Worried losing her license

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This is what happened. 

I have a friend who is employed by a Travel Nursing Agency and got terminated from the assignment facility. 

She was called for investigation by the Pharmacy team because of drug diversion after a month of the incident. She's working the night shift, exhausted, and nauseated at that time because of workload and 3rd night shift in a row, so she pulled out 1 blister pack (10 tabs) of Zofran from Omnicel without thinking what would happen. Though she didn't use and ingested it, she just drank ginger ale instead and felt mild relief. She brought the unused and non-tampered Zofran back home and totally forgot about it. 

The pharmacy team investigated her after a month because they saw her on CCTV. They said they are required to report the incident to the BON. She confessed to everything, told them what happened, didn't deny the incident, and what led her to do that without thinking. The pharmacy team even praised her for her honesty. The nurse Manager supported her and recommended keeping her in the unit. She returned to this Pharmacy team the unused, non-tampered blister pack of Zofran.  

They obtained urine drug tests and alcohol tests on that same day and of course, all were negative because my friend hasn't done drugs or drunk alcohol in her entire life. 

Right now, she doesn't have a job and her employer is supportive and told her that she needs to complete a clinical remediation. After, they will search and help her to relocate to find a new assignment, though they are already working on finding a new facility for her. We asked if her previous facility reported her to BON, but they said they didn't have any idea and would notify my friend if they got any updates. 

I'm really worried about her because she's not eating well and crying all the time because of that insident.

Specializes in ICU.

Thank you all for the insights.

 

Do you think she will lose her license because of this? Or what are the possible repercussions? 

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Specializes in Geriatrics, Dialysis.
Fatima Marei said:

Thank you all for the insights.

 

Do you think she will lose her license because of this? Or what are the possible repercussions? 

It's very unlikely she would lose her license.  Nurses that divert narcotics rarely lose their license and this is not a controlled med so I wouldn't think any state would impose a suspension or revocation over this . There will be some kind of punishment, how harsh that is I have not a clue as that will depend on the state BON. 

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She will be just fine, we pull zofran, Tylenol, IB, etc all the time for staff.  She could have even pulled from the In-House. But for the future tell your friend to have the DON or another nurse present when this occurs to witness and sign off if needed to protect herself for every having to worry or stress.

Tell your friend she will be just fine, stay positive and better things are coming. :)

it sounds like this place was just trying to find a reason to let her go or blame someone. 
she dodged a bullet.

remember, everything happens for a reason even if we don't understand it at the time, we will further down the road.

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Specializes in ICU.

Thank you for this positive reply Sharron though we are still not sure what will the Board decide. At least it made my friend calm which she needs right now especially since she's about to pop out. We are trying to stay positive despite of this and whatever BON will do to her. 

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Specializes in Geriatrics, Dialysis.
Sharron Hensley said:

She will be just fine, we pull zofran, Tylenol, IB, etc all the time for staff.  She could have even pulled from the In-House.

The Tylenol, IB and I assume the etc. you mentioned are all OTC, that's no big deal. Difference here is she pulled the Zofran which is an RX med so that should not have been pulled for personal use. Would be a gray area that she might get away with if she pulled from house supply if it was available and she has a prescription for it. 

It's not a violation that's likely to land her in monitoring but there probably will be some kind of repercussion since it is prescription only med. What that is depends on how harsh the BON decides to be.  State's have a way to access previous BON decisions, best bet to get an idea of how they would be likely to respond is to look and see what they have done in the past for nurses with the same or a similar offence. Guaranteed she's not the first nurse in her state to get reported for taking a non-controlled med from a workplace.

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Specializes in ICU.
sleepwalker said:

Why? It's not a controlled substance. She made a mistake, admitted it, and rectified the problem. IMHO, the BON will eventually get around to investigating and essentially determine it's not worth something worth pursuing. 

What kind of repercussions do you think?

What kind of repercussions do you think?

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Specializes in Vents, Telemetry, Home Care, Home infusion.

