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?
I'm feeling very tearful and upset about this. I was actually considering going to talk to the employee health person about this, unheard of for me. They offer some confidential counseling I've heard.
Not only do I feel like I'm wrecking someone's ability to earn a living, but I am paranoid about the social repercussions for me if word gets out that I turned in one of my own. I feel very anxious.
I am a nurse in recovery. The person who reported me may have saved my life, and certainly changed it for the better. I would report any nurse I felt concerned about. The hospital will drug test the nurse and if there is cause, report him to the board. Without consequences a using addict will continue with the same behavior. Patient safety aside, your reporting your concerns may be just the push he needs to get help.
All actions have consequences. You have every reason to be feeling the way you do.
Ok, again, I should just step away from the keyboard, but honestly
I don't give 2 squirts in a firey place if one abuses substances who has no connection to me but to work with me. Compassion, yes, but otherwise, I am not the addict whisperer. It is a disease process that one has to accept and choose to seek treatment for, which works or doesn't.
A seasoned addict will twist everything around so it becomes YOUR fault they use, they were caught, they were not caught, should have known, should have done.....
I go to work to work. Not to second guess what the heck anyone else is up to or not up to. But one brings my jaded butt into their hot mess the moment you start involving me and my livelihood in wasting saline nonsense, attempting to remedicate my patients....please, enough already.
Then to top it all off, making someone feel guilty for then protecting themselves and their patients is way too much. Get a grip RNdynamic, and stop involving others in your addiction process. You can't honestly think "no one knows" and we all have to be silent. This isn't a crime family.
It is Ok Emergent to say you did what you did to protect yourself and your license and the patients under your care. Which is the right thing to do.
Do we really treat them with as much care and compassion as someone who say, has cancer. Even if they relapse? Probably not. There are aspects of addiction that are hurtful (lying, stealing and so on). So it is not exactly the same. It is a big ask to be treated the same. We don't have cancer and we do morally repugnant things. It's a fact.
I agree with lot of what you said and it is fantastic to hear about people successfully going through recovery.
However, I absolutely think that nurses who are addicts should be treated with compassion, exactly the same as someone with cancer. Exactly the same as a runner who requires early knee surgery. Or a person who has always smoked and has lung cancer. Or someone who has committed a crime, or someone who is homeless or etc etc.
My professional opinion when I am in nurse mode is that I am not there to judge but to give compassion even when it is difficult. In my personal life, I try to do that but think more about each situation. In fact, if I were to judge (which is pretty natural), I would probably feel more sorry for the addict than the cancer patient as the addict will have the added burden of blaming themselves and seeing the aftermath of their actions.
It isn't a big ask to be treated with equal compassion, Dolce Vita.
Report it to your superior. Let them handle it. If they suspect impairment, they have every right to draw a tox screen. By continuing to waste with this person, you are enabling them, if indeed he is using.
the scenario described that noone had any way of factually knowing what you had in that syringe, and that's why they shouldn't witness. My question is what is the factual, DOH approved way to you do if you are legitimately in that situation?
the scenario described that noone had any way of factually knowing what you had in that syringe, and that's why they shouldn't witness. My question is what is the factual, DOH approved way to you do if you are legitimately in that situation?
Most of the time a peer will approach you to waste with them, from the Pyxis/Omnicell, to drawing up, showing the amount they are given, to the room, and then they co-sign and waste; that is what we do where I work-I work at a Level I Trauma PediER; in an emergency it will be different, but there are still protocols to still waste and witness while an emergency happens.
The situation presented here was that the nurses here won't witness waste of something in a syringe if they don't know what it is. It's not realistic to call another nurse to witness every time you fill a syringe, in case you have to waste it.
Out of curiosity, If you were a nurse that legitimately had to waste a syringe of narcotics that you had drawn, how would you properly do it?
Follow your hospital's policy. Which is to open the vial in front of another person, draw the med, and waste the med without leaving that person's sight.
A lot of nurses trust each other and just cosign wastes to save time. Never do that with someone you don't know or trust, because it will bite you on the butt.
As I read these replies, I am compelled to write a response of my own. I am an RN. A few years back, I fell into the death watch that is addiction. Hopelessly lost, I was. I, like many other healthcare professionals, patted myself on the back for getting away with it for so long, completely oblivious to my own obvious and telling actions. I can almost promise you that this guy has all the markers for using. I too worked every scrap of OT I could get. Had younger, inexperienced, or part timers sign for wastage. (NS, usually). Shameful though it is to admit, I even left many patients with a tiny fraction of their medication dose, so I could have that little bit more.
My co-workers knew, beyond a doubt, that I was diverting for my own use. Accidentally left a syringe in the staff room, with morphine remnants and blood on it, got caught fidgeting with PCA pumps that later turned up short of solution, etc. I was spoken to, warned off, and so many times promised myself that I was done with it all after such close calls. Unfortunate that it doesn't tend to work that way...
There are some great comments here, and also some very ignorant ones. What needs to be said is that nobody CHOOSES to become an addict. Nobody brings their addicted uncle to school for career day. We all think we have it under control, until one day...we don't. Very, very few addicts will ever get help before being forced to! Though he may be very angry, and quick to blame everybody for his down-fall, I promise that he will, at the same time, recognize the part you played in helping him to regain some control over this mad disease!(To this day, years later, my mind instantly thinks, "b#%*h!" when I think of the one nurse in particular who kept an eye and reported her suspicions, though at the same time, I am so very grateful to her for starting the process that eventually led to me being a recovering, rather than active, addict!)
Please, try to realize that deep inside, maybe even sub-consciously for some, most addicts are secretly praying and hoping to get caught! You did the best thing for all involved, in my opinion!
clee1
832 Posts
You did the right thing, for ALL involved.
Rest easy, Nurse.