Would you report possible diversion?

Nurses General Nursing

Published

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... :(

Specializes in Med/Surg, Ortho, ASC.
On your conscience be the consequences. Prepare yourself for the guilt that you may rightly have awarded yourself. :nailbiting:

Utter BS.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

*walked in, read RNdynamic's post* Hell no! *walks back out*

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
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 the.....................??? are you talking about??!!!

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Specializes in Hospice.
On your conscience be the consequences. Prepare yourself for the guilt that you may rightly have awarded yourself. :nailbiting:

This thread was doing just fine. Honest discussion, no snark, no flaming. Really refreshing.

And then you showed up. I honestly have no rebuttal to your absurd comments except to say "Wrong. You're so wrong". Are you high at this moment? Because your responses are devoid of logic and completely false.

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

I know it sounds harsh but you have to cya in this situation. You did the right thing for yourself and him if he is diverting.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I feel awful about this situation. For the nurse who may be relapsing. For the patients who may be being harmed. There have been nurses who have been found DEAD .....with NEEDLES IN THEIR ARMS in bathrooms, diverting medications. It is insane to suggest we just ignore it and not report because we "want to be good people". How would any of us feel if that nurse WERE diverting and overdosed? It's happened!!!

Addition is not a crime. It's an illness. One resistant to treatment, but can be treated. The addict needs treatment. I believe with all my heart t his person in full blown relapse from what you are saying emergent. You may well have saved a life. Or lives. Caring for patients while impaired, or driving home while under the influence, can kill, too.

RNDYNAMIC you continue to amaze ....that's all I will say.

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This is what I was thinking. If OP chooses to report it, do not preface it with "I think Nurse X is diverting because..." Simply state "I think you should be aware that Nurse X has been pulling narcotics for my patients without my request, and then asking me to waste them with him/her."

Let your manager draw his/her own conclusions.

Agree! Stick to the facts! Report what you know, not what you suspect.

I did report once; a nurse came to me (I was acting charge that day) and I turned it right over to the house manager. Very strange activity in our Pyxis. I never suspected anything based on behavior, I don't think anyone did. While I felt bad about the situation, I would do it again in a heartbeat. I liked the nurse a lot, hopefully they got help.

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Do you have a statute you can point to that states nurses have a duty to report drug diversion? May we see it?

In general, state law does not hold nurses responsible for ratting out diversion. Your own employer's policies may vary. Rather, institutions are often required to submit a report to the state for suspected diversion following an internal investigation, not nurses. It helps to know what you are talking about, instead of spewing out a bunch of boo-hooray like "Nurses have a DUTY blah blah blah dgnsdfklgnjsdlkgads."

Here's Massachusett's duty to report statute:

Public Health Regulations: Nursing Duty Conduct

Here's a federal duty to report regulation:

Title 21 CFR - Part 13

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Specializes in Telemetry.
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.

All right, everyone. Synchronized forehead smack on three...

One...

Two...

Three...

SMH!!!

That's about all I can manage right now.

I will say RNdynamic never fails to make me go WT....

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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

Not too many years ago, small community hospital, I did in fact work the ER. We do have a camera pointing right to our pxysis machine, and did require an override for too many narcs for one patient. We also have code carts that are stocked with medications for a code.

But story for another thread. The main point here is that nurses who divert use new, inexperienced, and or PRN nurses who may not know that you need to see a waste in order to waste it.

Much like anything else in nursing--you don't put your name on something you do not do or do not see. It can get you in the same amount of hot water as a nurse who is doing the actual act.

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On your conscience be the consequences. Prepare yourself for the guilt that you may rightly have awarded yourself. :nailbiting:

This is the addict in someone speaking. Manipulation into believing that by protecting herself (and yes, by names on wastes, she got involved in this) she needs to feel guilty or "bad" about reporting it.

No she doesn't.

Use, don't use, whatever--but don't involve other people. Own your addiction.

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Specializes in Dialysis.
On your conscience be the consequences. Prepare yourself for the guilt that you may rightly have awarded yourself. :nailbiting:

Why should his conscience have issues? I think of him protecting persons who were under the other nurse's care. You seem to take no responsibility for your own issues, which you have publicly acknowledged on this forum. The first step to recovery is acknowledging the problem and taking responsibility for the problem

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