nursingpins: T1 - It is a bigger problem than most know about - often overlooked Waiting for
ocdgirl2000 to respond #RNchat
ocdgirl2000: #rnchat T1 frequently methadone clinics are blamed for diversion of their medication,
when more likely is pain management or Dr's offices.
OSUMarkRN: T1: I think it is still on the rise. #RNchat
InfusionNurse: Happening a lot in the OR...diverting instead of wasting.. #rnchat
ocdgirl2000: #rnchat T1 methadone is one of the most overdosed drugs around, but usually the pills,
not the liquid. pills often RX'd by Docs,not clinics.
bthenextstep: T1 my experience has been limited to what I read, and hear about. just had an incident
nursingpins: T1, I have seen act go on for a long time (with nurses)- but all get sloppy & do
themselves in (without interv.) #RNchat
ocdgirl2000: #rnchat T1 opiate use and abuse is ridiculously high. and overlooked. addiction to pills
escalates, then..they end up with us!
EllenRichter: T1 We were hoping that computerized dispensing units would prevent misuse, but anyone
who is creative can get around that #RNchat
bthenextstep: so are we asking the question of why it is happening? or how to prevent it? T1 #RNchat
bthenextstep: @EllenRichter T1 my argument for that is.. a computer is only as good as its user.
ocdgirl2000: #rnchat T1 before U know it, they are on lollypops, patches, diluadids, snorting, then
nothing helps, the pain of withdrawal worsens.
rnchat: @bthenextstep Haven't asked either yet, but you can answer that if you'd like. More about
how big the problem is. #RNchat
OSUMarkRN: T1: I think there is a very large hidden population who have learned to adapted to
computerized documentation. #RNchat #RNchat
EllenRichter: T1 @ocdgirl2000 boy you must have some hair-raising stories #RNchat
bthenextstep: T1 I'd only be guessing at how big the problem is. Lately I have read more and more
about it. And now seeing it locally! #rnchat
nursingpins: T1, I think the comp. systems helps - esp. smaller unit doses for MS and Dilaudid
ocdgirl2000: #rnchat T1 the addictive personality usually is a behavioral thing. recognize the
ocdgirl2000: #rnchat T1 recognize the symptoms of opiate withdrawal vs pain do you know the
EllenRichter: TI @nursingpins Dont be fooled--there are staff who swap pts' narcotics for saline, even
small doses add up #RNchat
nursingpins: @ocdgirl2000 behaviors that are common (I've seen) works many extra days - mood
swings etc - you are right. #RNchat
rnchat: @ocdgirl2000 T1 - so what are the key behavioral clues? #RNchat
EllenRichter: T1 @ocdgirl2000 No, tell us what opiate withdrawl symptoms are #RNchat
ocdgirl2000: #rnchat T1 when I first started doing this I didn't know!LOL! also there is a "seeking"
behavior quality that goes along with this.
EllenRichter: T1 Many times healthcare professionals get hurt & take narcotics, only to find they get
hooked on them. Then seeking @ work starts #RNchat
AnthonyBurich: Sorry that I'm late. Nursing school student, Northern California. Howdy. #rnchat
bthenextstep: T1 behavioral or not: one is having an RN treat another RN's patient for pain - knowing
the patient has not had any pain. #RNchat
ocdgirl2000: #rnchat T1 yes there is pain, stomach, cramping, diarrea, back,legs,inability 2 sleep,
runny nose,watery eyes,(flu-like) profuse diaphoresis
OSUMarkRN: @EllenRichter T1 Do you believe we should allow nurses to work if they have a Rx for
pain meds? #RNchat
bthenextstep: @AnthonyBurich welcome! #rnchat
ctsinclair: RT @EllenRichter @nursingpins Dont be fooled--there are staff who swap pts' narcotics
for saline, small doses add up #RNchat (shakes head)
ocdgirl2000: #rnchat T1 1 of ours IS an RN, lost license.orthopedic, worked 4 Docs.soooo sad!!
