Suspicious of nurses and possible drug use?

medpsychRN · Jan 28, 2005

Be careful...very careful. This is a serious allegation and without proof can come back to haunt you. I have worked with nurses who were recovering and when they diverted narcotics, it wasn't by lying about wasting. There used to be 2 tenths of a cc on top of the stated volume in injectable narcotics. One nurse just helped herself to the extras! There are many ways to steal drugs. Managers are usually aware of such things. And yes, people get caught.

Tweety, BSN, RN · Jan 28, 2005

I would bump it up the chain of command. This is a management problem. Be sure to be specific and not say things like "she goes to the bathroom a lot, and smokes a lot". Get your ducks in a row and report your suspicions and ask to remain anonymous.

A coworker of mine got reported for suspcious behavior when she always took a little bag to the bathroom with her every four hours. Turns out she was self-cathing.

Good luck. If you and others think there's a possibility, then you have an obligation to talk to management about it.

medpsychRN · Jan 28, 2005

I'm wondering if there are other behaviors beyond using the BR frequently or smoking? Substance abusers have other symptoms eg, frequently call in, errors, forgetfulness. I'm taking a diuretic and always in the BR LOL!

bargainhound, RN · Jan 28, 2005

Consistently document the behaviors with times and dates and forward to manager for follow up. The problem can be addressed through work performance and dependability and the job description.

carolbo · Jan 28, 2005

There must be a contact person in your organization where you can go and talk to get it off your chest

Ask that person to listen to you and tell them you dont want any consequences

Just tell them you want to get it off your chest as it is bothering you and interfering with your work

And I am sure you will feel better and the problem will appear much smaller and also will get sorted out very quickly

carol

southern_rn_brat · Jan 28, 2005

I am a nurse in recovery. I also had a similar problem with a co-worker. As an impaired nurse myself I just KNEW the behaviors...the frequent breaks, "dropping" pills and having to waste them, wasting meds without a witness, ALWAYS giving every prn med possible...etc etc etc. I was reluctant to say a word to anyone because I didn't want to "point the finger" at an innocent nurse.

I had the opportunity to discuss this one day with 2 members of the BON and asked their advice. What they told me shocked me. I am BOUND by my nurse practice act to report ANY suspicious behavior. What they told me was that IF the person truly is innocent, nothing will come of it and they will become more conscious of their actions (for example, we KNOW not to waste a med without a witness). But if I do NOT report it, I am legally liable if they were to really be impaired and someone gets hurt.

If you have a company that has employee health, report this to them and they will take care of it from there. If you don't, you can log onto your state's professional assistance program website and report it there. It is confidential and you just might save lives.

I know, for me, that I wish someone HAD reported me long before it actually happened.

SmilingBluEyes · Jan 28, 2005

I am a nurse in recovery. I also had a similar problem with a co-worker. As an impaired nurse myself I just KNEW the behaviors...the frequent breaks, "dropping" pills and having to waste them, wasting meds without a witness, ALWAYS giving every prn med possible...etc etc etc. I was reluctant to say a word to anyone because I didn't want to "point the finger" at an innocent nurse.
I had the opportunity to discuss this one day with 2 members of the BON and asked their advice. What they told me shocked me. I am BOUND by my nurse practice act to report ANY suspicious behavior. What they told me was that IF the person truly is innocent, nothing will come of it and they will become more conscious of their actions (for example, we KNOW not to waste a med without a witness). But if I do NOT report it, I am legally liable if they were to really be impaired and someone gets hurt.
If you have a company that has employee health, report this to them and they will take care of it from there. If you don't, you can log onto your state's professional assistance program website and report it there. It is confidential and you just might save lives.
I know, for me, that I wish someone HAD reported me long before it actually happened.

Thank you for your candor and the guts to tell us this. I salute you.

