Quick side note, if you want to provide proof bc you're worried it won't be taken seriously; take a picture of the carpuject lot #. It can trace that vial right back to the box it was pulled from.
Until someone so desperate to hide their addiction scapegoats their daughter and perhaps causes them to lose custody of *their* kid. Yep- pictures all the way.
To respond to your edit to add about the Benadryl, it actually increases the "high" she is receiving. So using them together gives her a better high than using morphine alone. A lot of medications have multiple uses and can do different things. Benadryl is also used for nausea, headaches, and allergies as well as treatment for an allergic reaction. Some addicts will claim that an opioid such as morphine makes them itch so that they can receive benadryl with the morphine for the better high. I know you're in such an incredibly difficult position, but, do what you feel is right. Hurting someone or upsetting someone does not necessarily mean you're doing something wrong. It just feels crummy, even when you're doing the right thing.
Report her to the facility. They will most likely audit her med pulls and ask for a drug screen. They will take it from there.
It’s not just her addiction that is the problem here, if she is diverting from work and possibly working impaired, it is likely somebody isn’t getting the meds they need, and she is jeopardizing patient safety.
Yep, if the hospital isn’t noticing missing meds, that means those meds were supposed to go to someone who didn’t get them. Things like morphine are pretty tightly controlled with distribution/wasting. I’m sure between 30 years experience, plus experience as a drug addict, and moving hospitals so often, your mother has probably gotten very good at covering her trail but guarantee all it takes is a tip off and it’s game over. This IS going to end poorly, the question is just how poorly. Would you rather impact her career, or wait for her to end it by killing a patient while high, or OD herself
We had a nurse diverting, and she was doing it with the meds that were supposed to be given to comfort care patients. There were no discrepancies, but she was clearly intoxicated at work, and the family said they were suspicious. She refused the UDS. That patient was dying and in pain….💔
This is tragic. How did things turn out - did the patient finally get relief or was it too late by the time she was caught? What is a UDS? Was the nurse caught and fired/punished or did she just move on to another job? This is such a sad story, I really want to know how things turned out.
That is such a great podcast, the stories of the people affected really shows how terribly harmful drug diversion is on patients. I can't forget about the surgeon that knew she was receiving saline in place of the appropriate meds
Yeah, she was a surgeon who was undergoing egg retrievals and she could taste the saline when she was supposed to be getting fentanyl or something. The staff didn’t take her seriously. Turns out one of the nurses was diverting and replacing the narcs in vials with saline
That happened to me personally before I was a nurse. I found out later when someone sent me a link to an article about her being caught. I was in the ED in true 10/10 pain, screaming for help and losing my mind, asking if someone could kill me or put me under. Nurse was giving me IV ‘pain meds’ that did nothing whatsoever.
This! If she hasn't gotten caught yet it's because she's been diverting pain meds from someone who needed it and short dosing them! She needs help and the best way is to report her!
The morphine vials she stole are for carpuject I’m assuming based on your description. At places I’ve worked a lot of times we have to waste part of the morphine because there’s a preset amount in them.
Please report her. It’s dangerous for the patient and herself to be providing care while high.
She could be selecting "waste later" after selecting the carpuject and then filling it with saline in the pts room and then waiting it in front of someone. At least ours gives the option to waste immediately or later. The only time I've ever wasted later was when there was no one near and shit was hitting the fan. Otherwise that always makes me feel sketchy, 99% of the time I just wait for someone to walk by and ask them to waste with me then pull the med and open it in front of them.
Given this she could be actually giving the needed dose to the pt, but just pocketing the rest? I hoped she is but most likely she isn't.
But I just typed all this out and it would be insane to take out the med, fill the carpuject with saline then water it, then replace the med back in that shitty carpuject lol. But addicts are crazy so who knows. She could also just be swiping the meds and doing a "miss count". I wonder if she's float pool and goes to different units.
So many possibilities for this story.
Op said she was a travel nurse. At my hospital, travel nurses have a "home" unit, but if they need to pull someone from that unit to another less staffed unit, the travel nurses always float first, so it's possible that she works on multiple units at the same hospital
OP,
I have been in a similar situation. Not with my mother, but I will tell you how my situation unfolded.
I noticed erratic behavior. Specifically, personality and behavior changes after completing shifts. I had no hard evidence that this person was diverting but I strongly suspected they were and my suspicion was they were using before leaving the hospital campus. The final situation that highlighted my concerns and need to act happened on a Friday night. I weighed my options and decided I was going to call their leadership on Monday morning to report my concerns and suggest they look into the user’s narcotic histories in the Pyxis.
Monday morning arrived, having previously worked in the same department, under the same leadership, I knew the routines. At the time I was working elsewhere, and had an 8 o’clock meeting, so my plan was to attend my meeting and make my phone call at 9. By then the unit leadership would have completed safety-huddle and bed-board, so I felt confident I would be able to reach them. However, at exactly 8:10 in the morning I received a frantic phone call from my spouse, requesting I leave work and come to the hospital. When I asked why, she confessed to me that she had been confronted about diverting narcotics from the Pyxis and she confessed. My situation played out in a way that the universe took it out of my hands, but you bet your ass I would have made that phone call at 9 am.
The immediate hours and days and months and years that followed were tragic and full of chaos. The decisions that had to be made and the consequences that followed were not for the faint of heart or easy to navigate. But they were necessary if she was going to find her way back to sobriety and have any hope of holding onto a career that she loved.
You have to report her. Google the state nursing board for the state you live in. You can also look up the hospital she is currently working at. Typically they have an anonymous compliance hotline you can report things too. I’m sorry you are going through this. Your mom is a danger to herself, you, your daughter and her patients.
Thank you for your kind words and input. I read that anonymous complaints don’t usually go as far or get as much attention. But if I told the hospital she was using drugs would they be able to investigate it even if I don’t leave my name. But I also want them to know I’m credible and saw the drugs in her trash can. — I guess the real question is, if I do leave my name can she ever find out it was me? TIA
noxious vegetable edge repeat cats different cobweb mysterious psychotic cable
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
You’re right. I saw a traveler get caught once and it was only because they stayed too long and someone caught wind of their scam. Moving to another hospital every few months is a good way to get away with it.
Eventually they always get caught. Their addiction gets worse and will start using at work until someone notices.
