Earlier this month, a registered nurse (RN) was sentenced to serve 24 months’ probation for taking a resident’s pain medication at a Pennsylvania nursing home. She also had her nursing license placed on probation for three years by the State Board of Nursing. The RN was sentenced to serve two consecutive 12-month terms of probation after pleading guilty to misdemeanor charges of possession of a controlled substance and theft by unlawful taking.
While working at the nursing home on Sept. 15, 2022, the RN was seen getting narcotics from a medicine cart by other staff during early morning hours when residents were normally sleeping. She did not respond when staff questioned her about discrepancies in the medication count.
The police were notified, and staff told officers that the RN appeared to be impaired and was nodding off at the nurses’ station. Police said the RN had made withdrawals of seven doses of Lorazepam, nine doses of morphine sulfate, and 11 doses of oxycodone for the resident, but the medications were not given to him.
During an interview with police in March 2023, the RN admitted to removing substances from the medication cart on Sept. 14 and 15, 2022, and then ingesting them.
According to her attorney, the RN self-reported the incident to the State Board of Nursing in February 2023. She was diagnosed with substance use disorder, is receiving outpatient treatment, and now submits to random drug testing.
This was the second time the State Board of Nursing imposed disciplinary action against the RN for a drug-related offense. In January 2019, she was arrested for taking narcotic pain relievers from a hospital pharmacy over a four-month period. Hospital officials had become suspicious that she was diverting prescription medication after a review of her dispensing activity between December 2017 and March 2018. They said amounts of three medications were unaccounted for: hydromorphone, fentanyl, and lorazepam. She told the hospital officials that she sometimes diverted medications requested for patients or kept other narcotics that a patient ended up not taking without documenting it as waste, police reported. She said she had not withheld medication from patients.
Compliance Perspective
Issue
Experts estimate that 10–15 percent of our nation’s population struggles with impairment from alcohol or drug dependency. Nurses, as part of this statistic, are distinct due to their ability to access drugs in the workplace. Because as many as one in ten nurses could be affected by a substance use disorder, it is critical that each facility implements a proactive diversion-prevention program. The consequences of failure to do this include a negative impact on residents’ quality of care, legal and ethical concerns, and potential for high scope and severity citations once a diversion problem is uncovered. Nurses who divert medications have developed a number of ways to conceal diversion. Efforts must identify the types of medications most likely to be taken, signs that diversion has taken place, and signs of impairment.
Discussion Points
- Review your policies and procedures on preventing, identifying, and responding to drug diversion. Update as needed.
- Train appropriate staff on actions that can be taken to prevent, identify, and respond to any suspicion of drug diversion. Provide education on the impact of drug diversion on residents as a form of abuse and neglect, staff responsibility to report concerns immediately, and the consequences of theft of controlled substances. Document that the trainings occurred, and place the signed document in each employee’s education file. Med-Net Academy offers all clients three PowerPoint training programs in our new category of Substance Use. Visit MNA to access all three. Additionally, in the Fraud, Waste, and Abuse Category of MNA, a program titled Drug Diversion: What Every Facility Needs to Know is available for viewing by all clients.
- Periodically audit to ensure that all controlled substances are accounted for on each shift, and that proper documentation of controlled substances has occurred. Your consultant pharmacist can be included in this effort.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
