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...

[BittyBabyGrower, MSN, RN]

It's a hard place and a rock for

sure. I have reported one co-worker when I worked in PICU, kind of the same thing, I was a fill

in and every time I worked this person would always ask me to sign for a waste that I didn't witness, which I refused to do. She finally stopped asking me. Two other per diems noticed the same thing. I went to the manager and voiced my concern and they did drug test the person, low and behold it was positive for benzos. I did feel bad, but sometimes you have to do what you have to do.

[Emergent, RN]

I've been advised by a former manager from our unit to alert the head of pharmacy of my suspicion so they can start scrutiny of this nurse's patterns of use in our dispensing machine. She's no longer employed by the hospital, but knows how things work.

[kbrn2002, ADN, RN]

As much as I am averse to possibly ruining a career with a false allegation this time it sounds like there may be something to this. Unfortunately I have to recommend bringing your concerns to management in this case. Especially as you have been witness to some of these questionable wastes. If you don't say something and the suspected diversion is discovered through other means you could at the least get pulled into the investigation and be put in a position of defending yourself for not saying something as soon as you suspected something was going on.

[Davidspeicher]

As an ER nurse with 25 years experience I would not waste with this person I would ask them why you were drawing medications up on my patient I would also discuss this with your nurse manager it sounds to me as though he is diverting medications I am a male nurse and I would never draw up medications on another ER patient without that nurses knowledge of me doing so. I also charge and I would not discuss this with other nurses only your nurse manager. The reason I would discuss it with the nurse manager is that they can track it in the Pyxis if you have one or whatever machine you use to draw it out of they will be able to tell if this is a reoccurring problem with this nurse doing this with other nurses too. If it is consistent with narcotics and only narcotics then it would appear to me that someone is diverting narcotics

[Davidspeicher]

As an LPN you probably have not worked in an ER as LPNs are not able to do assessments now with that being said ERs do not usually have any type of camera or block on their Pyxis or dispenser very machines as this would cause many problems if you had to keep overriding it during a code or in a situation where the doctor ordered more on let's say a burn or someone that needed more narcotics than usual

[Ard123]

Legally and ethically you should report him. However , there's a lot of gaps in the law and enforcement thereafter, and not reporting will most likely lead in no action against you even if he gets caught, unless you intentionally leave behind a lot of evidence connecting you to his crime (ie bragging or telling others of you not reporting your friend , getting caught red handed with diverted drugs yourself, taking money that can be traced back to you) only those sorts of evidence can ever be successfully used against you in the court of law. Otherwise, pleading the fifth and denying allegations with no physical evidence gets you off the hook of any wrong doing (if that is what you are afraid of). But back to the real question : will you or will you not report him? Well, that's up to you. Either way , he is probably going to get caught whether it be you or another employee.

[Davidspeicher]

Refusing to witness probably will not help as this will look like you are the problem again talk to your nurse manager let them know what is going on and how you feel I would ask this nurse not to pull any narcotics out on your patientS.

[elijahvegas, ASN, RN, EMT-P]

Yeah I wouldn't go so far as to call him out on it, but I would definitely say in ina very clear and direct manner "please do not draw up medications for my patients unless I've asked you to, ESPECIALLY narcotics" point blank. If you want to give him another more subtle hint drop in something like "you have a restricted license right ? It's not gonna look good for you if you keep having to waste narcs for no reason" that way he knows you've noticed, and might want to back off. Ethically the right thing to do is to report it but personally I don't know if I have the stomach to completely wreck someone like that, especially based on suspicion alone. I'd never lie for fora coworker, but I'm not sure how I'd handle throwing one under the bus, esp if they are as model-esque as you portray. And finally I'd top it off with something like "him not looking to get involved in some BON/Management battle if they decide to come down on you and want to drag me along too for cosigning."

After that, refuse to cosign any waste ever.

As a matter of fact, I don't think ill ever cosign for anything ill haven't witnessed when it comes to someone with a restricted license. Hate to be that guy but it's a little too close to the sun for my taste

[Hoosier_RN, MSN]

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.

And my bestie is in it as well so I have no misconceptions.

[djh123]

I don't quite understand what you're describing, but if you think he's taking (stealing) and/or using narcotics, you should report him. I reported someone recently, and in a way I didn't want to either, but felt like I had to. And he had been reported by others.

[dishes, BSN, RN]

I've been advised by a former manager from our unit to alert the head of pharmacy of my suspicion so they can start scrutiny of this nurse's patterns of use in our dispensing machine. She's no longer employed by the hospital, but knows how things work.

It makes sense that the head of pharmacy is made aware of diversion suspicions, as their scrutiny is what will determine the next steps. At what point will you speak to your current manager about the issue? The unit manager needs to be in the loop.

[Emergent, RN]

It makes sense that the head of pharmacy is made aware of diversion suspicions, as their scrutiny is what will determine the next steps. At what point will you speak to your current manager about the issue? The unit manager needs to be in the loop.

The current manager is an interim one. She fell into the job when the previous one resigned. She's pretty useless and I don't quite trust her to follow through or be impartial, since she, too, used to work with this fellow.

I suppose I should talk to her though. I'll wait until after I speak with pharmacy.