Tuesday, July 28, 2009

Narcotic use and diversion

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?

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