Being a registered nurse in California is not easy at the moment. The state has had a shortage of nurses for some time, which has worsened this year. Combined with the stress, strain and risk for any working nurse in the current situation, and, understandably, many are struggling to cope. Some have turned to opioids and other drugs to help.
One of the common ways that nurses access these drugs for themselves is through diversion. They receive the medication prescribed to a patient but do not pass it on to them. There is less chance of being caught than stealing drugs out of the storeroom or pharmacy, where someone will eventually notice they are missing.
However, the patient still has to think they are receiving their medication. So, to cover their tracks, a nurse must replace the drug with something else. For instance, if they break open a vial of fentanyl and consume it themselves, they need to fill the vial with another substance such as water to inject into the patient — or maybe a mix of water and fentanyl so that the patient doesn’t immediately notice that the drug isn’t all there.
There is a reason vials are sealed. It keeps the contents sterile. Tap water is not sterile and may contain harmful bacteria that could infect the patient with diseases such as Hepatitis C. On top of that, the patient will suffer because they are not getting the painkilling medicine they need.
You cannot afford to turn a blind eye to your knowledge or suspicions. As hard as it may seem to report a colleague who is diverting drugs, it is the best thing you could do for them. They may be able to join a rehabilitation program and keep their license and their health. Ignoring their behavior puts them at risk as well as your patients. It could also leave you needing to defend your own nursing license after the truth finally comes out.