Stealing drugs!! what's your opinion?????

Lemonhead · Nov 30, 2003

Originally posted by VickyRN
North Carolina... thanks for any information. I know that our State Board is one of the few--if not the only State Nurses Board--that is elected by nurses. Other states' boards are appointed by state politicos.

Let me see what I can dig up from my "research files.." I had researched and written to the NC board in reference to some major changes our boards are putting in to place with their diversionery programs and received a nice, professional letter from them...I didn't realize that the board was elected by other nurses..wow, that's interesting. In this state, they are "appointed" by the Governer after being referred...yeah, that's right, the Governer that doesn't have a clue about nursing.....

CCU NRS · Nov 30, 2003

I did not read all of the replies but I would liek to toss a word in. I have personally been responsible fo catching two people that were steeling meds.

the first was a nurse I followed after a night shift and she reported that she had given each of here Pts demerol three times because they were having so much pain. One was mostly out of it and could not be counted on to provide any information, the other was completely awake and alert. I just happend to mention his having had so much pain overnight while assessing him, he replied no I had a pretty good night. I checked the MAR to see if maybe she had been confused about medicating this Pt and sure enough she had charted medicating him three times. I called my supervisor and she looked into it. Later I found out they checked all of the MARs on the unit and found that she had charted giving demerol 50mg and 75mg 23 times to all the different Pts on the unit that had demerol ordered.

The second time I was working on the floor and noticed that one of the nurses was always jumping up to go give any PRNs that anybody called for, she sort of hung around the desk waiting for people to call and ask for pain meds and then she would jump up and say "Oh i will get that" I also noticed she was going to the locker room way too much. I told the charge nurse that she seemed a little funny about all of this. The charge called the pharmacy and asked them to check her record from there and see how many narcs she was giving. She had over the past three days gotten over 75 narc pulls from the pyxis mostly demerol codeine and morphine. They were going to question her about it but before they could she told the secretary that she having A REALLY bad period and was hemmorhaging and had to go. She left a taped report and it was about 2:30 she never returned to work.

Lemonhead · Nov 30, 2003

Vicky, these are a few of the links that I have from the NC laws--some of this is very lengthy--but I did give you the link of the "Controlled Substance Act" of North Carolina just to show you that just about every drug is considered a "controlled substance" when it comes to criminal law.

I couldn't find anywhere how it is handled in regards to criminal charges for a nurse that has been found to be stealing--it's very odd--some states file criminal charges, some don't--it's not clearly written on ANY state board site if they do or don't--I have only found out from writing to specific board employees--and even those responses are vague.

What might be interesting to find out, for your courses, is who all is involved in an "investigation" when a nurse has admitted to theft or is suspected..in the state of Ohio, they call in local law enforcement, the Pharmacy Board and of course, the nursing board. Even with that--there is no rhyme or reason to how the investigation is done--the police can drop it for lack of evidence, the Pharmacy Board and nursing board can pursue it and re-enter criminal charges if they feel there is evidence--they can also go directly to the County Prosecutor, even if the local law enforcement does not believe there is a case...so, I'd be curious to see how it is handled in North Carolina. The best way to find that info is to call a hospital, ask them from the first step to the last, how they handle a nurse suspected of theft. One of the most important things to understand, if criminal charges are pursued, they have to be proven "beyond a shadow of a doubt", with the nursing board, it is not criminal court, so there only has to be "evidence" indicating guilt...that's why I've said before, there are nurses charged with violation of nursing acts that truly may be innocent.

Another thing to educate nurses about, is that if they screw up in one state, it will follow them to any other state they are licensed in--doesn't matter where you screwed up--and since NC is a compact state, any violation would automatically be reported to the other involved states.

What I think is very positive in North Carolina, is they take nurses in to the confidential program on a case by case basis---some states automatically exclude nurses that meet some very basic factors -- for instance, the state of Ohio is trying to exclude any nurse that diverts...in other words, the majority of us that are in these programs...

