A Nurses Responsibility: Report Possible Narcotic Diversion

This problem affects all of us - the patients, the coworkers, the families. I have seen it all through my career. It seems easier to be silent. By being silent we enable. That is not helpful for anyone. It just perpetuates the problem. Nursing boards are aware of the problem and are supportive. Employers have treatment programs. This is a problem that cannot be ignored and needs to be taken seriously. It affects our integrity as a profession. It destroys trust with patients. The longer the behavior (drugs, alcohol, or both) goes on the harder it is to change. This problem is not going away. Attitudes have to change. The silence has to be broken.

The first time I witnessed/discovered drug diversion by a fellow nurse, my first instinct was to ignore it. I could not believe the obvious. A nurse, who I liked and considered a friend, was taking narcotics signed out for a pt. There had to be a mistake. There was a logical explanation. She wouldn't do that. I was mistaken. How could I think that of my friend? Of course when I questioned her about it she played on all of my own reservations and denied it.I didn't report it for 24 hours, and that could have cost me MY job.

The rule for reporting drug diversion that you personally witness is pretty cut and dried. However, what about a situation where you overhear a conversation in which a co-worker tells another co-worker that they think someone is diverting? Or what do you do if the information is third or forth hand, like when someone says, that someone says that someone says that so and so is diverting?

The IMPAIRED nurse must do this, the IMPAIRED nurse must do that....what a label!!! I thought "impaired" meant when one is actively under the influence.Frankly, I do not appreciate the BON's treatment in most cases of addicted nurses. What happened to the nurse's HIPPA rights? Why is everyone on the unit, and everyone they decide to tell, now aware of the nurse's "disease"? How can the board force someone into a support group, the majority of which are 12 step programs that say ABSTINENCE is the only answer to addiction? It just blows my mind that in this day and age, when science has proven a biological component for addiction, that so many still believe abstinence is the only answer. Diabetes is a biological disease, but no one would ever dream of telling a diabetic to go to 12 step group to control their need for insulin. What about medication for treating addiction? The idea that complete abstinence is the only answer stems from the belief so many have that addiction is a moral issue, a moral failing, a matter of willpower.Also, not all addicted nurses steal. Some of them actually have the decency to go out on the street and BUY their drugs. It's insulting to imply that all addicted nurses are at risk for diversion, there is a difference between being an addict and being the type of person to steal. So many old prejudices and discriminatory attitudes about addiction, even from educated people. It really surprises me.

It's a looooooong way down from that Ivory Tower.

Thanks for a great article!Bhavana, this article IS the enlightened view! Your defensiveness calls for SELF examination. When it comes to this particular issue, it seems you are either very naive or in some kind of personal turmoil yourself!:redpinkheRe: overhearing a conversation 3rd hand? I think I'd give a heads up to the higher up, maybe even remain anonymous. Tough situation which I've never been in myself.A nurse who is UTI and makes an error that harms or kills a patient, vs. a nurse who is simply caught/reported/comes clean re: pilfering meds, and is forced to submit to due process? BIG difference in outcome.

I've been around several nurses who were diverting. I consider myself pretty observant, but I had NO suspicion at all of any of them. Hindsight maybe, but not at the actual moment.

Well written response Bhavana; I see much compassion in your reply. I must agree with most of what you wrote.

Brava! I love the way you put compassion on the addict. It is a disease, one protected by the ADA, by the way. Being so, we as nurses should want to do whatever we can, to help the person succeed. We as healthcare workers want to eradicate drug addiction, and part of that is putting on our compassion, learning all we can about it and using what we learn to help those in need. These drug addicts are our mothers, fathers, sisters and brothers. They did not dream of one day, becoming an addict. One small change in your circumstances, and it could be you. OP, Thank you for this article! Peace!

Quote from oramarThe rule for reporting drug diversion that you personally witness is pretty cut and dried. However, what about a situation where you overhear a conversation in which a co-worker tells another co-worker that they think someone is diverting? Or what do you do if the information is third or forth hand, like when someone says, that someone says that someone says that so and so is diverting?

Quote from Chin upNever act on hearsay. Never. You can cause a lot of undue hardship, and you yourself will lose credibility. Hearsay is never the truth, just bits and pieces of truth stuffed in a lie. Would you want anyone to act on hearsay about you. Peace!

Actually drug addiction as well as alcoholism takes a great damage to human body and attitude images. Thanks to explore your insight thought. it will help to prompt all of us to avoid drug addiction and other narcotic substances.