Antikigirl, ASN, RN · Jan 28, 2005

Man, my staff must really think I am on drugs if smoking and frequent trips to the bathroom are s/sx! LOL! I do smoke, however...wish me luck, 10 people at my work are trying to quit, and I am cutting back so I can be in a better position to quit myself (cold turkey hasn't worked 3 times on me, so I really have to plan well so I will quit and stay quit!)....so oh my...I will soon add 'munchies' to my list (we all have been using low calorie snacks or lifesavers as diversions), and general numb mind and quick temper from the withdrawls! I am really in deep water if someone was to go by those s/sx alone! I also drink LOTS of water and tea at work...so bathroom...yes I know it well! LOL!

You have to have more than those symptoms in order to assume someone may have a problem with alcohol or substance abuse. I mean...the things I mentioned are very valid, and someone can say that to easily explain the s/sx you are using!

Also, logically look at your waste with no witness situation. Okay that is an error and should have been reported at the time, or should have documentation to the fact the med was wasted with the witness signature on it. If not...maybe hard to prove at this point. Some folks, even good folks, will CYA from such serious accusations by saying"...oh no, I gave it to the patient...where did you get the idea I wasted without a signature?" Then oops...ball is in your court to prove... A tricky situation!

And also, look at the med in question. I have had to investigate these situations time and time again, and I found that most nurses are generally quite smart...and know that taking one narc isn't worth their licenses, especially a common narc like vicodin or the like. One pill...that is usually an error, a whole card...now that I would be concerned about. Check the patient too, if you feel someone may be pocketing meds a little at a time, then your patient will be suffereing from pain or anxiety because they didn't get their meds..that must be seriously noted and documented or you don't have much to stand on! Again another situation that you were being too quick to judge and the ball gets back into your court for more proof!

Yes, be very careful with the accusations...make sure you have everything fully documented before you go to managment. And to tell you the truth, something simple as a med error or nonwitnessed waste can have many rational reasons behind them, but are still an error..that should have been reported at the time you found out (again with proof) so ian investigation into the probelm should have happened right then and there! Even a shift afterwards is too late in some cases...so call it when you see it, and don't make an accusation, just say you noted a med error and that alone can start an investigation by someone even if you don't see it happening (most cases you can't let anyone know an investigation is underway because then the word is out and the accused won't dare do anything then...so many times it looks like nothing is being done, when it really is and they are waiting to catch someone in the act for proof...so making a fuss can actually backfire on that investigation...).

meownsmile, BSN, RN · Jan 28, 2005

All you can do is document or report any problems with meds. If they are having to waste without witness, reorder dropped/wasted meds someone in the pharm is probly seeing it to. If not the person you report it to can easily check pharmacy logs.

I have suspicions sometimes of people i work with but i can only report what i see. Instance at hand, a patient was ordered valium PO for prophylactic DT's and i had to order a dose first thing one morning because of patient symptoms. Come to find out, which i knew they had probly sent some down before pharm closed the night before,, they had send 3 doses, one documented given to patient, and low and behold none in the patient cassette. Hmm, wonder if pharm made a mistake, did they drop the missing doses and have to waste them, put them in the wrong cassette? I dont know,, but i still had to report it and run to pharm for the patients dose. It's up to someone else to watch for patterns. Eventually they get bold and are more comfortable diverting meds and they DO get caught.

vortex72 · Jan 28, 2005

I'm a recovering RN. Just recently completed my 3 year contract in proffessional assistance.

There are many addicts or potential addicts in the medical field. Basically, all you can do is gather information and report the information to your superiors. I can almost 100% guarantee that confronting the person will get you nowhere, especially if they are using because the denial and self preservation are acute.

I diverted for around 4months and was never confronted or actually "caught red handed" This rarely happens unless someone OD's in the bathroom which is a tragedy but it does happen more than you would think. I got caught by the pharmacy records when they did a quarterly review and found I withdrew more narcs than anesthesia one night!

I cooperated with the inquiry and went into the impaired nurses program. I've been clean around 4-5 years to this day.

An addict wont stop until they are ready. The only time I would recommend forcefully confronting the person is if they are obviously impaired and you fear for their patient's safety.

Shell5 · Jan 31, 2005

Thank All Of You Very Much. You Have Given Me Good Feedback. It Gives Me Lots To Think About.