This is probably more info than you want, but I'm just too in to getting the word out...let me know if there's anything else I can help you with.

http://www.ncbon.com/LicHelp-altern.asp#Criteria%20For%20Participation

http://www.ncbop.org/druglaw.asp

http://www.ncbop.org/ncbop22.htm

Lemonhead · Nov 30, 2003

Vicky, here's one I forgot that you might be interested in:

http://www.ncbon.com/Disc-DrugScreens.asp

Big Bab's · Nov 30, 2003

Originally posted by CCU NRS
I did not read all of the replies but I would liek to toss a word in. I have personally been responsible fo catching two people that were steeling meds.

the first was a nurse I followed after a night shift and she reported that she had given each of here Pts demerol three times because they were having so much pain. One was mostly out of it and could not be counted on to provide any information, the other was completely awake and alert. I just happend to mention his having had so much pain overnight while assessing him, he replied no I had a pretty good night. I checked the MAR to see if maybe she had been confused about medicating this Pt and sure enough she had charted medicating him three times. I called my supervisor and she looked into it. Later I found out they checked all of the MARs on the unit and found that she had charted giving demerol 50mg and 75mg 23 times to all the different Pts on the unit that had demerol ordered.

The second time I was working on the floor and noticed that one of the nurses was always jumping up to go give any PRNs that anybody called for, she sort of hung around the desk waiting for people to call and ask for pain meds and then she would jump up and say "Oh i will get that" I also noticed she was going to the locker room way too much. I told the charge nurse that she seemed a little funny about all of this. The charge called the pharmacy and asked them to check her record from there and see how many narcs she was giving. She had over the past three days gotten over 75 narc pulls from the pyxis mostly demerol codeine and morphine. They were going to question her about it but before they could she told the secretary that she having A REALLY bad period and was hemmorhaging and had to go. She left a taped report and it was about 2:30 she never returned to work.

Wow!!..that's alot of meds!!!.....Both these gals obviously needed some major "help" and you did the right thing!...no one is disputing that if there is suspicion it needs to be followed up on, I think the problem is HOW to go about it......Obviously, both these instances have theft issues, and that should be dealt with....but does that necessarily mean that these nurses are not salvagable???....I don't think so, but that's the big issue here....I personally think they should get the "help" they need and a second chance if they want it, of course it should require monitoring to confirm their continued sobriety.....Bottom line, you did the right thing....so, where should those nurses go from there???

Big Bab's · Nov 30, 2003

Originally posted by Lemonhead
Vicky, here's one I forgot that you might be interested in:

http://www.ncbon.com/Disc-DrugScreens.asp
Lemon and Vicky.....On the other side of the coin, the "monitoring Program" that I am in, is doing its best to get contracts around the state from all the hospitals, nursing homes, offices...etc. anywhere that healthcare professionals work....Our hospital is contracted with them, what this means is that the hospital pays $10 or 20$ (not sure which), a year per licensed professional on the payroll, and in turn, if a situation comes up all the facility does is call the "program director" who takes over from there, he/she will do an "intervention" and assessment, if the person is found to have a "problem" it is then outlined for them that they can 1) got to rehab and complete it, 2) then enter into a 5 year monitoring contract when they are released from rehab and go back to work......Now if the person decides NOT to go, THEN they are reported to the BON and go thru disciplinary action, suspension, treatment blah blah blah........usually the BON will send them directly to the monitoring program anyway....So basically your best bet, unless you've MASSIVE proof of NO problem existing and a lawyer to back you on it, is to go voluntarily, and finish your contract....and remain anonymous to the BON.......they will never know and your license is unblemished.....granted its not the greatest, but it is a far cry better from other states that "lock you up and throw away the key"!!.....there is always room for improvement, but at least this gives us the opportunity to get "help" without fear of losing all that we hold dear, family, career....etc...One interesting tidbit, this program is not just for nurses, we also have Drs, pharmacists, CNAs, nursing students, lawyers, pharmacy techs (I think thats everybody?)....and we all have essentially the same contracts, in some states you see that the nurses get much more harsh treatment than the doctors and here, we are all the same, kinda cool, huh??

