Help here

[Gonesilent13]

I am not in the medical field so be patient with any miss use of terminology.

I am here because I have an issue with my wife who is a nurse. I am under the belief that she is diverting or taking meds from work. She is an admitted alcoholic/ addict who has been left untreated for the last 18months. She has had multiple relapses that I have accounted to drinking. I don't think it was alcohol now that I have found more evidence. About a month ago I found a vial of dilaudid in her work coat. There was only a small amount left in the vial. Two weeks later it was still there, then gone when I checked last night. Yesterday I was in her bag looking for tape and there was a used needle, empty vial of morphine, and a wipe that had been torn open then replaced in the wrapper.

I asked her and the response I got was extremely defensive.

I'm not sure what to do. Last thing I want is someone to get hurt if she's doing it. Is it normal to end up with narcotic vials,used needles, and wipes in your pocket at the end of the shift. Seems like there would be a protocol for disposal of these things. If nothing else I'd expect a nurse to toss the swap in the trash and the needle in the sharps.

Any help on standard practices and polices of hospitals would be benificial. I don't want to turn my wife in as that's a hard thing to do. I do understand the addiction side as I'm in recovery myself. I'm not expecting her to be perfect but left untreated someone will get hurt or possibly die.

Thanks.

[lovinlife11]

I once came home with a stool softener a patient had refused in my pocket. It shook me up.... No narcotic pain meds nor needles should be found in the pocket of your wife!

[FurBabyMom, MSN, RN]

I once made it halfway home with the set of PCA pump keys in my pockets. Totally forgot to return them to the pyxis. I'd verified PCA settings with a coworker on one of my patients PCA (new syringe) and checked on my other patients (still asleep but breathing :) ) one last time prior to report time, charted my 6A rounding on my patients and logged off the computer I was using. Followed very shortly by one of my coworkers rapid responsed one of their patients, a situation which went downhill quickly. Nothing like ending a shift with a code, helping to document that and transporting a patient to ICU... Followed by report. Luckily my day shift relief had had the same group of patients the previous day (she only wanted changes/updates not a full report). That would be the THE day I hadn't checked my pockets prior to leaving! Incredibly thankful it was only the PCA keys that had hitched a ride in my pockets leaving work.

I would agree with others...it should definitely not be happening frequently. I know coworkers and former classmates who accidentally left work without wasting some of a narcotic or benzo, but returned to work, wasted the remainder with a coworker and moved on. Usually something crazy happened at the end of their shift to get them off track from wasting (generally a code or something like that). I don't put used needles in my pockets or personal belongings. I have no reason to put any needles in my pockets either... I know where I used to work, they ran audits of times medications were pulled from the pyxis and what times they were scanned at bedside for administration as well as the time for any documented wasting of medications.

I would agree with others, it certainly sounds like your wife (original poster's) needs help. I don't know the best way to go about this though. I know the states I have been licensed in, the general public or family could report an issue or concern to the BON... But the BON in every state I've worked in takes narcotic diversion very seriously, as they should (they'd withdraw a licensee's right to practice until the investigation was completed). I don't know what would happen to speak to someone at her place of employment (manager, etc). I've seen these things cost nurses jobs and/or their license or restrictions... BUT, on the other hand that price is far less than someone else getting hurt because of a staff member's diversion. Particularly for the patients she'd care for and/or your family original poster. It certainly sounds like denial is an issue. I think you're certainly right to take it seriously.

[Callahan, RN]

I have accidentally left insulin needles in my pockets, but they were still in the original packaging... there isn't any acceptable reason that a "used" needle should make it home with a nurse. Those go straight into sharps, not in your pockets under any circumstance (that I can imagine).

As a student, I almost left the hospital once with a "refused" vicodin in my pocket. Thankfully I caught myself and promptly returned it to the Omnicell.

A partially empty narc bottle/vial should never make it home with a nurse. As stated before, partially used narcs must be "wasted" and witnessed by another RN.

I guess I could see how a completely empty bottle/vial could get left in your pocket, but as soon as the nurse discovers it it should go straight from pocket to trash... not into her/his bag or purse.... that is fishy.

I am a new nurse and still working on my time management and organization skills, so I am probably a bit more sympathetic to things being left in one's pockets on accident.

