We often read and hear about nurses, physicians, and pharmacists getting caught diverting drugs in health care facilities. Some have wondered after the fact, how could this go unnoticed? And how could this go unnoticed for so long? When it actually happens to a colleague, I would think the normal response would be picking your jaw off the floor. But, it does happen. That is a major reason why health care facilities employ monitoring programs.
The intent of this post is to share an experience about a former colleague, a colleague who diverted and was eventually caught. This situation happened several years ago. This colleague had been a nurse for a very long time, in her 50's, and married. Both made good money, and lived in (what I heard was) a beautiful home. At work, for the most part, she was very helpful in lending a hand, often smiling, and advocating for her patients. Life appeared good for her. And for the most part, she was a most excellent nurse. She looked after her patients, often speaking of them fondly.
However, in a relatively short period of time (let's say, over a period of a year), her baseline behaviors began changing for her. For the most part, it went fairly unnoticed and that all these behaviors were in fact connected.
1. Calling in every day off and offering to work extra if needed. If she was called in, after about a couple hours of work, she would then beg to be sent home (not feeling well).
2. Entering patients rooms not assigned to her or reading their charts/notes.
3. Offering to medicate patients for other nurses not assigned to her.
4. Getting into heated debates over the phone with physicians because she believed that her patients were not being medicated enough or properly, asking (if not demanding) more potent pain killers.
5. Offering to change a PCA machine medication for a patient not assigned to her.
6. Being absent for periods of time or needing to frequent the bathroom.
7. Complaining about her assignment at times, especially if there were not enough chronic pain or surgical patients under her care.
Now, this list of behaviors, in and of themselves, are not too terribly shocking. By themselves, we as nurses have often witnessed them in our colleagues during the course of our careers. By themselves, none raise up a "ding, ding, ding...red flag, red flag...something is happening here." However, when lumped together over a period of time, a picture does seem to develop. Often times, this picture only becomes apparent after the fact, after the colleague is suspected and caught. After picking your jaw off the floor, you may have a tendency to want to kick yourself for not seeing it while it was happening. Then, a normal response would be, "well, who else is doing it in the facility?" It is then that you come to understand why monitoring programs are in place and are necessary.
It does shake your confidence some as a nurse. It can also make one feel angry...for it almost feels like betrayal. A betrayal as to why that nurse was in the facility in the first place (an access to drugs), a betrayal to you as a colleague and as a professional (hmmm, how many times was I lied to?), and betrayal towards the patients under the care of that nurse (how many patients actually did not receive pain medication who actually needed them?).
Feelings of self abasement can often be experienced. "I should have seen this. If I had, I could have at least prevented this from happening or been instrumental in pointing that nurse towards help." Having mixed emotions about this occurring on your unit is often common. Our entire nursing staff was floored, if not devastated. When a nurse diverts, it hurts. It ends up hurting many persons around them...patients, as well as colleagues.
My ex-colleague who appeared as a model nurse got busted during a routine random urine screening. When asked for a urine sample, we had heard that she had declined. When pressured, she bolted. After nearly running over a hospital security guard with her car, she was apprehended in the hospital parking lot. When she and her car were searched, it was reported that they had found more than drugs on her person. In her car, she had various hospital supplies ranging from IV tubings and bags to small equipment. The last I heard about her was when I saw her name on a list of nurses who had lost their licenses (in my board of nursing's bulletin). She dropped out of sight then after.
Now, when I look back and think about her, I feel sort of sad. It still leaves me asking questions, however. How could this have happened to her? What initiated her drug use and how did it snowball into what it became? Why didn't she get help for this if it were available? Questions, always questions. I may never know the answers. In the end, when I think about it, it just leaves me feeling incredibly sad.
