at work 3 weeks ago some (6 syringes!) of demerol were missing from the controlled med cabinets and last week our night shift crew (including myself) had to be tested because a demerol pca was missing when the count was done at 0300 since someone was leaving at that hour. everyone passed the drug test!
now we're having to be crash private eye detectives, everyone is held as suspect. something i really don't want to spend my time worrying about when i became a nurse, i've got peoples lives on the line.
so, if you have experienced narcotic drug theft at your work. what happened and how did you deal with it?
i have learned a lot from posting this thread. i have gained insight regarding culprits that may not be nurses (ie pharmacy techs) --- and why weren't they tested along side all of us nurses who tested negatvie?!!
i remember when i was just an aide and the icu nurse b stated one morning while we were walking up to the step down unit that he could only tolerate coffee as his illicit drug while at work, if he thought otherwise, he had the insight to know that his career would be finished!
one time i suspected someone diverting medication from the medicine count when her six patients in a row were requesting vicodin, how very odd is that! i thought to myself and in addition it was her last night working at our hospital!
in the case of the ativan, the only reason they suspected the tech was because ativan disappeared from another unit too. if she hadn't been so greedy, i have no doubt i would have been charged, as i was the one to sign it in and count it at the start of the shift.
Specializes in med/surg, telemetry, IV therapy, mgmt.
in all the years i've worked and in all the cases of drug thefts that were going on, it's always been a shock to finally discover who the thief was. usually, as their thievery gets bolder, or their addiction gets worse, they start getting sloppier and greedier about what they are grabbing.
the fact is that most who wouldn't even dream of diverting drugs don't even think about these things, which is why it's probably always a shock when we do hear about them. all you can do is always follow the rules. make sure you sign out every narcotic, get witnessing signatures when required and do end of shift counts if they are a part of your routine no matter what. outside of that, i don't feel it's ever my job to play detective. if i do witness something, however, i have an obligation to report it. i've been in ltc where some of the charge nurses wanted to blow off the narcotic counts on the excuse that they never gave anything out of the narcotic drawer during their shift. i wouldn't fall for that one--ever. some of the biggest narcotic crooks i've known of have been in ltc. they got away with it and were harder to find for this very reason of other nurses not keeping up with the narcotic counts.
got an interesting story, kind of old, but will illustrate the ingenuity of these crooks. very early in my career i started in ltc. we had an elderly patient who was addicted to demerol and got 50mg of it im every 4 hours round the clock. the pharmacy used to send us 30ml multi-dose vials of it, 4 or 6 at a time. we stored them in the locked narcotic drawer. one day, an astute charge nurse who was cleaning and straightening out the narcotic drawer noticed that something didn't seem quite right with the tin seal covering on one of the vials of demerol. it looked like it had been partially pulled off but had been pressed back into shape. she showed it to the don who notified the pharmacy service. they verified that this initial cover seal had indeed been broken and they discovered puncture marks in the rubber diaphragm of the vial. they tested the contents of the vial of demerol and found that it contained only a 50% strength of demerol. someone had removed the demerol and replaced what they took with sterile saline. putting two and two together it became clear that the patient's recent comments about her shots not working began to make more sense (most people just blew her off because of her addicted state). the culprit was an lvn who the don had hired about 3 months before, get this, with a known history of valium abuse. the don had hired this nurse after she had begged for the job stating she was totally rehabbed.
i also worked in one acute hospital where two nursing assistants had observed an lvn taking unit dose vials of demerol or morphine from the medicine cart and putting them into her bra. they kept this to themselves for a number of months because they were afraid to report it. this, folks, is what happens when subordinate workers feel like they are treated like second class citizens and have no self-esteem. anyway, they finally confided what they had seen to a young rn who they trusted and the case broke within a week. the lvn was escorted into a private office and asked to empty her bra and her pockets or be escorted to jail under citizen's arrest. she was taking the drugs for her boyfriend who was addicted to them. what she would do is go through all the medication sheets and target the patients who had prn demerol or morphine orders. by the end of her shift, every one of those patient's medication sheets would have indicated that they had recieved the maximum number of doses they could have had during the shift, given by her. she never withheld a dose from a patient, but collected up the unused doses and took them home. [in those days, our lvns often gave our medications for us, a job we gladly delegated to them.] she was falsifying patient records to do this. she was terminated. don't know if she was reported to the state bon or not.
From what I understand, it depends on office policy. Some offices will write for 3 months, some won't. At the end of 3 months, I'd go in and see her for med checks.
Sometimes it will vary state by state, and as I said, offices within the states.
I'm pretty sure that federal law prohibits giving amphetamines or narcotics over 30 days at a time, and each scrip requires a doctor visit, not a phone call. Is it actually my state law and not federal? The OP was talking about amphetamines.
at work 3 weeks ago some (6 syringes!) of demerol were missing from the controlled med cabinets and last week our night shift crew (including myself) had to be tested because a demerol pca was missing when the count was done at 0300 since someone was leaving at that hour. everyone passed the drug test!
now we're having to be crash private eye detectives, everyone is held as suspect. something i really don't want to spend my time worrying about when i became a nurse, i've got peoples lives on the line.
so, if you have experienced narcotic drug theft at your work. what happened and how did you deal with it?
am i the only one shocked that you had to take a drug test??? that is a complete invasion of your privacy and complete disregard to staff. i know that the saying "your innocent until proven guilty" has generally gone out the window, but this is insane. what next, a strip search at the end of each shift, just in case you didn't take anything? at what point did we become so passive and submissive?
In my area, we don't use those Pyxis things you guys do. We just have plain old carts for the non-lock-up drugs, and a locked cupboard in a code-locked room for the S4s and S8s (eg. lorazepam, valium, morphine, fentanyl etc). If we get a drug from the cupboard, we need two nurses to count the drug and sign the drug book and the patient's chart. Both nurses are supposed to go to the patient's bed to administer the medication (although that doesn't always happen). We also count all the drugs in the cupboard on the night shift. Maybe I'm not sneaky enough, but I can't even think of a way to steal drugs without getting caught here. Well, unless you never actually took them in to the patient...
EmmaG, RN
2,999 Posts