LilgirlRN, ADN, RN · Nov 30, 2003

I used to work with a nurse a long time ago who was one of the best, smartest nurses I have ever known. Taught me everything I know about cardiac nursing. She would come to work with RX valium, vicodin and fastins and take them before beginning work. Another nurse and I went to our boss and voiced our concerns and we were told basically to mind our own business. Her behavior continued and we went to the boss of the intensive care areas, who just threw it back to my boss who put me on probation for insubordination. After he left and got a job elsewhere we found out he was sleeping with her. Since that time she has ended up turning her license in and has tried to commit suicide more than once. Her last attempt (that I know of) involved shooting herself in the abdomen with a shot gun, was on the vent, double barrel colostomy etc. She lost her mind, I wonder if things would have been different for her if she had gotten help when she first needed it? If you see someone who is in need of help, please don't hesitate to try and get it for them even if they don't seem to want it at the time. You may lose someone that is important in your life if you hesitate.

Erin RN · Nov 30, 2003

Lemonhead and Babs..Thanks for sharing your stories!!

One of my very best friends was an RN addict. She was caught and went through rehab, monitoring etc. She has been clean and sober for 12 years. She freely talks about it and although she has not used for a long time she will still say she is an addict. She knows what would happen if she "slipped" even once and is not ever willing to go back there. She is probably one of the best RNs I have ever worked with!!

I agree with Liligirl that we, as a profession know little about addiction. I have wonder if that is partly due to the fact that we are afraid of it? We have access and we see on a daily basis what a little narcotic can do for a person.

My mom was the administrator of a Care unit hospital..they had an entire wing dedicated to healthcare professionals and it was ALWAYS full...MDs, RNs,LPNs and Pharm. It happens, these people are just as educated and just as compassionate as the rest of us but for whatever reason they take the tumble.

I do not believe that banning them from the profession forever is reasonable. I do believe removing them from it while rehabilitating them and then monitoring them makes sense.

I am with Tweety in that addiction is a disease. Although that first pill, injection or drink is a choice..why do some go on to addiction when others are able to maintain??? I think the reason is twofold..external (environment) and internal (genetics). I am of the opinion that some individuals are more prone to addiction than others.

As far as those that feel that these healthcare professionals should never be allowed to practice again. If they have been rehabbed and have jumped through the hoops and are clean and sober, why not?? If we "threw out" all members of society that had, had previous monkeys on their back you might be suprised who would be in the garbage can. I recently watched a program on the discovery channel about JFK and his "doctor" that traveled with him..Did anyone else see that?

Tweety, BSN, RN · Nov 30, 2003

Originally posted by Big Bab's
I almost forgot, I say "sober and always will be" because I personally use Rational Recovery to maintain my sobriety....which teaches making a conscious decision to NEVER use again....it treats it as a behavioral issue, and makes ME accountable for my sobriety instead of me "relapsing" and blaming a fictional disease.....The disease theory has NEVER been proven and AA/NA use it to create a "self-fulfilling prophecy" with its teachings of "powerlessness" and non-accountability......BUT thats a whole other can of worms!......Anywho, used in this fashion it is no more reckless than someone saying "I will never drive my car off a cliff on purpose!".....of course you wouldn't, so why would I??.....Thanks for listening!...I do not expect everyone to believe in the same things that I do....The whole topic of addiction is very controversial at this stage of the game BECAUSE no one theory has ever been proven and that in itself makes it a very "hot topic"......Thanks again!!:) :)

Thanks for clarifying what you meant. That makes it clearer. I certainly am not going to open the can of worms you described. :)

Best wishes for continued sobriety and congratulations for the sobriety you have found.

bail · Nov 30, 2003

Lemonhead, thank you so much for your advice.........I take it very seriously..........a question, did you at any time ask if your urine was positive or negative at the beginning of things? and did you see a copy of it?