nursingpins: T1, most nurses I've known use (abu) oxy and hydro at first then MS and Demerol - then
real problems. (we need more drug testing) #RNchat
ocdgirl2000: #rnchat T1 another is presently in nursing school, mom is RN too.
bthenextstep: @OSUMarkRN @EllenRichter T1 I don't think we should make a blanket statement about
any/all RN's who use/need Rx narcs #RNchat
AnthonyBurich: @bthenextstep Thank you! What is T1? #rnchat
EllenRichter: T1 @osumarkrn Tough question. Narcotics can interfere with decision-making, yet many
are on chronic narcs & U would never know #RNchat
AbbieCitron: T1 Many cases I work on, pt. starts with true pain, prescribed narcs by many MDs,
become seekers, then have to be put on Methadone. #RNChat
ocdgirl2000: #rnchat T1 one was a physician, he lost his license, but not a methadone client.
philbaumann: Even if you're not a nurse, I think the convo over at #RNchat is worth a lurk.
InfusionNurse: T1 know of an RN who got hooked post surgery, then started taking, then sold her RX to
an undercover narc cop and got busted! #rnchat
OSUMarkRN: T1: "yet many are on chronic narcs", hence why at times we are not going to see the
EllenRichter: RT @philbaumann: Even if you're not a nurse, I think the convo over at #RNchat is worth
nursingpins: T1 many patient drugs are taken when admitted - need better monit. #RNchat
bthenextstep: @AnthonyBurich scroll back through the search string of #rnchat. T1 is about drug
rnchat: I'm tempted to let T1 keep going the full hour. Show of hands: would you like that?
shelisrael: RT @PhilBaumann Even if you're not a nurse, I think the convo over at #RNchat is worth
ocdgirl2000: #rnchat T1 there have been overdoses I have heard about in past of RNs who took
methadone!they passed away!!!sick!!one actually owned clinic
EllenRichter: T1 Monitoring of colleagues' behaviors relating to drug use is a very touchy
situation...most would rather turn their heads away #RNchat
OSUMarkRN: Reposting b/c it was lost... T1 "yet many are on chronic narcs", hence why we don't see
the 'behaviors'. #RNchat
bthenextstep: @ocdgirl2000 T1 I agree w/ you. I think regardless of your occupation, nurse or patient -
the behavior is the problem. #rnchat
nursingpins: T1 You are right Ellen - I see that 1st hand. #RNchat
bthenextstep: T1 don't you think the RN's who are guilty of this act would find another outlet had they
not be/been an RN?? #rnchat
AbbieCitron: RT @OSUMarkRN: Reposting b/c it was lost... T1 "yet many are on chronic narcs", hence
why we dont see the behaviors. #RNChat
SeerGenius: #rnchat i'm a lurker and not a nurse, but T1 sounds interesting - and not in a fetish kinda
way, but informing way.
ocdgirl2000: #rnchat T1 the brain is wired for addiction in some and not in others. addiction info is
fascinating! I would highly reccommend classes!
EllenRichter: @rnchat What is question #2? Now you have me curious! ;) #RNchat
nursekris99: T1: Cancer nurse. See problems all the time from family members. #RNchat
AnthonyBurich: @OSUMarkRN Very similar to "functioning" alcoholics - and we know there are LOTS of
them around. #rnchat
bthenextstep: RT @AnthonyBurich: @OSUMarkRN Very similar to "functioning" alcoholics - and we
know there are LOTS of them around. #rnchat
OSUMarkRN: @AnthonyBurich T1: agree #RNchat
nursingpins: @AbbieCitron - as long as they get the meds - will not see the behav. The problem is
when they dont have them. #RNchat
ocdgirl2000: RT @ nursingpins: T1 many patient drugs are taken when admitted - need better monit.