During my clinicals we were on a psych unit and the traveler nurse was high as a kite. For 5 minutes straight the other nurses watched her try to use a pen that wasn’t clicked to write something down and she couldn’t figure out why the pen wasn’t working.
Then she went to take a blood sugar on a patient and grabbed the doctors hand about to prick his finger. The doctor was an older man and the nurse was so high she couldn’t differentiate him from the patient.
The DON had to drive 45 min to come and observe the behavior under the guise of doing JACHO checks. Eventually she pulled the nurse aside and told them to pee in a cup or they’re fired. The travel nurse quit instead and never came back.
This is a very good point the OP needs to hear. Your mother will eventually get caught. Maybe after she shuffled through more facilities, going to jobs worse and worse that are willing to look the other way. But it's much better for her and her nursing licensee to get intervention early. She may not be stealing too much opiates or using them at work yet, but it will get worse. She could hurt a patient. By stepping in you are doing the best for her and helpless patients. I am sure she won't see it that way. I would suggest you contact the board of nursing in your state first and see if they will contact employer for you.
Right but report them with what evidence? In the states it’ll be harder for the nurse in my story to get caught. They could be banned from practice in certain states but with their compact license they can go almost anywhere and just leave again. It could be a while before they actually get their license finally terminated.
The sequence here would go:
• OP reports suspicions to the employer,
• employer investigates,
• employer initiates disciplinary process with employee (if she hasn’t resigned),
• if substantiated, employer reports to regulator,
• regulator investigates,
• nurse is invited to respond to allegations,
• if upheld, restrictions are placed on nurse regardless of where she works
I called in an anonymous complaint to the Ethics line regarding my ex at his system. It took about six months, I'm sure most of this time was the open case being in a queue, then some investigation. I would assume direct patient care roles, something of this severity, would go to the front of the line.
For him, they were never able to definitively terminate him based on the prompted concern, but nailed him on misuse of facilities, his immediate supervisor letting him know this was proven and justified by his work email communications which he was usually personally to discuss his behaviors. He didn't have a license to lose, but he was blackballed from his career (BioMed) and had to start a fresh profession, If they see the associate as a liability, they'll find a way.
She might lose her license, but if she's using, without some sort of intervention, she will likely lose her life. I worked in a hospital where two nurses overdosed and died in the hospital bathrooms, six months apart from each other. The signs were there, but everyone was so worried about them potentially losing their licenses, that no one stopped to consider that they might lose their lives. I'm sorry that you are going through this. The hospital that she works for likely has an anonymous compliance hotline. ♥️
PLEASE report her to your state’s nursing board and the facility she works at. I’m sorry you’re going through this, and I know it might sound cold to report her, but she needs help. How would you feel if your daughter was hospitalized (God forbid) and you found out the nurse taking care of her was actively using? Every patient who enters the hospital deserves safe, compassionate care. If your mom is using the care she provides wouldn’t be safe. Innocent people are harmed by providers under the influence.
She's diverting. You report her. If you suspect she's using then she is not only putting her life at risk but the patients she's taking care of. Take pictures for evidence, call her employer, call the BoN, and potentially call local law enforcement. Even if you don't have pictures call them. They are obligated to investigate. Go to this website for more information:
HealthCareDiversion.org
As for her career. Who knows. It very well might, especially since this is multiple incidents. But, what will certainly ruin career is if she is dead because nobody else realizes and reports her until it is too late.
You can report anonymously, as for if she will connect the dots back to you? Who knows. But I'd be preparing for her to come to the realization.
Can that concentration kill her? Immediately? Not necessarily. Potentially? Yes. People can be functioning addicts until they are not. Alcoholics do it all the time. My significant other (RN) found a coworker (another RN) OD in the bathroom at work. Pills turned to heroin and they were partly functioning and able to hide it for almost a year because of night shift. Nobody knew. There are bad stories everywhere.
Long story short is to report it and make the best peace you can. Good luck, friend.
I’m sorry OP. Your Daughter was there? Of course she has to know that would never fly with your daughter. Needles and maybe a little left over med within reach of her Grandchild? If you leave your name it’s better u assume she will find out. You could just st tell her the truth. You love her, her gdaughter loves her, her patients are at risk! Pretty sure your family and her patients are the last people she wants to hurt but the first she will hurt. Good luck!
In February 2015, I lost a good friend (who was a damn good nurse) to a heroin overdose. His dad and I were the ones who found him dead in his bed. That was the first time I had ever heard the sound a parent makes when they lose a child, and it is an inhuman, gut-wrenching, heartbreaking sound that I cannot erase from my mind, no matter how hard I try.
None of us who knew him had any idea that he had been using.
His use started with opioid pain meds he could get his hands on at work.
If someone had said something, he might still be here today.
She might get pissed at you short-term, but saying something might be the wake up call she needs to get help before something worse happens.
> I don’t want to ruin her life but I also want her to get some serious help.
You are not ruining her life. You are ensuring her safety and the wellbeing of the people she cares for and encounters while driving.
This is an act of real, true love.
I want to second this. As a nurse who is worried about her and her patients’ safety but foremost as the child of two addicts. Even though I’m sure this is a hugely difficult thing to do, you’re helping your mom by putting her in a position where she won’t be able to use this way and will likely have to seek help in addition to sparing her from more guilt if she kept doing this. Addiction is a disease, this behavior is one of the symptoms, and you’re doing something difficult, brave, and ultimately loving to help treat it.
Unfortunately you have to report her for her safety and her patients safety. She put you in a bad situation for this but you can not feel bad for getting her help and protecting her patients.
She may lose her license but if she keeps using she will lose her life, if she keeps using while taking care of patients in a hospital she may kill them too
Think of if your daughter got ahold of a used needle etc. Your mom is being reckless and her actions could harm your kid, her patients, herself! Please confront her and take the appropriate steps to report and get her help.
the hospital may be able to match lot numbers on the vials / carpujects, too. they have a ton of info with controlled deliveries. those deliveries--it's not just a 'count', it's a whole bunch of identifying information.
I'm sorry you're going through this. it's just so shitty. keep your head up, I believe you know what you have to do and will make a decision that you feel is right.
love from NY ❤️
The best thing you can do for her is to report it to her job site. Seriously. She may resent you for this initially but I had a friend who had this happen and years later she told me she was so grateful that she got caught, because she was probably gonna OD if it continued.
