Would you report possible diversion?

Hoosier_RN, MSN · Mar 20, 2016

This isn't true at all, certainly not in a right to work state. And when the hospital reports him to the BON (this is generally where the legal "mandate to report" is) -- the BON assumes everyone is an addict and sets the bar to prove that you are not very, very, very high.

Most facilities will only report you if that suspicion is so strong that they feel it's valid. To do otherwise can be construed as harassment, and opens a facility for a lawsuit. Many facilities offer an on the spot drug test. If you refuse it's instant termination, which then the facility may report you. Most don't bother unless they have another ax to grind. Have seen this scenario way too many times over the years.

Now, they can fire him for anything that they want to in a right to work state. As another poster stated, pharmacy will catch on if they haven't already

Emergent, RN · Mar 20, 2016

This person is off restrictions. When he was on them he worked a non-pt care job in the hospital. When he came off of them he came back to the ER. When he first returned, he talked frequently about going to meetings, ect. Now, not.

I work per diem at the hospital now. Ever since then, every time I work with him, he pulls this stunt. This last time he ONLY pulled the narc to be given by IM. He did not bring the antibiotic pill that was also ordered.

This time I acted irritated. He acted nervous because I told him I marked the med "prepared" in the computer. I questioned him about no antibiotic. I think he knows I'm suspicious. If he does this again I will refuse to witness.

meanmaryjean, DNP, RN · Mar 20, 2016

Not only have I thought about reporting, I have reported twice. A thorough investigation was made. Both times the person I suspected WAS diverting. Both RNs lost their licenses. This was their choice to make. The patients under their care have no such choice. I did the right thing.

dishes, BSN, RN · Mar 20, 2016

This person is off restrictions. When he was on them he worked a non-pt care job in the hospital. When he came off of them he came back to the ER. When he first returned, he talked frequently about going to meetings, ect. Now, not.
I work per diem at the hospital now. Ever since then, every time I work with him, he pulls this stunt. This last time he ONLY pulled the narc to be given by IM. He did not bring the antibiotic pill that was also ordered.
This time I acted irritated. He acted nervous because I told him I marked the med "prepared" in the computer. I questioned him about no antibiotic. I think he knows I'm suspicious. If he does this again I will refuse to witness.

I would report the signed wastes to the manager, it will trigger the pharmacy to do an audit. Since you signed the wastes it will look better if you come forward, otherwise if someone else reports it, you will be investigated too.

That Guy, BSN, RN, EMT-B · Mar 20, 2016

Report it to the managers. Let them follow up with it.

allnurses Guide · Mar 20, 2016

I agree with the above. He is targeting you because you are per diem and not there all the time, so he tells himself you won't be as wary of him.

I would trigger the audit and let him know next time you can't waste something you don't understand why was drawn in the first place and that you didn't witness being drawn. If he has nothing to hide it will be apparent. If he has something to hide, you may be saving several lives and lots of suffering, including that of the nurse himself.

NurseD2016 · Mar 20, 2016

Wow this is a hard question but an easy well too. It would be most acceptable to speak with the person about your concern. If that does not work then confidentially let the nurse manager know what has been happening and they will investigate.... H :)

lmccrn62, MSN, RN · Mar 20, 2016

I have done it. The hardest thing to do but the right thing to do.

TxDogMom · Mar 20, 2016

I agree with the above. He is targeting you because you are per diem and not there all the time, so he tells himself you won't be as wary of him.

Absolutely agree on this point. Refuse to sign wastes with him from now on. He'll figure it out. I'm guessing you're not the only one he is doing this to.

Kooky Korky, BSN, RN · Mar 20, 2016

You should not co-sign for him if you don't know what's in the syringe. Also, don't sign for anything you don't actually watch being wasted. Just tell him what you have noticed and how often. He might come clean and even welcome the chance to get help after being busted.

dirtyhippiegirl, BSN, RN · Mar 20, 2016

Most facilities will only report you if that suspicion is so strong that they feel it's valid. To do otherwise can be construed as harassment, and opens a facility for a lawsuit.

I'm IN my state's monitoring program. I think people who haven't been through it like to think there is an element of fairness or a process that would routinely separate, say, a spat of odd behavior or false accusations from true addiction.

macawake, MSN · Mar 20, 2016

If you had a strong suspicion of a coworker's diversion of narcotics, how you handle it?

If I had a strong suspicion that a coworker was diverting controlled substances, I would report it. If I had a weak, vague gut feeling type of suspicion that something was up with a coworkers' behavior, I would probably choose a watchful waiting approach.

He has a history of being on a restricted license.

I assume that the reason his license had restrictions placed upon it was that he was caught for or confessed to diverting narcotics and not for some other reason?

It would probably financially ruin his life to get in trouble again, I don't know how many chances they give people.

Well, if he is diverting/using again, that's on him. He is the one ruining his career, not you. You need to protect yourself (you might get implicated in this mess since he's having you co-sign his wastes) and you definitely need to protect your patients.

Is it really the right thing to snitch on someone like this?

As I've mentioned in some previous posts, I used to be in law enforcement prior to embarking on my nursing career. In my opinion, snitching is something that criminals do. It's not a term I'd apply to a nurse who reports a legitimate concern. Whereas I do think that we owe our coworkers both loyalty and support, I draw the line at enabling an addict and covering up for criminal behavior. Especially since diversion and addiciton may place patients at risk.

Off the top of my head, a nurse can have three reasons for diverting narcotics.

1. For his or her own personal use, either "just" off-duty or 24/7.

2. For the intent of selling the narcotics for profit.

3. To give to a family member/friend/acquaintance (either voluntary or because of coercion/threats).

I work per diem at the hospital now. Ever since then, every time I work with him, he pulls this stunt.

Is your coworker exhibiting any physiological signs of opiate intoxication at work?

Does he regularly do other things than draw and bring narcotic medications to help out with your patients without you having asked for his assistance? Like for example, pass the rest of your patient's meds, take and record your patient's vital signs, help with ADLs etc.? If not, his behavior is exactly as you have deduced, highly suspicious.

A person who has had restrictions placed on his or her license will be very much aware that management and coworkers will watch them more closely than they would someone else without that history. It makes no sense for a person who's free of his addicition to draw attention to themselves by behaving oddly around narcotics, if that was his or her previous vice. It would however make perfect sense if the individual had gotten hooked again, since addiction is a powerful motivator and caution is often thrown to the wind.

Emergent, I don't envy you your situation and I can't tell you what you should do. Personally, I would likely report my coworker in the scenario that you've described. Given his history and his present behavior, I would strongly suspect diversion. You/we can only hope that he receives fair treatment in the ensuing process, but that part isn't really in your/our control.

Good luck!