Big Bab's · Nov 30, 2003

Tweety, I gotta say that I am very impressed with your level of understanding and open-mindedness......in fact I'm impressed with most of the opinions expressed here in regards to Lemon's and my stories.......No matter how many times I tell it to a new person, I still never know what kind of reaction I'm gonna get...shock, awe, disgust, encouragement, anger, I truly never know, and because of that I always "hold my breath" waiting to that reaction.....It's nice, for once, to have people take it at face value instead of picking apart my sobriety because its "not the right kind of sobriety", I swear!!....people have really said that to me!!....wacky Huh!??!.......It really is a matter of finding a program that is inline with your own personal beliefs and values, and then sticking to it.........I agree that addiction more than likely has components that include genetics and environment, but to what extent??....is 90% genetics and 10% environment??....or the other way around??...or 50/50??.....There's really no concrete evidence to go by yet...which is why AA/NA needs to stop telling everyone, including the BON's and the court systems, that "it's the only way!"......Its just not true and I am evidence to that...the other thing is that AA/NA is SUPPOSED to gain members by "attraction rather than promotion", and they PROMOTE themselves to the courts all the time and people are then MANDATED to meetings that may be really helpful to some, but to others extremely harmful.....For some it goes against all they know and believe........its not right.

Tweety, BSN, RN · Dec 1, 2003

Originally posted by Big Bab's
Tweety, I gotta say that I am very impressed with your level of understanding and open-mindedness......in fact I'm impressed with most of the opinions expressed here in regards to Lemon's and my stories.......No matter how many times I tell it to a new person, I still never know what kind of reaction I'm gonna get...shock, awe, disgust, encouragement, anger, I truly never know, and because of that I always "hold my breath" waiting to that reaction.....It's nice, for once, to have people take it at face value instead of picking apart my sobriety because its "not the right kind of sobriety", I swear!!....people have really said that to me!!....wacky Huh!??!.......It really is a matter of finding a program that is inline with your own personal beliefs and values, and then sticking to it.........I agree that addiction more than likely has components that include genetics and environment, but to what extent??....is 90% genetics and 10% environment??....or the other way around??...or 50/50??.....There's really no concrete evidence to go by yet...which is why AA/NA needs to stop telling everyone, including the BON's and the court systems, that "it's the only way!"......Its just not true and I am evidence to that...the other thing is that AA/NA is SUPPOSED to gain members by "attraction rather than promotion", and they PROMOTE themselves to the courts all the time and people are then MANDATED to meetings that may be really helpful to some, but to others extremely harmful.....For some it goes against all they know and believe........its not right.

Thank you. I'd like to think over my lifetime I've developed an attitude of nonjudgemental openmindedness. Because as a gay man, expecting fairness and equality, I expect and preach the same to others.

The bottom line to me is that you are clean and sober today and are a functioning tax paying productive member of society again. You are the example that it is imperitive to get nurses help when they become addicted, whether they steal or not. Give them the opportunity to get sober and practice nursing again. But I certainly understand why more choice should be given. Thanks for opening my mind to that and for sharing what it's like to be you.

I subscribe to the idea that alcholism and addiction has a physical component that leads to behavioral issues, and thus can be considered a "disease". Thus you get things like the dt's when it's withdrawn. But it can definately be handeled from a behavioral model, as well as a spiritual model. I don't like the idea that AA preaches that get get sober one must get right morally. But it certainly does afford people a lot of peace of mind, and with peace of mind one is more apt to stay sober? Everyone should take a moral inventory, share it, and then go make amends to those he/she have harmed. Wouldn't that be a great world? But to force it on people as a way of recovery is wrong.

However, for habitual drunk drivers, nurse addicts, etc. I am in favor of mandating something because the public safety is at stake. Don't give them a choice. Get sober or loose your license.