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
Musculoskeletal injuries and pain
Knowledge of medications
What are the ethical dilemmas posed by this case study?
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
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.