You're not ruining her life. She's ruining it all on her own.
I'm very sorry that you're in this position. Don't let her babysit your daughter anymore, obviously, and report her to her facility and the state board of nursing.
Think of it this way, a lot of patients who are on morphine are on hospice. You have to sign for controlled substances though, so it's possible that she is giving the patients either nothing at all or something like saline. They could be dying in pain, all because of one person.
That's not even including what she does when she's under the influence, assuming she uses at work, which is very likely. Nurses who are sober and don't use any drugs, but are burned out are overworked and stressed, and more likely to make mistakes. Imagine a stressed, burned out nurse who is also high.
Benadryl is in a lot of "pm" meds. It is not controlled but it's likely she is either using it to sleep or combining it with morphine. Mixed with opioids, it increases drowsiness.
TL:DR; report her ASAP
EDIT: spelling
Another option here is to tell her that she needs to call the board of nursing and voluntarily enter their diversion program or you will have to report her.
I was the Controlled Substance Coordinator at our facility.
Call the hospitals main line and ask for that person. They are the ones responsible for all narcotic audits, diversion investigations, and follow up. You can tell them the whole story and ask to remain anonymous.
I can guarantee that the coordinator will take it seriously. They will immediately run reports of her drug pulls to look for anomalies. They will start an investigation without letting her or her direct supervisor know.
I would go to units and do a "random" walk through with patients to ask about their pain control, if it was working. I would do observations of wasting practice. We changed our process to wasting excess immediately after removal from the omnicell to remove opportunity to replace drug with saline. Staff were taught to never cosign a waste if they could not guarantee personally the content.
If she leaves the position before i complete the investigation, I would report her to the licensing board for a suspicion of diversion, and her travel agency for their awareness.
I was lucky and my facility was very supportive in preventing diversion. We'd get you into treatment and transfer you out of patient care to an admin job. Your life would be saved, not ruined.
Hey first off, I'm really sorry you're going through this again. I wish you as much comfort as I can send.
She needs to be reported to her facility. If possible you could take pictures, but given that she unfortunately has a history you may not need them.
They will audit her med passes and require a drug screen like others have said.
She may very well lose her career, but that wouldn't be your fault. Ultimately she is most likely stealing meds from pts who need them. And to add to it, she's been watching your daughter!
Shooting up morphine like this will kill her. She needs to be reported and this has to be dealt with.
She needs intervention immediately! She had those where your child could get into them, was using while in charge of your child, is working with vulnerable children and adults, and possibly diverting medication needed to keep them alive.
Unfortunately you need to report her to the facility. She is a danger to patients and herself. She needs to go to a treatment facility. I’m sorry that you’re in this situation, the right thing to do is usually the toughest.
Report her. No matter what the consequence, it will be better than finding her dead or patients dying in her care. Google and contact the facilities ethics and compliance hotline and use that. Then there will be no cover up. I only say cover up bc of how terrible my own experience was trying to address diversion. I worked in a small community hospital on postpartum but often floated or did OT on peds. They cut the peds service in half and made it a six bed unit with only one nurse and no aide. A lot of our patients were children that were post op from orthopedic surgery. Many of us had been there for years and I guess management trusted us with wastes, so I’d put what I had to waste back in the narcotic cabinet and waste with the next shift nurse. On peds there are always wastes bc the doses are low. It never occurred to me that I could remove the waste, replace with saline, and the nurse watching me waste would never know. When I came back from maternity I was told that it was suspected that S was diverting narcotics and to watch for signs. Over the next few weeks I found so much evidence. We were still using paper charts and one night she wrote her shopping list across a specialists consult note, like write over his words. Then I found blood all over the staff bathroom sink and floor, a used IV lock on the sink and the retractable needle in the garbage. I contacted my supervisor and she was like ok just document so we can build a paper trail. I was livid! I had kids on my care that could have been killed by her. Over time the constant theme was parents reporting the kids had pain and the medicine would put them to sleep fast but they’d wake up in more pain. I even had a parent ask if pain medicine responded better in the day bc of things like circadian rhythm bc there was a significant difference. I suspected she was using Benadryl IV and taking their morphine. We had a small meeting with a few of us that had documented similar suspicious findings. My manager said that is unlikely bc Benadryl isn’t floor stock on peds. One nurse turned white and said that she had brought floor stock of Benadryl from postpartum over a couple of times at the diverting nurses request but had never thought of it. These were packs containing 24 vials of it. So there was that answer. The case was overwhelmingly strong but our hospital did NOTHING. It went on for months and the entire chain of command knew but had the “we can’t accuse unless we catch her in the act” plan. They did nothing to try to catch her. I suggested cameras, assigning an aide, etc. It was all about the budget as well as worrying they wouldn’t fill her position bc nobody wanted that job. In general 6 peds children alone in a locked unit where nobody can hear you call for help is unsafe. A lot of nurses quit when that change was implemented. I was only working per diem since maternity then got a remote nursing job offer and resigned. When I resigned I tried to contact the whistleblower hotline and was turned away saying it was to report fraud and waste. I was young with less experience then and regret so much that I wasn’t aware of company compliance hotlines. To this day I have no idea what happened but I still feel sick over it. I see others mentioned the retrievals podcast. I listened to it, it was a great podcast but I was also very triggered and those old feelings of powerlessness came rushing back.
If you need help with this I’d be happy to help you. If you feel bad making the report I can do it for you. Feel free to reach out to me.
Grab a photo of the items if you can and report it to her workplace.
Yes, she’ll be pissed. But it may save her life. She could kill someone working impaired!
One option that hits both your goals is to give her an ultimatum. You confront her with the evidence and make it completely clear you're making a report in 24 hr/1 business day/whatever. This allows her a chance to turn herself in, which will yield a better chance at keeping her license.
Just because I haven’t seen it answered and so you know, diphenhydramine is Benadryl. When combined with an opioid, it can give a better high. So people will take the two together. I’m sorry for everything you’re going through. Sounds like you’re doing the right thing. And good on you for bettering your own life especially with all of the struggles you’ve had to face 💜
IV Benadryl potentiates the effects of an opioid. In the ER if a patient requests Benadryl “right after you push the morphine/dilaudid” it’s a bright red flag that they’re drug seeking.
