Would you report possible diversion?

[Emergent]

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?

Feeling conflicted...

[Kooky Korky, BSN, RN]

I agree that there is a need to be less public about this sort of thing. I don't think physicians are publicly humiliated like this, at least, in my state.

[Rose_Queen, BSN, MSN, RN]

I agree that there is a need to be less public about this sort of thing. I don't think physicians are publicly humiliated like this, at least, in my state.

All licensed professionals are treated pretty much equally in my state when it comes to being listed on the website for license disciplinary actions.

This is the disciplinary action against a physician:

This is the disciplinary action against a nurse:

I'd say that's pretty darn even public notice. I wouldn't say public humiliation- it's nothing but the facts. Not really any different than, say, court reporting about judgements and sentences.

[Oliver's Mom]

I would NOT co-sign for any (unknown) wasted medication in this scenario. For all you know, he could be setting YOU up by accusing YOU of taking the medication after it's wasted. And why would another nurse be medicating your patient anyway?

[foggnm]

If someone is drawing up narcs on YOUR patient when you didn't ask them to, then that is very suspicious behavior. But you should not hesitate in the least to report your concerns. Fortunately now pharmacy systems are so good that it is often easy to see when nurses are diverting drugs. You could also tell him "I didn't see you draw that up, so I can't waste with you." Don't feel bad for them just because they are a good nurse. Drug use has no place in healthcare, especially in the the hospital where you are doing things that can be very harmful to the patient.

[TriciaJ, RN]

Do not report him. If you do, you are likely not a good person.

I have a history of diverting IV narcotics. I was eventually caught because of a pharmacy audit. There was an investigation taking place while I was in a rehab facility and I didn't even know it. Almost all nurses who divert drugs are eventually caught and when they are caught, it is through a paper trail. For example, where I worked if a nurse pulling narcotics at a rate of three standard deviations above what is average for their unit, they get flagged and a critical eye is put on them. Eventually their addiction catches up to them.

If I were you, I would leave it alone. You could really be sabotaging him by demonstrating that you know about his diversion. When a nurse is diverting drugs, management will often try to rehabilitate that nurse as long as the nurses' peers have no knowledge about it. The moment that you demonstrate that you are aware of what the nurse is doing, management will assume everyone else knows and they will be much less likely to give that nurse a probably well-deserved second chance because they will be afraid of drama and rumor and so forth. It becomes a bigger issue at that point.

If you take the initiative by reporting, you are really doing some unnecessary harm.

This guy is already on his second chance. If a pharmacy audit doesn't turn up anything untoward, then they have nothing on him. But if he's relapsed, it's much better for him and everyone else that this be addressed. It's certainly not the responsibility of his coworkers to salvage his career when he is actively trashing it.

[TriciaJ, RN]

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.

It's never easy doing the right thing. But you did do the right thing. You gave your coworker another chance to get help. You protected patients. You might have even saved a life on the freeway that you'll never know about.

By all means talk to the employee health nurse, or your EAP. But also know you have a huge online community in your corner.

[JordanRose]

Do not report him. If you do, you are likely not a good person.

I have a history of diverting IV narcotics. I was eventually caught because of a pharmacy audit. There was an investigation taking place while I was in a rehab facility and I didn't even know it. Almost all nurses who divert drugs are eventually caught and when they are caught, it is through a paper trail. For example, where I worked if a nurse pulling narcotics at a rate of three standard deviations above what is average for their unit, they get flagged and a critical eye is put on them. Eventually their addiction catches up to them.

If I were you, I would leave it alone. You could really be sabotaging him by demonstrating that you know about his diversion. When a nurse is diverting drugs, management will often try to rehabilitate that nurse as long as the nurses' peers have no knowledge about it. The moment that you demonstrate that you are aware of what the nurse is doing, management will assume everyone else knows and they will be much less likely to give that nurse a probably well-deserved second chance because they will be afraid of drama and rumor and so forth. It becomes a bigger issue at that point.

If you take the initiative by reporting, you are really doing some unnecessary harm.

Nope. The harm is to the patients who are not getting their needed medications. I worked with a nurse who was given multiple chances to get clean (because she was a pet of the DON), and she failed every time. If you know you are diverting, than man up and get help for yourself. Probably better than to do that then to allow someone report you.

[Tenebrae, BSN, RN]

Do not report him. If you do, you are likely not a good person...... management will assume everyone else knows and they will be much less likely to give that nurse a probably well-deserved second chance ...... .

I tend to think that the person who steals medication is somewhat less of a good person than the one who reports their concerns to management.

As for well deserved second chances, in my country theft of medications is most likely an automatic dismissal, report to nursing council and likely criminal charges and loss of registration.

If a work place chooses to give a diverting employee a second chance it is a statement of kudos on that work place not because the criminal actions of the nurse, potential harm to patients and fellow co workers are somehow well deserving of a second chance.

As I write this I'm fully aware you may be taking the piss and out to see how much of a rise you can get out of people. I'd like to think that as opposed to the alternative and you actually may be serious

[wwd3569]

Absolutely!!!!!! If he's drawing up narcs for your patient he's involving you. You better be certain or be anonymous!

#thinkbeforeincludingme