of/seen everything.

Just when you think you've seen and heard of everything. I keep meaning to make a post entitled The Strangest Thing Ever To Happen To Me As A Nurse Is...

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Very insightful post. I am neurotic about watching wastes carefully and making sure people wasting with me physically see me waste. You NEVER know. Some of these stories are almost unbelievable but of course happen every day :(

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Specializes in Flight, ER, Transport, ICU/Critical Care.

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