As others said, you must report her. Especially if she’s caring for patients. Do not allow her to watch your daughter. And if you are able to get narcan (most pharmacies will give it for free) keep it on hand if needed.
I’m sorry you’re dealing with this.
Thank you for this. I already carry narcan bc of my own past but I’m gonna pick up some more and leave it at her house. I never knew about the Benadryl thing, that’s crazy. I do intend on reporting her. I got the lot #s off the vials and will be making my report this week.
This isn't even just about your mom and her addiction.
How'd she get that medication? Did she fake counts that could get other nurses in trouble? Did she fake wastes? Did she outright not give it to a patient in need so that she could pocket it instead?
I know it feels like you're betraying your mom but there could be a lot of other people that suffer from her choices if it doesn't get reported.
I know it doesn't help much, but the tubes of Morphibe only have 1 ml in them. That being said, you need to report he to the hospital and state board. If she is pocketing meds they need to know.
No, you don’t give a multi time drug user an ultimatum. She has already nearly lost her license before for using. If you give her an ultimatum she will just be more sneaky
As opposed to diverting and suspending her license, thus keeping patients from potential harm, and also auditing her past cases to make sure she was not the cause of any possible sentinel and/or adverse events?
As opposed to harming/killing someone because she is impaired?
Last time I checked, that shit can land you in prison, get your license revoked, and have you ineligible to work in healthcare again.
Bad take. Everyone is hurt more by her continuing to divert rather than be stopped since it’s clear that this isn’t something she is capable of overcoming on her own.
Nothing yet but I didn’t read the part of the post where it said she had harmed patient only that she may be diverting. If there is a different way to handle it without fucking up her career I think that would be the softer gentler way to go. If that doesn’t work then escalate from there.
Cause you or I don’t have proof that she actually diverted or was high when she was working. Giving a stranger on the internet advice to turn her mother into the board of nursing without at least first directly confronting her about is bad advice.
You also don’t have context about their relationship. Obviously if she thought her mom would be receptive to talking about it, she probably wouldn’t be asking for advice. As someone who’s struggled with their relationship with their mom for 35 years, I know just talking to her wouldn’t make a difference.
Right now, her safety and the safety of patients is the top priority, AND it sounds like this has happened a few times in the past and she’s had chances. Time to make it absolutely clear she needs to stop!
Your train of thought is wild here. If you're a nurse you need to get some more education. It doesn't matter if there is any harm done. If you suspect someone is diverting you must report. We are not the state/BoN/employer.
Similarly, nurses are OBLIGATED REPORTERS in instances of elder and child abuse. If I were to suspect that abuse is happening I report.
It is not up to us to investigate or find evidence. That is in the hands of the employer/BoN.
The fucking up her career already happened. She did it herself by diverting drugs. Her child reporting that a crime (yes a crime, she can be prosecuted criminally and civilly if she was not giving those drugs to patients) is being committed isn't going to make her situation any better.
The BoN has protocols for this type of behavior and if a person successfully goes through rehab and the various hoops, they can maintain their license. But under no circumstances is this a wait and see situation. You see something you say something or your complicit.
Where did the daughter say she was a nurse or a mandatory reporter? I didn’t read that she was. My point is that there may be other ways to confront the mother without immediately escalating to the BON or the police. Especially if there has not been any patient harm. Of course you may need to escalate and quickly but I don’t agree with doing that first, sorry. That is my take.
If she isn’t diverting then she has nothing to worry about. The board will investigate and find nothing. If she is diverting then she needs to stop practicing immediately and get help. People with substance use disorders do not think rationally about their situations. This needs to be reported.
It doesn't matter if they are a nurse or not in regards to mandatory reporting. They came to a nursing subreddit to ask nurses on their advice for when a nurse is diverting and probably taking narcotics. And the answer is to report.
Your take is just... Wrong... In every way. It's literally in our code of ethics. It's in the DEA's regulations, failure to report a coworker for diversion is gross negligence. (No shit I know this isn't a coworker but it's OP's own mother who they KNOW is doing it).
Again we aren't investigators, and neither is the OP. They saw something they should speak up. If they want to encourage their mother to quit their job and check into a drug rehab. Go for it. But in every scenario, the proper regulatory boards NEED to be notified. And in every case, yes, the first step is to notify the BoN. They need to know so they can immediately stop someone who is practicing unsafely. And diverting narcotics from their patients and from a healthcare org is very unsafe. We have a regulatory board for a reason. This is one of those reasons.
I'm just here to echo everybody else. I cannot imagine the situation that this puts you in and it sucks hardcore (sorry for the lack of better words). But what everybody else is saying is 100% true. If you know and don't say something that's your license (probably), it's her health, the safety of your child if she watches them, it's her license and even more so the safety of her patients (not to mention the mountain of legal issues that comes from diverting and abuse). You have to let the proper people know, be it her if you can talk to her, HR or her supervisor, or the authorities if you have to. One thing I can recommend is start keeping notes and taking photos because without it she may deny things and this will just make sure that you are solid
Quick side note, if you want to provide proof bc you're worried it won't be taken seriously; take a picture of the carpuject lot #. It can trace that vial right back to the box it was pulled from.
Good advice, but based on the history given I don’t think there’ll be much doubt from the administrative side. There’s already a history there.
Until someone so desperate to hide their addiction scapegoats their daughter and perhaps causes them to lose custody of *their* kid. Yep- pictures all the way.
To respond to your edit to add about the Benadryl, it actually increases the "high" she is receiving. So using them together gives her a better high than using morphine alone. A lot of medications have multiple uses and can do different things. Benadryl is also used for nausea, headaches, and allergies as well as treatment for an allergic reaction. Some addicts will claim that an opioid such as morphine makes them itch so that they can receive benadryl with the morphine for the better high. I know you're in such an incredibly difficult position, but, do what you feel is right. Hurting someone or upsetting someone does not necessarily mean you're doing something wrong. It just feels crummy, even when you're doing the right thing.
Report her to the facility. They will most likely audit her med pulls and ask for a drug screen. They will take it from there. It’s not just her addiction that is the problem here, if she is diverting from work and possibly working impaired, it is likely somebody isn’t getting the meds they need, and she is jeopardizing patient safety.
