It’s easy to take a simplistic view on how drug diversion in healthcare facilities affects a nursing career. If someone is stealing Ativan, Oxycodone, Fentanyl, Vicodin etc., you just catch the culprit and get them out of your facility, right? But let me tell you a couple stories that will explain how it can ruin others lives as well.
I was recently at a long term care facility speaking with the Director of Nursing, and I innocently asked H”ow are things going around here?” She kind of hesitated and said, “Not good.” Obviously, there was something was going on and I was anticipating a discussion on their recent survey, which had not gone perfectly.
She continued by saying that “Things will just never be the same.” The cause? A few months prior to this conversation, it was discovered that a staff member of 10 years had been stealing narcotics over a few months. The culprit was recently caught after months of confusion, questions, and false accusations amongst the staff. This has caused multiple staff to quit. The ones that remained were terrified about what was going to happen next. Trust amongst the staff had all but disappeared.
Clearly, we have to blame the individual who stole the narcotics. But the culture of relaxed policies and procedures allowed the frustration, anger, fear and confusion to go on for much longer than it needed to. Over the span of weeks, due to complacency of the staff, just one individual was allowed to change the culture of kindness to mistrust.
The Importance of Effective Policies and Procedures
Sadly, this is not a unique story. I’ve seen it play out in other facilities as well. Policies and procedures are in place for a reason. Believe it or not, they are designed to help protect you and your nursing career! However, they are only as effective as the individuals who implement and follow them, as this other case shows.
A non-medical staff member knew that the nurses who had access to the medication cart were lax about locking their medication cart. This was particularly when they would do a dressing change for a particular resident in an LTC. The dressing change took a significant amount of time, and the diverter knew what they were looking for. The med cart was just outside the room, so of course they would hear if someone got into their cart, right? Unfortunately, this wasn’t the case.
This one simple act of not securing controlled substances single handedly destroyed the morale at the facility. After weeks of false accusations, back-stabbing, and threats amongst the nursing staff, the culprit was identified via the video surveillance system. Hurt feelings and mistrust lasted for years following this incident.
So what can we learn from these cases? Remember these pointers:
1. Anyone can steal controlled substances.
2. You cannot stop someone from stealing if they want it bad enough. However, effective policies/procedures that are appropriately followed can prevent a diverter from destroying the spirit of a facility.
3. If you are in charge of controlled substances and things don’t make sense, report it immediately.
4. If you sign off on wasting, etc., make sure you actually witnessed it.
5. Minimize access to controlled drugs or reconcile frequently.
6. No one cares more about your nursing license than you.
If you suspect that a co-worker is struggling with addiction, or that drug diversion is happening in your facility, don’t wait for it to affect your nursing career. Take some action now.