Drug Diversion in Nursing

One of the most serious challenges in the occupation of nursing is resisting the lure of addiction. But with the sheer availability of narcotics and opiods in nursing occupations, it is the casual use of pilfered ( and very strong,) pharmaceuticals that can springboard casual abuse into an unhealthy drug habit. Mood elevation and stress relief by the pill method can begin a nurse’s journay to drug dependency.
In the dark bolgia of drug addiction, factors such as affording drugs and the need to go to work can often prevent an overdose in the making. But in the case of career nurses, attendance, daily habits and the nursing lifestyle can feed a habit. Nurse may see evidence that another nurse is stealing meda, and using patient medications, without understanding what these behaviors mean.
Other nurses may shrug off strange behavior and mood swings that occur while otheers aee them doing unsupervised med pass duty. Nurses may not realize that state discipline records for regulatory infractions will follow them around their entire career.
Ideally nurses are caught and disciplined by management for incidents of drug diversions. But where oversight is slack and cost-cutting eradicates supervision, some nurses will slide down a slippery slope. If a nurse commits one act of drug diversion anf getsv away with it, they are likely to do it again.
Usually the casual abuser or recreational user of drugs stops short of a worsening a habit through exhausting their resources. But all a nurse has to do to feed their habit is to go to work. This fact doesn’t even begin to be able to address the difficulties that drug diversion makes for the patient.
People might expect nurses to know better. But when the only thing between a nurse and a drug overdose is a thinly spread staff and an unlocked medicine cart, problems will occur. Sometimes the nurses doing the drug diversion are on too-friendly terms with the individuals doing the closed circuit camera scrutiny
And many nurses fall victim to addiction by the dint of by having immediate access to powerful and clinically addictive nedications. Because the world of nursing is suffused with tasks consisting of interactions handling drugs. The temptation is impossible to ignore.
Once a drug habit forms, superhuman strength can’t make it stop
And nurses are only human.
About 80% of theft in retail or service professions is estimated to be internal. As value-based medical service models replace community benefit models, facilities that dispense drugs to patients become part of those crime statistics.
While police officers do not patrol nursing corridors and hospital wards, the goods are much more stringently restricted than folded sweaters or designer handbags. Electronic handprints and punch codes for med cart access cannot eliminate instances of drug diversion. Rather, unsupervised access to schedule one and two drugs such as narcotics enables any nurse to abuse their pharmaceutical access. Each nurse can elect not to exercise discretion in palming this or that pill or stealing an unwanted drug dosage.
Technical specifications and licensed nurse training are designed to prevent the mishandling of drugs and pills. But medications in the dosage sizes given to patients are usually a tiny pill or two. These are so small that drug diversion is not physically difficult. Such pills can be concealed in the mouth, hand, fingers, pocket, or even a hairband or cellphone cover.
Many nurses feel insulated from the threat of detection or capture due to the small community or office space that nurses inhabit. Nurses who filch medication from patient dosages may feel that the presence of other nurses in a small staff or closed community discounts the risk of getting caught.
There is an old saying that “familiarity breeds contempt.” Familiarity with the nursing homr or hospital workplace may orient a nurse to oversight shortcomings. Daily nurse work can bring forth feelings of antagonism against patients and causr anger and aggression against the facility owners or operators.
The angle of security cameras and the known infrequency of the facility to review the security footage may encourage drug diversion. Also, in a facility where narcotic record keeping MAR fidelity is poor, certain nurses may exploit these circumstances to pilfer patient medications.
In the nursing world, theft of drugs from patient dosages is called “drug diversion”. This practice indicates by its name how nurses behave as if they are following routine med passes. Drug diversion usually occurs in a busy hospital or care facility where oversight responsibilties are routinely overlooked.
Three case studies below illustrate how nurses can exploit vulnerabilities in hospital and long term care facility. But it is not only medical institutions that must be wary for drug diversion. Home health nurses operate in an environment even more probable to experience drug diversiin. The isolation and probable unlikelihood of detection creates a temptation some nurses may not be able to resist.

The legal liabilities that any nurse opens themselves up to, when caught committing drug diversion, are significant. The legal problems such nurses may create for a hospital group or long term care facility management corporation may be career-ending lawsuits.
Not every nurse steals medication. Some nurses are so wary of falling prey to drug use and drug diversion temptations that they make sure to dispense medications under closed circuit cameras and in the presence of another person or a group of nurses. But drug addicts are prone to secrecy and stealth to support their habit.
The possibility is also very high that some nurses are using employment in long term care facilities as a means to skim narcotics from their routine pharmaceutical distribution. If a nurse has a predisposition to emotional problems, job stress, or drug addiction, they may seek out second-rate facilities where security and supervision are slight.
(see the following article for case studies in Drug Diversion).

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