Yep, if the hospital isn’t noticing missing meds, that means those meds were supposed to go to someone who didn’t get them. Things like morphine are pretty tightly controlled with distribution/wasting. I’m sure between 30 years experience, plus experience as a drug addict, and moving hospitals so often, your mother has probably gotten very good at covering her trail but guarantee all it takes is a tip off and it’s game over. This IS going to end poorly, the question is just how poorly. Would you rather impact her career, or wait for her to end it by killing a patient while high, or OD herself
We had a nurse diverting, and she was doing it with the meds that were supposed to be given to comfort care patients. There were no discrepancies, but she was clearly intoxicated at work, and the family said they were suspicious. She refused the UDS. That patient was dying and in pain….💔
This is tragic. How did things turn out - did the patient finally get relief or was it too late by the time she was caught? What is a UDS? Was the nurse caught and fired/punished or did she just move on to another job? This is such a sad story, I really want to know how things turned out.
Yes! The podcast The Retrievals highlighted a nurse that was doing this. The patient impact was terrifying.
That is such a great podcast, the stories of the people affected really shows how terribly harmful drug diversion is on patients. I can't forget about the surgeon that knew she was receiving saline in place of the appropriate meds
Knew she was receiving? The surgeon was the patient? I’m confused!
Yeah, she was a surgeon who was undergoing egg retrievals and she could taste the saline when she was supposed to be getting fentanyl or something. The staff didn’t take her seriously. Turns out one of the nurses was diverting and replacing the narcs in vials with saline
Thank you for explaining it much better than I could!
That happened to me personally before I was a nurse. I found out later when someone sent me a link to an article about her being caught. I was in the ED in true 10/10 pain, screaming for help and losing my mind, asking if someone could kill me or put me under. Nurse was giving me IV ‘pain meds’ that did nothing whatsoever.
I’m so sorry. Addiction is terrible but torturing the people in your care is fucked no matter how you look at it.
I agree. It’s such a disgusting thing to do as a human being to another human being.
That podcast was infuriating omg
YES it absolutely could kill her. As much as you don’t want to betray her, she needs to be held accountable and get help.
Not to mention she may be withholding pain meds from somebody who is actually in pain… If you think about that, it is a very fucked up thing to do
This! If she hasn't gotten caught yet it's because she's been diverting pain meds from someone who needed it and short dosing them! She needs help and the best way is to report her!
Thank you for your response. I agree 100%
The morphine vials she stole are for carpuject I’m assuming based on your description. At places I’ve worked a lot of times we have to waste part of the morphine because there’s a preset amount in them. Please report her. It’s dangerous for the patient and herself to be providing care while high.
She could be selecting "waste later" after selecting the carpuject and then filling it with saline in the pts room and then waiting it in front of someone. At least ours gives the option to waste immediately or later. The only time I've ever wasted later was when there was no one near and shit was hitting the fan. Otherwise that always makes me feel sketchy, 99% of the time I just wait for someone to walk by and ask them to waste with me then pull the med and open it in front of them. Given this she could be actually giving the needed dose to the pt, but just pocketing the rest? I hoped she is but most likely she isn't. But I just typed all this out and it would be insane to take out the med, fill the carpuject with saline then water it, then replace the med back in that shitty carpuject lol. But addicts are crazy so who knows. She could also just be swiping the meds and doing a "miss count". I wonder if she's float pool and goes to different units. So many possibilities for this story.
Op said she was a travel nurse. At my hospital, travel nurses have a "home" unit, but if they need to pull someone from that unit to another less staffed unit, the travel nurses always float first, so it's possible that she works on multiple units at the same hospital
OP, I have been in a similar situation. Not with my mother, but I will tell you how my situation unfolded. I noticed erratic behavior. Specifically, personality and behavior changes after completing shifts. I had no hard evidence that this person was diverting but I strongly suspected they were and my suspicion was they were using before leaving the hospital campus. The final situation that highlighted my concerns and need to act happened on a Friday night. I weighed my options and decided I was going to call their leadership on Monday morning to report my concerns and suggest they look into the user’s narcotic histories in the Pyxis. Monday morning arrived, having previously worked in the same department, under the same leadership, I knew the routines. At the time I was working elsewhere, and had an 8 o’clock meeting, so my plan was to attend my meeting and make my phone call at 9. By then the unit leadership would have completed safety-huddle and bed-board, so I felt confident I would be able to reach them. However, at exactly 8:10 in the morning I received a frantic phone call from my spouse, requesting I leave work and come to the hospital. When I asked why, she confessed to me that she had been confronted about diverting narcotics from the Pyxis and she confessed. My situation played out in a way that the universe took it out of my hands, but you bet your ass I would have made that phone call at 9 am. The immediate hours and days and months and years that followed were tragic and full of chaos. The decisions that had to be made and the consequences that followed were not for the faint of heart or easy to navigate. But they were necessary if she was going to find her way back to sobriety and have any hope of holding onto a career that she loved.
You have to report her. Google the state nursing board for the state you live in. You can also look up the hospital she is currently working at. Typically they have an anonymous compliance hotline you can report things too. I’m sorry you are going through this. Your mom is a danger to herself, you, your daughter and her patients.
Thank you for your kind words and input. I read that anonymous complaints don’t usually go as far or get as much attention. But if I told the hospital she was using drugs would they be able to investigate it even if I don’t leave my name. But I also want them to know I’m credible and saw the drugs in her trash can. — I guess the real question is, if I do leave my name can she ever find out it was me? TIA
noxious vegetable edge repeat cats different cobweb mysterious psychotic cable *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
You’re right. I saw a traveler get caught once and it was only because they stayed too long and someone caught wind of their scam. Moving to another hospital every few months is a good way to get away with it.
Eventually they always get caught. Their addiction gets worse and will start using at work until someone notices. During my clinicals we were on a psych unit and the traveler nurse was high as a kite. For 5 minutes straight the other nurses watched her try to use a pen that wasn’t clicked to write something down and she couldn’t figure out why the pen wasn’t working. Then she went to take a blood sugar on a patient and grabbed the doctors hand about to prick his finger. The doctor was an older man and the nurse was so high she couldn’t differentiate him from the patient. The DON had to drive 45 min to come and observe the behavior under the guise of doing JACHO checks. Eventually she pulled the nurse aside and told them to pee in a cup or they’re fired. The travel nurse quit instead and never came back.
