"Diverting" medications

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Specializes in Psych.

At what point does someone's license get revoked? How many places must they get fired from before they're permanently done?

I am so mad I could spit.......

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

details?

or are you just venting?

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

For someone's license to be revoked, his/her license number must be referred to the state board of nursing along with an allegation that violated one or more rule or regulations. Personnel from the BON will investigate the allegation and decide what action to take, if any.

So if no one has ever properly referred the diverter's license number to the state BON with a formal complaint, it is no surprise that licensure revocation has not happened.

In addition, most state BONs do not immediately revoke one's license. Discipline is usually progressive, starting with formal warnings or censures, then monetary fines, then mandatory remedial education, then probation, then limited licensure, then suspension of licensure, then revocation.

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And keep in mind that referral to the Board is often an employer function. Many people go from employer to employer getting away with everything they do or don't do. And other people have employers that get rid of them and then the employer notifies the Board with false allegations. Some employers will engage in both extremes.

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Specializes in Pedi.

The BoN doesn't track employees' job histories and the jobs they've been fired from. A complaint needs to be made with the BoN before a nurse's license is investigated. Since there are no details in the OP, we can't speculate on the scenario. How do you know why this nurse was fired from previous jobs?

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Specializes in Psych.
details?

or are you just venting?

It's a long, quite uninteresting story....I was just wondering what it took for someone to lose their license. Apparently quite a bit. It's just disheartening to say the least. Thanks for the replies.

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Specializes in Psych.
The BoN doesn't track employees' job histories and the jobs they've been fired from. A complaint needs to be made with the BoN before a nurse's license is investigated. Since there are no details in the OP, we can't speculate on the scenario. How do you know why this nurse was fired from previous jobs?

Of course I don't know why she was fired. But she was fired from a place that's notoriously difficult to get fired from (a teaching, magnet hospital with a solid union), as well as a pretty bad nursing home. I am speculating but also have observed several things AND been called into the DON's office to make a statement. But that will probably come out to be nothing which is, again, disheartening :(

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Specializes in SICU, trauma, neuro.

So have you caught her diverting or seen her acting impaired at work? Or are you speculating based on the fact that she's been fired from these jobs?

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Specializes in Psych.
So have you caught her diverting or seen her acting impaired at work? Or are you speculating based on the fact that she's been fired from these jobs?

I have seen her sign out dilaudid for a resident that is prescribed it PRN but never takes it for anyone else. He mentioned to me that he does not take it. She would sign it out to him every 3 hours, like clockwork. I have never noticed impairment, no. But then again I am quite green. All I know is management is aware of the situation and it's difficult to work with someone you can't trust as a nurse.....

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Just be 1000% sure that you do not witness, witness "wastes" or get involved in any way, shape, or form unless you actually SEE it.

I would think that if there is no supporting documentation on pain level, then after the medication pain level to support every 3 hour pain medication, then that would be a red flag.

People who divert are usually very good at it. Usually, they involve patients/residents who are confused, demented, and can't give an accurate portrayal of if they received their pain medication or not. So because there's no "proof" in this situation, they can be fired as opposed to any formal complaint against the BON.

It is usually very hard to prove unless there is a major error. And a lot of the time that comes with a nurse who declines to witness a waste that they did not see, or declines to witness the pulling of a PRN narcotic until they assess the patient's pain as well, most notably in LTC.

If management notices a pattern of one nurse continually giving a narcotic medication during their shift, and the patient/resident rarely needs narcotic pain meds otherwise, that is also a red flag. But again, a nurse could say that "no one else assesses pain" or some other excuse. Which could be feasible, especially in LTC.

Bottom line, cover yourself. Make sure that if you have this patient/resident (or if you are the medication nurse) that you are sure that you assess this patient's pain, make note of it, and make note if the patient declines the med if the patient states pain.

Be careful.

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Specializes in Hospital Education Coordinator.

In Texas you would be expected to turn this nurse in to the BON for investigation. They do not have control over the employer, only the license.

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I have seen employers cover for "med diversion" because they do not want the publicity.

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