Narcotic use and diversion

[LivingDeadNurse]

okay i had to do a discussion paper for class on a nursing legal issue. This blog is for my nursey buddies that are already nurses or those that are just starting. I don’t think enough people are informed on this so here goes…my paper
Narcotic use and diversion in nursing is growing and is becoming even harder to identify. More training for nurses is needed to teach the signs and symptoms of nursing diversions. Drug abuse is the number on reason named by state boards of nursing for discipline action against nurses. Not only is this abuse but it’s also neglect on the patients behalf. Some nurses pretend to give the drug to a patient, preferably one that cannot speak for themselves, and take the drug themselves. I had wished that my facility had been more proactive on teaching us the warning signs of diversion and also the signs of nursing drug abuse, even if they are hard to spot. Stricter rules and regulations on accessing medications should be enforced. Unfortunately most places like long term care facilities do not have the newer equipment to avoid easy access. Being at one of those facilities I learned that my med cart was easily accessed and that was a hard lesson to learn. 32 Lortab were missing at the end of my shift. It was my cart and I was supposed to be the only one that had accessed it. The culprit was caught but only after drug testing, having my rites read to me by the police and 3 weeks of investigation, crying, sleepless nights and a full investigation from the nursing board. A fellow nurse while talking to me had stolen the narcotics from the backside of my cart, which opened from both sides. I never even knew she had had gotten them. I had to Protest against the old med carts and requested that they be replaced with better locking and one sided accessible carts, which we now have today. Reading other articles has helped me identify some of the diversion signs: Volunteering to administer medications for others, noticing that patients are not receiving relief from administered narcotics, frequent reports of waste, re-taped packets. Not to mention the physical signs: agitation, sedation, hand tremors and headaches. This nurse may offer to work overtime, but takes many breaks, tardiness, or many miss days of work. Most nurses are users not sellers and will use at work. They may inject the drug and administer the rest so that the patient shows some relief to keep down suspicion. The nurses need to be educated about narcotics use and diversion in order to report to the manager with their concerns. If they lack the education they may be helping the abusing nurse and are unaware. Narcotics need to be monitor and discrepancies should be reported. Don’t assume that the liquid narcotic is just off it could be diversion. This is your license on the line are you going to protect it? Please feel free to share your stories

[amberdouglas]

Maybe I'm just to naive to ever notice when it's going on around me, but the only experience I've ever had with a nurse that had diverted narcotics, was at a hospital I worked at about a year a half ago. The supervisor asked a bunch of us how we felt about working with a nurse that had her lic. flagged due to narcotic diversion. We all said fine, as long as she doesn't do it agian. Well, right after that a new new was hired onto the cardiac floor from 20+ years of OB...obviously we all knew it was her. About 3 months later, she was fired...go figure.

[Teeituptom]

Once you have stolen drugs, either by stealing them, or not giving the pt the full dose or by depriving the patients of their medicine. In my mind, you have crossed a line, you have violated a Trust, you have also committed a felony. Yes you are ill, but to me you are irrevocably damaged and your license should be gone forever. I do not believe in rehab. while I may forgive you of your actions you have crossed a line with me that can not be restored by you telling me that you are sorry, that you have an illness. That just does not work for me. God Bless you

[cali510]

I discussed a problem with discrepancies with one of my former supervisors who had been a nurse for more than 50 years. She enlightened me about a method or two used to hide the fact that drugs had been stolen, which really opened my eyes. I told her I was surprised that nothing about this subject was discussed in nursing school and we were not taught how to protect ourselves from accusations and from the actions of others. She gave me a lot of pointers on how to be more careful about signing out meds and accounting for them. She told me that she learned a lot of this the hard way over the years.