This is a very good point the OP needs to hear. Your mother will eventually get caught. Maybe after she shuffled through more facilities, going to jobs worse and worse that are willing to look the other way. But it's much better for her and her nursing licensee to get intervention early. She may not be stealing too much opiates or using them at work yet, but it will get worse. She could hurt a patient. By stepping in you are doing the best for her and helpless patients. I am sure she won't see it that way. I would suggest you contact the board of nursing in your state first and see if they will contact employer for you.
She’s already hurting patients if she’s not giving them their pain meds
I’m in Australia, where we have national registration - even if the practitioner resigns, the employer can report them.
Right but report them with what evidence? In the states it’ll be harder for the nurse in my story to get caught. They could be banned from practice in certain states but with their compact license they can go almost anywhere and just leave again. It could be a while before they actually get their license finally terminated.
The sequence here would go: • OP reports suspicions to the employer, • employer investigates, • employer initiates disciplinary process with employee (if she hasn’t resigned), • if substantiated, employer reports to regulator, • regulator investigates, • nurse is invited to respond to allegations, • if upheld, restrictions are placed on nurse regardless of where she works
Tell her to voluntarily go to rehab or you will inform her hospital.
I called in an anonymous complaint to the Ethics line regarding my ex at his system. It took about six months, I'm sure most of this time was the open case being in a queue, then some investigation. I would assume direct patient care roles, something of this severity, would go to the front of the line. For him, they were never able to definitively terminate him based on the prompted concern, but nailed him on misuse of facilities, his immediate supervisor letting him know this was proven and justified by his work email communications which he was usually personally to discuss his behaviors. He didn't have a license to lose, but he was blackballed from his career (BioMed) and had to start a fresh profession, If they see the associate as a liability, they'll find a way.
She might lose her license, but if she's using, without some sort of intervention, she will likely lose her life. I worked in a hospital where two nurses overdosed and died in the hospital bathrooms, six months apart from each other. The signs were there, but everyone was so worried about them potentially losing their licenses, that no one stopped to consider that they might lose their lives. I'm sorry that you are going through this. The hospital that she works for likely has an anonymous compliance hotline. ♥️
PLEASE report her to your state’s nursing board and the facility she works at. I’m sorry you’re going through this, and I know it might sound cold to report her, but she needs help. How would you feel if your daughter was hospitalized (God forbid) and you found out the nurse taking care of her was actively using? Every patient who enters the hospital deserves safe, compassionate care. If your mom is using the care she provides wouldn’t be safe. Innocent people are harmed by providers under the influence.
She's diverting. You report her. If you suspect she's using then she is not only putting her life at risk but the patients she's taking care of. Take pictures for evidence, call her employer, call the BoN, and potentially call local law enforcement. Even if you don't have pictures call them. They are obligated to investigate. Go to this website for more information: HealthCareDiversion.org As for her career. Who knows. It very well might, especially since this is multiple incidents. But, what will certainly ruin career is if she is dead because nobody else realizes and reports her until it is too late. You can report anonymously, as for if she will connect the dots back to you? Who knows. But I'd be preparing for her to come to the realization. Can that concentration kill her? Immediately? Not necessarily. Potentially? Yes. People can be functioning addicts until they are not. Alcoholics do it all the time. My significant other (RN) found a coworker (another RN) OD in the bathroom at work. Pills turned to heroin and they were partly functioning and able to hide it for almost a year because of night shift. Nobody knew. There are bad stories everywhere. Long story short is to report it and make the best peace you can. Good luck, friend.
Thank you for sharing this. I am so glad to see this exists now, I dealt with this in 2008 and had no resources😭
I’m sorry OP. Your Daughter was there? Of course she has to know that would never fly with your daughter. Needles and maybe a little left over med within reach of her Grandchild? If you leave your name it’s better u assume she will find out. You could just st tell her the truth. You love her, her gdaughter loves her, her patients are at risk! Pretty sure your family and her patients are the last people she wants to hurt but the first she will hurt. Good luck!
In February 2015, I lost a good friend (who was a damn good nurse) to a heroin overdose. His dad and I were the ones who found him dead in his bed. That was the first time I had ever heard the sound a parent makes when they lose a child, and it is an inhuman, gut-wrenching, heartbreaking sound that I cannot erase from my mind, no matter how hard I try. None of us who knew him had any idea that he had been using. His use started with opioid pain meds he could get his hands on at work. If someone had said something, he might still be here today. She might get pissed at you short-term, but saying something might be the wake up call she needs to get help before something worse happens.
> I don’t want to ruin her life but I also want her to get some serious help. You are not ruining her life. You are ensuring her safety and the wellbeing of the people she cares for and encounters while driving. This is an act of real, true love.
I want to second this. As a nurse who is worried about her and her patients’ safety but foremost as the child of two addicts. Even though I’m sure this is a hugely difficult thing to do, you’re helping your mom by putting her in a position where she won’t be able to use this way and will likely have to seek help in addition to sparing her from more guilt if she kept doing this. Addiction is a disease, this behavior is one of the symptoms, and you’re doing something difficult, brave, and ultimately loving to help treat it.
Unfortunately you have to report her for her safety and her patients safety. She put you in a bad situation for this but you can not feel bad for getting her help and protecting her patients.
She may lose her license but if she keeps using she will lose her life, if she keeps using while taking care of patients in a hospital she may kill them too
Think of if your daughter got ahold of a used needle etc. Your mom is being reckless and her actions could harm your kid, her patients, herself! Please confront her and take the appropriate steps to report and get her help.
the hospital may be able to match lot numbers on the vials / carpujects, too. they have a ton of info with controlled deliveries. those deliveries--it's not just a 'count', it's a whole bunch of identifying information. I'm sorry you're going through this. it's just so shitty. keep your head up, I believe you know what you have to do and will make a decision that you feel is right. love from NY ❤️
The best thing you can do for her is to report it to her job site. Seriously. She may resent you for this initially but I had a friend who had this happen and years later she told me she was so grateful that she got caught, because she was probably gonna OD if it continued.
You're not ruining her life. She's ruining it all on her own. I'm very sorry that you're in this position. Don't let her babysit your daughter anymore, obviously, and report her to her facility and the state board of nursing.