#RNchat omg! I second THAT!!!
rnchat: @EllenRichter It's about how nurses can leverage social web - but this convo amazing. I
can save that topic for the next chat. #RNchat
AnthonyBurich: @bthenextstep Most definitely! #rnchat
rnchat: NOTE: I've decided to hold off on another topic. T1 seems to have sparked some juicy
awesomeness. Continue my friends! #RNchat
RoRod101: Hi All, Sorry to be late. Can I join? My name is Ro. I am a RN NP Nurse Educator &
DNP student. #RNchat
bthenextstep: T1 so yeah or neh to moving on to T2? I'm good w/ either. :) #rnchat
EllenRichter: @rnchat Sure, we can fill an hour with this topic (T1) :) #RNchat
bthenextstep: T1 so should RN's be drug screened ? yearly? I remember only on hire? #rnchat
ocdgirl2000: @nursingpins #rnchat they leverage the meds by selling, buy friends, love,superficial
things, distorts reality, gets worse, other addictions
OSUMarkRN: @bthenextstep T1: I think all h/c workers should be yearly. #RNchat
bthenextstep: T1 it is then #rnchat
nursingpins: T1 - Nurses need to be drug tested at least every 2 monts - or we will not change things
- sorry to say. #RNchat
EllenRichter: Welcome latecomers @rorod101 @anthonyburich @nursekris99 @seergenius #RNchat
bthenextstep: @ocdgirl2000 so then we're still on the behavior of addiction. I agree w/ that. #rnchat
rnchat: @RoRod101 Welcome, Ro. Here's T1 - http://bit.ly/1VZZNc #RNchat
bthenextstep: @OSUMarkRN T1 I do as well. #RNchat
EllenRichter: T1 ~For sure, random drug testing of health care professionals would certainly weed out
noncompliant people #RNchat
AnthonyBurich: @bthenextstep My class just got screened pre-clinical rotation. #rnchat
ocdgirl2000: #rnchat T1 they have to screen us @ hire Gov is into it! LOL! I would love it! great plus 4
job like ours, hard to find good methadone RN's
RoRod101: @rnchat Thx. About to ask that. :) #RNchat
InfusionNurse: shld be tested 2 when behaving suspiciously! RT @OSUMarkRN: @bthenextstep T1: I
think all h/c workers should be yearly. #rnchat
AnthonyBurich: @EllenRichter Thank You!! #rnchat
bthenextstep: @bamagirlRN That was my point. LOL I think the behavior is the issue - AND they
happen to be RN's. #RNchat
EllenRichter: T1 And those health care professionals on legitimate prescription drugs can have results
waived with valid rx #RNchat
bthenextstep: T1 I believe there is a protocol for testing when suspicion is found. But why not yearly
testing - period. #rnchat
nursingpins: T1 - Critical care nurses are so strange - would be hard to tell when a behav. is new - ;)
OSUMarkRN: @EllenRichter T1 agreed. #RNchat
chuymatt: so, are we talking someone watching me as I pee? I must say, the feeling with jobs like
that is that we are not trusted. #rnchat
ocdgirl2000: #rnchat T1 they should also breathalize RN's as well. especially in the AM.
bthenextstep: @EllenRichter T1 good point about the valid Rx. #rnchat
OSUMarkRN: @nursingpins OUCH! #RNchat
bthenextstep: @nursingpins T1 HAH.. you are so right. Sad.. but true. #rnchat
EllenRichter: T1 I'm wondering if we would have many staff left to work if there were random drug
nursekris99: T1: Our company has a random testing policy, but has yet to enforce it. #rnchat
bthenextstep: @chuymatt T1 so then how do you keep the workplace safe without offending someones
trust? (w/ yearly screening) #rnchat
ocdgirl2000: #rnchat T1 you would be surprised how high the blood ETOH level is 4 someone who has
a tolerance is!people who drink maintenance q day?heh!
