If you had a strong suspicion of a coworker's diversion of narcotics, how you handle it?
I'm talking, a nurse in the ER who habitually walks into the room with narcotic drawn up on your patient, right after you medicated, so then you have to waste with him. He has a history of being on a restricted license. He's a great nurse, very experienced, works a ton of OT.
It would probably financially ruin his life to get in trouble again, I don't know how many chances they give people. He functions very well on the job. Is it really the right thing to snitch on someone like this?
The pharmacy will catch up to them soon. Drug testing is pointless because anyone can have a script for norco. Impairment is different than diverting. Impairment you tell mgmt ndiverting I don't get involved and I don't consign.
Diversion of narcotics pushes a very special button on me. I was once a multi-trauma courtesy of an airplane crash. I was out of work for almost a year and a half recovering and the experience had a lot to do with me ultimately becoming a nurse. I can think of no trust more sacred than the administration of narcotics to those in pain. I won't tolerate a thief; not even a little.
If you have suspicions, speak up. A urine test should show rather quickly whether your colleague is using narcotics or not. The fact that his license has been restricted in the past means he already knows better. If he's back at his old tricks, he needs to find something else to do because he's not trustworthy enough to be a nurse.
OTOH, if he passes the urine test, everyone ought to be confident that he hasn't broken the faith. So as I see it, the only way he loses is if he's actually guilty. But if he is, he's already had a second chance. There ought not be a third.
Do you have a statute you can point to that states nurses have a duty to report drug diversion? May we see it?
In general, state law does not hold nurses responsible for ratting out diversion. Your own employer's policies may
From NH BON under misconduct:
(e) Unethical conduct including but not limited to conduct likely to deceive, defraud, or harm the pubic or demonstrating a willful or careless disregard for the health or safety of a client. Actual injury need not be established.
Not reporting suspected diversion would fall under disregard for health/safety of a client.
Being conflicted is ok, however we have an ethical obligation to report this. You should report to your supervisor. I do understand that we want to believe we work with trustworthy people.
Why is he medicating your patient without previous assessment. If you had just medicated your patients, with an assessment, there would be no need to be preparing medication for that patient.
Controlled drugs must be witnessed. If someone comes to you to waste for them without you seeing that drug being pulled from the original container, you now become an accomplice.
On your conscience be the consequences. Prepare yourself for the guilt that you may rightly have awarded yourself.
This is the worst kind of goofy addict thinking I have seen in a long time. I know addicts better than most. All nursing and patient concerns aside, and those are many. The utter lack of personal responsibility in what you are posting is extraordinary. What you say is now getting unpleasant. The OP absolutely did the right thing. More should do so without fear of judgements such as yours. We aren't in a schoolyard telling tales.
Without intervention, this behavior will continue. There are multiple reasons for diversion and the cause must be addressed in order to stop this behavior. The IPN program does help. Therefore we must report this behavior.
I have helped nurses through this problem, and today they are doing ok.
Uh oh, another "bad nurse" topic. The reality is that diversion is not so common; this isn't Nurse Jackie. Our realities as nurses are so different than this and typically involve staffing ratios, resources and other non-personal issues that affect our work.
The pharmacy will catch up to them soon. Drug testing is pointless because anyone can have a script for norco. Impairment is different than diverting. Impairment you tell mgmt ndiverting I don't get involved and I don't consign.
I don't understand your logic. Of course anyone can have a script for Norco, but not everyone will have a current script for Norco at all times. Even if you happen to have a legitimate Norco script, that won't automatically make it okay to work as a nurse while taking them. The effect of the drug doesn't depend on if they are legitimately precribed to you, stolen from your employer or bought from your friendly neighborhood dealer.
Even if a person isn't working under the influence of narcotics/impaired, diversion can still cause harm to patients. If a nurse takes the narcotic medications for her- or himself and administer iv normal saline to the patient in lieu of the narcotic medication that the patient was prescibed for pain relief, the patient suffers.
I think that waiting for pharmacy to catch up, instead of reporting it yourself when you have a strong suspicion that a colleague is diverting, is a cop-out. Patients are placed at risk and it will take longer until the nurse coworker with problems gets a chance to turn their life around. I actually think that you are helping your coworker by reporting them.
@holisticallyminded
Uh oh, another "bad nurse" topic. The reality is that diversion is not so common; this isn't Nurse Jackie.
It likely happens more often than you think. Nurses and physicians work in a high-stress environment, the work can be emotionally draining and we have easy access to drugs.
Emergent, please don't feel bad about what you've done. Your coworkers' behavior left you with only one realistic course of action available to you. It's the one you've chosen. If your coworker has relapsed he needs help and his patients need to be protected.
I had a person that was a close friend. I never suspected diversion, guess I assume the best of people, but all the signs were there. I thought it was just cause we worked night shift and she was young and dating online and ... all the honest and possible excuses ... anyway one day she asked me to cosign insulin and almost fell asleep while I was doing the independent double check and after the patient and I raised a stink I had a little talk with her that i would not cosign anything with her not even insulin until she checked her priorities. I just thought she was overly tired. Anyway, a couple months down the road I was called to the carpet and asked why I had stopped cosigning for her...when I explained that her behavior concerned me and how I thought it was just her being young and trying to do too much, they had to decide if I was to be punished for not reporting my concerns.
I was so upset because I was not covering, it just didn't occur to me that she was diverting, in the end I was not in any trouble but could have been... cya and report your suspicions, why do you deserve to get in trouble for something someone else is doing?
Buck up, Why are you the one crying and upset? Why are you the one considering counseling (on your own time and unpaid no doubt)? Why are you the one worried about wrecking some drugpig's career? Why are you the one who must worry about "social repercussions) because this bozo is taken out of service? Why must you feel the need to feel anxious?
Listen, I have been directly involved in the end of two careers and probable end of one before it even got started (in RN school). because I was very sure of what I myself, I was dead-on right.
Those types do not belong in health care. As for their coworkers, would they really want someone of that ilk caring for their loved one? That is the way you must look at things.
Stop being sniveling and wishy washy, get pissed at the problems this selfish loser has caused. You have nothing to be ashamed or negative over. It is out of your character.
ponymom, you obviously have never known anyone who's life has been affected by addiction. Unfortunately, those types are more prevalent than you can even imagine, especially in health care. You just never know who that drugpig selfish loser is for WE WALK AMONG YOU (some of us are in recovery, some not). You sound awfully smug over then fact that you were "directly involved in the end of two careers." Good times. Pat yourself on the back.
I'm guessing you are one of those people who thinks addiction is a moral choice and a weakness of character rather than a disease? Do you also refer to diabetics as selfish losers?
manstat
33 Posts
The pharmacy will catch up to them soon. Drug testing is pointless because anyone can have a script for norco. Impairment is different than diverting. Impairment you tell mgmt ndiverting I don't get involved and I don't consign.