Would you report possible diversion?

sjalv · Mar 21, 2016

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.

Please use the 'quote' feature where you can cite another member's post and subsequently write your reply.

I do not understand your logic. Refusing to witness something you did not actually witness is best practice. For all the OP knows, it could be Normal Saline or even water in that 3 mL syringe and the Fentanyl could be in the nurse's pocket.

gonzo1, ASN, RN · Mar 21, 2016

You need to do something about this right away. If you have signed wastes for this nurse you are going to be investigated as well as him because it is highly suspicious looking that these meds are being pulled out twice and one wasted. Even one incidence of this is highly suspicious. You will be investigated too when pharmacy notices this, and they will.

You have put your license on the line.

Farawyn · Mar 21, 2016

Uuugh, Emergent. You know what you have to do. I've reported this twice to management. It's very hard. But necessary, especially since your name is on it. It has to be you.

rnmaybe · Mar 21, 2016

Lots of times nurses that are diverting will work lots of overtime and take patients that may require lots of narcotics If their drug of choice is at work. Alcoholics will tend not to show up for work because their drug of choice is at home.

1sttime · Mar 21, 2016

Here is how you do it... draw up saline- tape an empty vial to the syringe- pocket the full vial. Waste. Score.

I tried many times to quit, but I could not say no to the extra shift, or when I actually did quit my job for 2 weeks, and the manager called an begged me to come back. I thought "I have quit for 2 weeks- so I must be able to go back to work without a problem". Wrong

Here is what I wish had happened-

1) I wish when I started diverting I had quit my job and moved on to another career- I knew it was wrong- but my addict self came up with reasons why it was right.

What happened was my diverting went from a little here and there, to enough to kill me... I didn't think I was impaired as I was still in the most emergent cases performing at a high level. One of the last things I did was get a line in a patient who two anesthesiologists could not get... Still, my cognitive tests at my substance abuse evaluation showed impairment in my ability to think. Now 4 years out I cannot believe I was so impaired, my mind is so clear now.

So definitely share your concerns with the manager- it is your duty to report this suspicion. If you do not this can go on for some time, until your coworker dies or hurts someone else.

Emergent, RN · Mar 21, 2016

I spoke to the pharmacist, he is going to start running reports to monitor this. He agreed with my suspicions.

RNdynamic · Mar 21, 2016

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.

Farawyn · Mar 21, 2016

1sttime, thank you. Great post, and glad you are doing well.

roser13, ASN, RN · Mar 21, 2016

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.

Why do I continue to be surprised at the convoluted logic? One of these days, I will learn to just not even go there with this poster.

flying_ace2 · Mar 21, 2016

Why do I continue to be surprised at the convoluted logic? One of these days, I will learn to just not even go there with this poster.

That's what I'm trying to do right now.......give. me. strength..........

Horseshoe, BSN, RN · Mar 21, 2016

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.

What a complete crock of horse manure.

RNdynamic · Mar 21, 2016

What a complete crock of horse manure.

Nothing personal against you, but with that statement, you're basically demonstrating that you are really ignorant. Care to expound?

Some (but definitely not all) hospitals will indeed take a rehabilitative approach to nurses who divert for the first time. Not everyone loses their job. Usually management wants to see the nurse has gotten treatment for their addiction, is in an assistance program, and basically demonstrates that they are trying to do the right thing after having been confronted.

However, it puts management in a harder position to do that when everyone on the unit knows about the diversion and starts talking about it. Not sure what's hard for you to understand.