AnthonyBurich: @EllenRichter Do you think a healthcare pro consuming narcotics on a script is still a
danger to patients and coworkers? #rnchat
nursingpins: T1 - Drug div. is a much bigger problem with nurses than most know about - I see it!
chuymatt: "to clock in, swipe your card, pee in the cup and breathe into the mouth piece." #rnchat
RoRod101: T1 Have not seen 1st hand. But one thing I keep in mind is nurse are human first,
therefore susceptible to human afflictions. #RNchat
OSUMarkRN: @nursekris99 T1: that's the prob with most random test P&P - it is never enforced.
RoRod101: @EllenRichter Thanks for the welcoming party. :) #RNchat
chuymatt: @bthenextstep keep a random drug testing policy that is signed off with hire. Ed. on s/sx
of diversion. Test those who seem it. #rnchat
bthenextstep: @AnthonyBurich @EllenRichter w/ that in mind.. aren't we all a pot threat to the patients?
(mere safety - not just nard use)#rnchat
nursingpins: T1 -nurses are human - same addict. personalities as gen. pop - but WE have more
nursekris99: @OSUMarkRN They DON'T test the ones who need it, and threaten people they just
don't like. But no one pees in a cup. #RNchat
EllenRichter: T1 @anthonyburich Yes, working with patients' lives requires a sharp mind, not a drug-
induced state. But I know there R exceptions #RNchat
ocdgirl2000: @RoRod101 #rnchat howdy! this is a fun chat!LOL! welcome!
Geek2Nurse: Hopping in late - Psych RN working toward PMHNP. My super power is insight into
*other* people's problems (not so easy with my own!) #rnchat
false2scams: T1 @ocdgirl2000 No, tell us what opiate withdrawl symptoms are #RNchat
chuymatt: @bthenextstep T1 on further thought, yearly testing does not seem like a horrible thing to
philbaumann: I worked in one facility that had random tests. No biggie - unless you didn't drink fluids for
an entire 12-hour shift. :) #RNchat
bthenextstep: @philbaumann what.. a nurse not drink fluids for a 12hr shift? never heard of such a
thing? ;) #rnchat
AbbieCitron: T1 So I'm curious, how and when is drug testing done at your hospital? or is it done?
chuymatt: I think that there might need to be further policies in place to address addiction as a
disease too. For those who are, Tx. #rnchat
ocdgirl2000: #rnchat T1 you go in room w-out anything to hide stuff, they don't stare so close, not so
bad!we do this to patients 2x/wk! get levels of RX
EllenRichter: T1 I know that firefighters, pilots, & many other professions require mandatory testing &
there are urine kits used to taint results #RNchat
RoRod101: @ocdgirl2000 Hey there! #RNchat
nursingpins: You are right Ellen - some nur are still the best - even when imp! - It is the tail end when
they get sloppy that does them in. #RNchat
bthenextstep: @chuymatt but it would still have to be done randomly.. so that no one could prepare
chuymatt: @bthenextstep I have a timer set on my watch for q2h to drink some water. So sad.
bthenextstep: @AbbieCitron i only know of the initial hire screening.. then only when suspected will they
drug screen. #rnchat
AnthonyBurich: @bthenextstep Agreed! Random prevents any detox attempts or other shenanigans.
RoRod101: @bthenextstep That's how I know it too. #RNchat
bthenextstep: @EllenRichter I think we all could agree - regardless of what can/could be implemented:
someone will always find a way around it. #RNchat
nursingpins: YES - Randon tests are needed. #RNchat
ocdgirl2000: #rnchat T1 @chuymatt addiction IS a disease.& it is treatable,or we would not be in
business!bless addiction treatment & funding 4 doing it
EllenRichter: @bthenextstep T1 Yes!! Anyone who is cunning & manipulative can find a way to beat
ANY system #RNchat
AbbieCitron: RT @bthenextstep: I think we all could agree-regardless of what can/could be
implemented: someone will always find a way around it. #RNChat
bthenextstep: So then - is there such a thing as a foolproof method? #rnchat
ocdgirl2000: #rnchat T1 there is no way around the spit tests, sorry! they are expensive as all heck!