[Callahan, RN]

Also, at my hospital, Pharmacy is really on top of the usage and disposal of narcotics. If your wife's hospital is as watchful as mine, it is just a matter of time before she gets caught.

[Gonesilent13]

Thanks for all the helpful information. Denial has been the game for a long time. I wish she'd just go into a facility for 30 days and try and get right. Her fear of asking for help is that other nurses will know and talk bad about her. I had the same feeling for a long time as well. For me I just go to the point that I was miserable enough to not care. She was le go from her last job as a nurse manager. She always told me it was managment related Issues. Im begining to wonder if it wasnt somehing else. She's been a nurse for 12 years. She knows what's right by now. If I find another vial from her I'm turning it in myself. I should have snapped a pic of the other ones. I know I can't force he to get help but I am greatful for hearing how it's supposed to be done. She's very ****** right now about me asking. My response was not wrong being her track record, my deliver however may not have been on point.

[Marshall1]

On so many levels and from so many view points this situation is scary, unstable and is not going to end well. I hope, before she or anyone she is taking care of, driving around or in close proximity to is hurt or killed she gets help.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

If she is involved in an accident on her way home from work, there will be consequences with such questionable 'items of substances' in her possession. There is no way to explain an open vial or used needle in your pocket. Patients's rooms have sharps containers in them. It would be especially difficult for a recovering person to explain this as so many people believe that once found guilty at any point, you will always remain as the number one suspect forevermore, guilty or not. So, I would suggest having her take the offensive approach with her employer rather than wait until she's placed on the defensive side.

But on a more assuring note, hypodermic needles are in plentiful supply on nursing units and don't have to be signed out. So, I'm sure she's not using a needle that was used on anyone else. We all put unopened syringes in our pockets and carry them to patients rooms for different injections and I dare say no one walks out of the room with the used syringes.

I wish you well in your struggles. I worked in detox for 7 years as supervisor and I remember all too well the frustrations that families had to go through.

[carrimarie1010]

I agree with the above posts. There is no reason a needle would be in ones pocket even in an emergency situation it would likely end up on the floor. I just hope she isn't using and driving your kids around. Now that you have explained more... I understand your concern. I wish you could rationalize with her without having to turn her in but we all know how rational an actively using person is. I do wish you the best and will keep you all in my prayers.

[Cessna172]

For what it's worth, used needles are one thing you would never find in a nurse's pocket/purse. Unless it was for their own use. Drug addicts know how to lie very well, and can be convincing as to why the drug paraphenalia or whatever isn't theirs or that they have no idea why or how it got there. But the other concern, really the biggest one I am worried about for you, is that people die quite easily when they accidentally overdose. It happened last month to my friend. Now her young kids have to grow up without their mother. (I hadn't seen her in a long time, and was unaware she was hooked on pills). Do what you need to do to get her help, and if she refuses, protect the kids from being in the care of a drink/high parent. Good luck.

[jmo1231]

Gonesilent, it sounds like your wife is addicted to IV narcotics . I don't understand the dilemma with turning her in to get help. She needs professional help ASAP. She had alot of responsibility between her children and her patients and she's using drugs! What if she's high when she's driving the kids to school ? What is she makes a medication error at work and a patient is injured or dies while she is under the influence of drugs? I suggest you stop asking advice and call the proper people to turn her in because obviously she's in denial and cannot just stop using drugs based on your story. There's young children at risk and a waiting game is not an option.

[all_over_again]

So many people could be saved from this disease if it weren't for the weird way some facilities do wastes. In one hospital, the waste had to be recorded at the Pyxis when the med was taken out even though there wasn't any place to waste it. In another, the waste was done after the dose was administered. Some nurses have replaced the missing med with water or saline after using the drug themselves.

An empty vial would be cause for concern, but isn't proof positive that your wife is diverting. However, the used syringe and wipe makes it clear in my mind that she used the med herself.

No one has to know. You can insist that she get help and use some FMLA time. If that doesn't work, then you can resort to more drastic measures. Some people are able to recover more easily than others. Make no mistake, though: If she doesn't get help, she will die. I nearly did.

Good luck.

A_O_A

[HunnieBadger]

I have to agree completely with A.O.A., FMLA would be a great opportunity to heal without repercussions. With that said death is all too close if she continues this path, maybe not from an OD but our organs tend not to deal well with these heavy IV narcs over the long haul. Wishing your family a strong recovery!