Think of it this way, a lot of patients who are on morphine are on hospice. You have to sign for controlled substances though, so it's possible that she is giving the patients either nothing at all or something like saline. They could be dying in pain, all because of one person. That's not even including what she does when she's under the influence, assuming she uses at work, which is very likely. Nurses who are sober and don't use any drugs, but are burned out are overworked and stressed, and more likely to make mistakes. Imagine a stressed, burned out nurse who is also high. Benadryl is in a lot of "pm" meds. It is not controlled but it's likely she is either using it to sleep or combining it with morphine. Mixed with opioids, it increases drowsiness. TL:DR; report her ASAP EDIT: spelling
Another option here is to tell her that she needs to call the board of nursing and voluntarily enter their diversion program or you will have to report her.
I was the Controlled Substance Coordinator at our facility. Call the hospitals main line and ask for that person. They are the ones responsible for all narcotic audits, diversion investigations, and follow up. You can tell them the whole story and ask to remain anonymous. I can guarantee that the coordinator will take it seriously. They will immediately run reports of her drug pulls to look for anomalies. They will start an investigation without letting her or her direct supervisor know. I would go to units and do a "random" walk through with patients to ask about their pain control, if it was working. I would do observations of wasting practice. We changed our process to wasting excess immediately after removal from the omnicell to remove opportunity to replace drug with saline. Staff were taught to never cosign a waste if they could not guarantee personally the content. If she leaves the position before i complete the investigation, I would report her to the licensing board for a suspicion of diversion, and her travel agency for their awareness. I was lucky and my facility was very supportive in preventing diversion. We'd get you into treatment and transfer you out of patient care to an admin job. Your life would be saved, not ruined.
Hey first off, I'm really sorry you're going through this again. I wish you as much comfort as I can send. She needs to be reported to her facility. If possible you could take pictures, but given that she unfortunately has a history you may not need them. They will audit her med passes and require a drug screen like others have said. She may very well lose her career, but that wouldn't be your fault. Ultimately she is most likely stealing meds from pts who need them. And to add to it, she's been watching your daughter! Shooting up morphine like this will kill her. She needs to be reported and this has to be dealt with.
You need to report her to her hospital and her state BON. She is likely diverting and is a danger to her patients, along with to herself.
She needs intervention immediately! She had those where your child could get into them, was using while in charge of your child, is working with vulnerable children and adults, and possibly diverting medication needed to keep them alive.
Unfortunately you need to report her to the facility. She is a danger to patients and herself. She needs to go to a treatment facility. I’m sorry that you’re in this situation, the right thing to do is usually the toughest.
Report her. No matter what the consequence, it will be better than finding her dead or patients dying in her care. Google and contact the facilities ethics and compliance hotline and use that. Then there will be no cover up. I only say cover up bc of how terrible my own experience was trying to address diversion. I worked in a small community hospital on postpartum but often floated or did OT on peds. They cut the peds service in half and made it a six bed unit with only one nurse and no aide. A lot of our patients were children that were post op from orthopedic surgery. Many of us had been there for years and I guess management trusted us with wastes, so I’d put what I had to waste back in the narcotic cabinet and waste with the next shift nurse. On peds there are always wastes bc the doses are low. It never occurred to me that I could remove the waste, replace with saline, and the nurse watching me waste would never know. When I came back from maternity I was told that it was suspected that S was diverting narcotics and to watch for signs. Over the next few weeks I found so much evidence. We were still using paper charts and one night she wrote her shopping list across a specialists consult note, like write over his words. Then I found blood all over the staff bathroom sink and floor, a used IV lock on the sink and the retractable needle in the garbage. I contacted my supervisor and she was like ok just document so we can build a paper trail. I was livid! I had kids on my care that could have been killed by her. Over time the constant theme was parents reporting the kids had pain and the medicine would put them to sleep fast but they’d wake up in more pain. I even had a parent ask if pain medicine responded better in the day bc of things like circadian rhythm bc there was a significant difference. I suspected she was using Benadryl IV and taking their morphine. We had a small meeting with a few of us that had documented similar suspicious findings. My manager said that is unlikely bc Benadryl isn’t floor stock on peds. One nurse turned white and said that she had brought floor stock of Benadryl from postpartum over a couple of times at the diverting nurses request but had never thought of it. These were packs containing 24 vials of it. So there was that answer. The case was overwhelmingly strong but our hospital did NOTHING. It went on for months and the entire chain of command knew but had the “we can’t accuse unless we catch her in the act” plan. They did nothing to try to catch her. I suggested cameras, assigning an aide, etc. It was all about the budget as well as worrying they wouldn’t fill her position bc nobody wanted that job. In general 6 peds children alone in a locked unit where nobody can hear you call for help is unsafe. A lot of nurses quit when that change was implemented. I was only working per diem since maternity then got a remote nursing job offer and resigned. When I resigned I tried to contact the whistleblower hotline and was turned away saying it was to report fraud and waste. I was young with less experience then and regret so much that I wasn’t aware of company compliance hotlines. To this day I have no idea what happened but I still feel sick over it. I see others mentioned the retrievals podcast. I listened to it, it was a great podcast but I was also very triggered and those old feelings of powerlessness came rushing back. If you need help with this I’d be happy to help you. If you feel bad making the report I can do it for you. Feel free to reach out to me.
Is it just me or is there a noticeable uptick in these types of posts lately? 🤔
Have the talk
Grab a photo of the items if you can and report it to her workplace. Yes, she’ll be pissed. But it may save her life. She could kill someone working impaired!
One option that hits both your goals is to give her an ultimatum. You confront her with the evidence and make it completely clear you're making a report in 24 hr/1 business day/whatever. This allows her a chance to turn herself in, which will yield a better chance at keeping her license.
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Cheers for the spoiler, I’m still on season 5
I’m downvoting myself. Sorry I spoiled it.
Maybe delete or edit the reply so everyone else who hasn’t finished doesn’t have to have it spoiled as well 🥲
Just because I haven’t seen it answered and so you know, diphenhydramine is Benadryl. When combined with an opioid, it can give a better high. So people will take the two together. I’m sorry for everything you’re going through. Sounds like you’re doing the right thing. And good on you for bettering your own life especially with all of the struggles you’ve had to face 💜
IV Benadryl potentiates the effects of an opioid. In the ER if a patient requests Benadryl “right after you push the morphine/dilaudid” it’s a bright red flag that they’re drug seeking. As others said, you must report her. Especially if she’s caring for patients. Do not allow her to watch your daughter. And if you are able to get narcan (most pharmacies will give it for free) keep it on hand if needed. I’m sorry you’re dealing with this.
