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You discover that another nurse on your hospital unit has taken Valium from a client's medication supply - you confront her and she says "i'm under a lot of stress - I'll never do it again please don't tell the nurse manager"
At risk factors:
- Working at night or rotating shifts
- Critical care assignments
- Excessive overtime
- Musculoskeletal injuries and pain
- Knowledge of medications
- ER nurses?
What are the ethical dilemmas posed by this case study?
- Patient danger
- Avoid conflict
- Feel sorry for the impaired person and don't want to get them in trouble
- The person may exert power over the nurse who should report it.
Warning signs of abuse:
- Poor work performance
- Frequent absenteeism
- Unusual behavior
- Slurred speech
- Isolation from peers
- Incorrect drug counts
- Excessive reports of narcotics that were wasted or contaminated
- Damaged or torn packaging for narcotics
- "Pharmacy error" reports are numerous
- Volunteer often to pick up controlled substances from pharmacy
- Unexplained absences from unit
- Trips to the bathroom correlate with administration of drugs
- Early arrivals - late departures volunteer to work extra shifts
What conditions require scruntiny by the Tx board of nursing?
- Personality disorders - borderline and antisocial
Are criminal background checks necessary?
Criminal background checks became mandatory Sept 1st, 2004. A study looking at data concerning this found:
- There were 1508 nurses disciplined from 2002-2006
- 28% of the crimes were felonies
- In the two year period after the CBC became mandatory there was a 638% increase discovered among practicing nurses who failed to disclose their criminal histories.