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If my suspicions were strong and the NM did not believe me, I would make a call to the BON. I've done that.
No offense Taz, but that seems awful harsh going from the NM right to the board...Plus it now could make you intimately involved...You could be wrong (remember, hospital pharmacies can track Pyxis usage - info that you do not have)...You could damage a career and a reputation based on suspicions...Besides, many hospitals, once they find out someone is using on the job, can refer to EAP, or allow the nurse to SELF-report, keeping the situation confidential...
Good question, but can you clarify something for me? You said taking narcotics...do you mean you think they're stealing them or do you think they're consuming them on the job? Do they have any physical signs of being under the influence of narcotics?
If they're stealing...can't that be verified with Pyxis? Can an RN obtain verification from the pharmacy? If so, you can take that to the NM, right? (Still a student...feel free to correct me.)
If they're consuming on the job....I would go to that person with an approach like, "Your eyes have been blah, blah, your speech blah, blah. It appears that you're under the influence of something and I'm concerned for the safety of your patients. If you are willing to stop, I will be willing to let this be an issue for you to handle on your own. But, I can't ignore the compromise of patient safety."
No direct threats, but a strong message that you know something's going on.
No offense Taz, but that seems awful harsh going from the NM right to the board...Plus it now could make you intimately involved...You could be wrong (remember, hospital pharmacies can track Pyxis usage - info that you do not have)...You could damage a career and a reputation based on suspicions...Besides, many hospitals, once they find out someone is using on the job, can refer to EAP, or allow the nurse to SELF-report, keeping the situation confidential...
Not familiar with EAP, I've never worked someplace that has it. The only choices my two places of work have is the NM, and HR. That's why I suggested the BON. If the NM does nothing then the hospital probably wouldn't. Yes, we allow self-reporting here but it has to be offered by HR. And in CA, the investigation would be dropped if it's unsubstantiated. I stand by my opinion.
Not familiar with EAP, I've never worked someplace that has it. The only choices my two places of work have is the NM, and HR. That's why I suggested the BON. If the NM does nothing then the hospital probably wouldn't. Yes, we allow self-reporting here but it has to be offered by HR. And in CA, the investigation would be dropped if it's unsubstantiated. I stand by my opinion.
In my facility, EAP stands for Employee Assistance Program. It allows three confidential visits per calendar year to a facility contracted counseling group. This is at no cost to the employee. Heaven knows that in our profession it's easy to loose perspective amidst the chaos!
what would you do if you suspected a co-worker was taking narcotics? what if your nm did not believe you? would you confront the nurse? just curious how others would deal with this situation.
document, document, document.
keep a record of what behavior leads you to suspect your co-worker. make sure it is factual and does not contain extrapolations or suppositions. does he/she check out a lot more pain medications than other nurses on the shift? document that. do patients that he/she has medicated complain of pain even after being medicated? document that. but do not say that you know the nurse is taking the meds out of pyxis for his/her private use unless you have actually witnessed the nurse slipping narcotics into his/her bag -- and then document exactly what you've witnessed.
we all have learned that excessive time spent in the bathroom is one indication of possible narcotic use. it could also be a nurse whose ulcerative colitis or ibs is flaring up. we've learned to suspect our co-workers who are unnaturally sleepy. could it be someone who's been up all night caring for a sick parent, child or dog? or someone whose new allergy prescription is way too much for them? make sure you document facts, not suppositions or assumptions. is it that narcotics are disappearing when only the two of you are on shift? still may not be the coworker you suspect. years ago, i was in a situation like that. the other nurse and i suspected each other, but it turned out that the pharmacy was actually sneaking onto our unit while we were busy and making off with our narcotics! at another job, there was a brand new nurse manager when i started -- the previous one had been caught with hundreds of boxes of morphine carpujects in his office filing cabinets. (after months of investigation by the dea!) if your nurse manager doesn't take your worries seriously, go to her manager. if you've gone all the way up the line, then perhaps consider going to the bon. i don't think you'll have to go that far.
Others have asked good questions about the scenario you initially provided.
Each facility has policies/procedures to direct employees in matters such as these. If the NM will not listen, then I recommend a sit down with yourself, the NM, and perhaps the DON or VP of nursing. EAP is a great option in some places to get folks the help they need. I know, in our facility, its automatic termination using on the job. If the issue is under influence of recreational drugs (pot, etc.) which in most states is a misdemeanor, its still termination. As others have said, kinda depends on whether it's diverting or something else.
zumalong
298 Posts
What would you do if you suspected a co-worker was taking narcotics? What if your NM did not believe you? Would you confront the nurse? Just curious how others would deal with this situation.