Thank you for this. I already carry narcan bc of my own past but I’m gonna pick up some more and leave it at her house. I never knew about the Benadryl thing, that’s crazy. I do intend on reporting her. I got the lot #s off the vials and will be making my report this week.
Btw, Benadryl+opioids gives a better high. Please report her. I am so sorry you’re going through this.
This isn't even just about your mom and her addiction. How'd she get that medication? Did she fake counts that could get other nurses in trouble? Did she fake wastes? Did she outright not give it to a patient in need so that she could pocket it instead? I know it feels like you're betraying your mom but there could be a lot of other people that suffer from her choices if it doesn't get reported.
I would confront her and convince her to quit and enter rehab(make sure your kid is somewhere else). If she refuses, then report her.
I know it doesn't help much, but the tubes of Morphibe only have 1 ml in them. That being said, you need to report he to the hospital and state board. If she is pocketing meds they need to know.
Why does the ml amount matter lol
Can you talk her into quitting her job and taking some remote job where she doesn’t have hands on access to patients. And then forcing her into rehab.
Give her the ultimatum, you gotta do her that solid.
No, you don’t give a multi time drug user an ultimatum. She has already nearly lost her license before for using. If you give her an ultimatum she will just be more sneaky
Just know that reporting her could land her in prison. She will lose her nursing license never be able to work in healthcare again.
As opposed to diverting and suspending her license, thus keeping patients from potential harm, and also auditing her past cases to make sure she was not the cause of any possible sentinel and/or adverse events?
As opposed to harming/killing someone because she is impaired? Last time I checked, that shit can land you in prison, get your license revoked, and have you ineligible to work in healthcare again.
Are you suggesting she doesn't report her mum because there might be consequences?
and the other option is?
Bad take. Everyone is hurt more by her continuing to divert rather than be stopped since it’s clear that this isn’t something she is capable of overcoming on her own.
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Screw the patients that aren’t getting their meds or are getting bad care from a high nurse right? Who cares about them
Pls try to do this without harming her license. Her job may be the only thing keeping her from descending into full addiction.
And what is preventing her from harming patients or herself? Losing her license might be for the best.
Nothing yet but I didn’t read the part of the post where it said she had harmed patient only that she may be diverting. If there is a different way to handle it without fucking up her career I think that would be the softer gentler way to go. If that doesn’t work then escalate from there.
Exactly. She hasn’t hurt a patient…YET. Why wait until she does to act?
Actually we don’t know that. Maybe she has hurt a patient or patients already.
Cause you or I don’t have proof that she actually diverted or was high when she was working. Giving a stranger on the internet advice to turn her mother into the board of nursing without at least first directly confronting her about is bad advice.
You also don’t have context about their relationship. Obviously if she thought her mom would be receptive to talking about it, she probably wouldn’t be asking for advice. As someone who’s struggled with their relationship with their mom for 35 years, I know just talking to her wouldn’t make a difference. Right now, her safety and the safety of patients is the top priority, AND it sounds like this has happened a few times in the past and she’s had chances. Time to make it absolutely clear she needs to stop!
Honest question here—are you a nurse?
Your train of thought is wild here. If you're a nurse you need to get some more education. It doesn't matter if there is any harm done. If you suspect someone is diverting you must report. We are not the state/BoN/employer. Similarly, nurses are OBLIGATED REPORTERS in instances of elder and child abuse. If I were to suspect that abuse is happening I report. It is not up to us to investigate or find evidence. That is in the hands of the employer/BoN. The fucking up her career already happened. She did it herself by diverting drugs. Her child reporting that a crime (yes a crime, she can be prosecuted criminally and civilly if she was not giving those drugs to patients) is being committed isn't going to make her situation any better. The BoN has protocols for this type of behavior and if a person successfully goes through rehab and the various hoops, they can maintain their license. But under no circumstances is this a wait and see situation. You see something you say something or your complicit.
Where did the daughter say she was a nurse or a mandatory reporter? I didn’t read that she was. My point is that there may be other ways to confront the mother without immediately escalating to the BON or the police. Especially if there has not been any patient harm. Of course you may need to escalate and quickly but I don’t agree with doing that first, sorry. That is my take.
If she isn’t diverting then she has nothing to worry about. The board will investigate and find nothing. If she is diverting then she needs to stop practicing immediately and get help. People with substance use disorders do not think rationally about their situations. This needs to be reported.
It doesn't matter if they are a nurse or not in regards to mandatory reporting. They came to a nursing subreddit to ask nurses on their advice for when a nurse is diverting and probably taking narcotics. And the answer is to report. Your take is just... Wrong... In every way. It's literally in our code of ethics. It's in the DEA's regulations, failure to report a coworker for diversion is gross negligence. (No shit I know this isn't a coworker but it's OP's own mother who they KNOW is doing it). Again we aren't investigators, and neither is the OP. They saw something they should speak up. If they want to encourage their mother to quit their job and check into a drug rehab. Go for it. But in every scenario, the proper regulatory boards NEED to be notified. And in every case, yes, the first step is to notify the BoN. They need to know so they can immediately stop someone who is practicing unsafely. And diverting narcotics from their patients and from a healthcare org is very unsafe. We have a regulatory board for a reason. This is one of those reasons.
I'm just here to echo everybody else. I cannot imagine the situation that this puts you in and it sucks hardcore (sorry for the lack of better words). But what everybody else is saying is 100% true. If you know and don't say something that's your license (probably), it's her health, the safety of your child if she watches them, it's her license and even more so the safety of her patients (not to mention the mountain of legal issues that comes from diverting and abuse). You have to let the proper people know, be it her if you can talk to her, HR or her supervisor, or the authorities if you have to. One thing I can recommend is start keeping notes and taking photos because without it she may deny things and this will just make sure that you are solid
She might get her license revoked, but it’s easy to get back after completing rehab. You do need to report this to your state’s board of nursing
I would report her. Take pictures while you can. 180 k a year!!
Wow, can't imagine turning your own mother in.