In my previous Manager job in PA, I was responsible for verifying physician and nurses license verification including checking board of nursing  (BON) monthly disciplinary actions.  It rare for this type scenerio to appear before the BON - unprofessional conduct for taking a RX med without an order to at worse--charge of theft. Suspect disciplinary action: ethics course  or medication administration course with monetary fine  $500-to sev thousand + permanent note on license. 

The American Association of Nurse Attorneys (TAANA)  has a referral service listing attorneys with experience appearing before BON --consultation might ease your friends mind re how your state may handle similar case.

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Specializes in ICU.

We couldn't find any similar cases like hers in her State. All are drug diversions of controlled/substance abuse drugs that undergone Probation with monitoring. 

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Specializes in Geriatrics, Dialysis.
Fatima Marei said:

We couldn't find any similar cases like hers in her State. All are drug diversions of controlled/substance abuse drugs that undergone Probation with monitoring. 

That's actually quite promising. If there are no similar cases, none have received any disciplinary action so it's pretty likely that she won't have any action against her license for this. 

 

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Specializes in ICU.
Nurse Beth said:

I agree with AnnieOaklyRN that it's serious from a BON point of view.

A urine drug test conducted a month later isn't necessarily helpful information, assuming they even tested for Zofran. Confessing after being confronted with a video doesn't warrant praise for honesty.

The BON will likely focus primarily on theft. If this progresses to the BON, suggest your friend take responsibility and refrain from using phrases like "unintentional," "totally forgot," and "without thinking."


Nurse Beth, does she need to fo self-reporting and just take the responsibility?

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Specializes in Tele, ICU, Staff Development.
Fatima Marei said:


Nurse Beth, does she need to fo self-reporting and just take the responsibility?

I know this is terribly worrying for your friend. Here's some things to consider:

Your friend may not or may not be technically required to report. I don't know. It depends on your state's BON's self-reporting guidelines. Some states have more detailed guidelines than others.

If the Pharmacy reported the incident, it may help her to self-report, and it would not hurt. It would show honesty and accountability.

If she does choose to self-report, it gives her a pre-emptive advantage. Include:

  • Why she took the medication, her physical state at the time and what she did with the medication afterward (returned it, didn't use it).
  • Her honesty: Mention that she admitted to everything and fully cooperated with the pharmacy team during their investigation.
  • Support from her manager: Include any statements of support from her manager, if applicable.
  • Actions she's taken since the incident, such as seeking additional support for managing stress, adjusting her work schedule, or any other corrective actions.

But I am not an attorney, my friend. I would take @NRSKaren's advice and consult with an attorney from The American Association of Nurse Attorneys.

 

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Specializes in M/S, Pulmonary, Travel, Homecare, Psych..
bluescoop said:

I'm not an expert on this, but I wouldn't think stealing a non-addictive and non-controlled substance would be cause for disciplinary action from the BON. That's good that she is supported by many people and praised for her honesty...not that there was even much to lie about if they have CCTV footage. She can talk to a nursing license defense lawyer for advice if she's that worried. Maybe see a therapist who has experience with this.

Diversion is diversion in the facility's eyes.  They, the facility, are liable for penalties and fines for allowing it to happen and for not properly monitoring medications (controlled or not controlled).  The thought process will be something to the effect of "She took Zofran today, what does she take when she has a back ache or migraine headache?". 

 

Some facilities let taking a Tylenol from stock meds slide.  Some don't though.  Whether the med was "patient specific" or stock med will matter too for, if it is patient specific, they are being charged for it but did not receive it.

 

Most facilities I've worked for would just terminate your friend.  Some will escalate it though and what the board decides is simply a matter of the mood of the person receiving the submission.  That too is what my experience has shown me.  How the BON reacts to such things varies much state to state (with diverting narcotics being universally shunned).  It also varies much (different from state to state I imagine) depending on what other things are going on at the time she is reported.  One day, your friend could get nothing, other days more.  You just never know.  Always best not to put them in a position where they have to make a judgment call on you.  Doing so can be a roll of the dice. 

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