Geek2Nurse: Darnit, I keep forgetting the tag. #rnchat
InfusionNurse: I agree..RT @nursingpins: YES - Randon tests are needed. #rnchat
Geek2Nurse: T1 I'm not against random testing, tho it's a pain for me, since Adderall makes me show
positive for amphetamines. #rnchat
nursekris99: We had an alcoholic on staff;her busting meant no alcohol even at office social functions.
Geek2Nurse: T1 Also take occasional Valium for Meniere's symptoms, & it sticks around for a few days
in the bloodstream. #rnchat
bthenextstep: @Geek2Nurse try using tweetchat- that's what helped me. or tweetdeck #rnchat
chuymatt: @Geek2Nurse As long as you have the Rx, it should not be an issue. #rnchat
Geek2Nurse: T1 So I worry about perceptions. Even tho my Rxs are on file with HR, anyone looking at
lab results doesn't know that. #rnchat
RoRod101: @Geek2Nurse U bring up something interesting what would happen with false positives?
bthenextstep: @Geek2Nurse but I think these are all s/s that would be accounted for as long as they
are known ahead. #rnchat
EllenRichter: T1 @rorod101 I didnt know there could be false positive drug tests...what causes that?
OSUMarkRN: Ok. Need to sign off. Good night. #RNchat
bthenextstep: Join me for a #rnchat TweetChat at: http://tweetchat.com/room/rnchat - drug diversion is
the topic of discussion #rnchat
nursingpins: The long term imp nurses are the ones that are the most destructive in the end - and the
ones that need the most help. #RNchat
AnthonyBurich: @bthenextstep Nothing foolproof. It's a vicious cycle - just look at all of the sports doping
scandals. Constant oneupmanship. #rnchat
Geek2Nurse: T1 And I can assure you, they wouldn't want me doing patient care *off* my Adderall. :) I
absolutely won't pass meds without it! #rnchat
chuymatt: @RoRod101 usually there is a 2° check. They should also check your teeth for poppy
ocdgirl2000: #rnchat T1 what we do is send out our pos n patients 2 the lab for LEVELS & break
down to consituents of exact drug content!falses eliminate
bthenextstep: @Geek2Nurse only the ones who need to know should be looking at the results anyway.
AnthonyBurich: @nursekris99 That sucks! The action of one ruins for all. #rnchat
RoRod101: @EllenRichter False in the sense someone taking therapeutic meds #RNchat
rnchat: T1 Follow-up: So what the noblest way for facilities to approach nurses caught diverting?
ocdgirl2000: #rnchat T1 sorry for typos, we are like lab rats where we work!LOL!
bthenextstep: @EllenRichter isn't that like the poppyseed false positive? #rnchat
AnthonyBurich: @OSUMarkRN Good night. #rnchat
bthenextstep: @chuymatt hah! beat me to the poppyseed punch. LOL #rnchat
bthenextstep: @AnthonyBurich night! thanks for the input! #rnchat
AnthonyBurich: RT @chuymatt: @RoRod101 usually there is a 2° check. They should also check your
teeth for poppy seeds... LOL #rnchat
nursingpins: T1 - need to be confront. - they know when they are caught. - Phil #RNchat
AbbieCitron: Good Night All. Enjoyed the informative chat! #RNChat
nursekris99: @rnchat A hospital I worked at removed narc privileges for a certain time. Then rehab,
testing, etc. #RNchat
EllenRichter: T1 The noblest way to deal with nurses (or any other health care professionals) is to offer
nursingpins: Good noct all - Thanks Phill #RNchat
bthenextstep: @OSUMarkRN night. thanks for playing! LOL #rnchat
chuymatt: @bthenextstep for those who have not seen the Mythbusters episode, it was a wonderful,
forgone conclusion. Very entertaining. #rnchat
bthenextstep: RT @EllenRichter: T1 The noblest way to deal with nurses (or any other health care
professionals) is to offer help. well said #rnchat
rnchat: Holy Cow! We're coming up on another fast hour of #RNchat - feel free to continue, but
we'll be wrapping up soon. See next few tweets.
ocdgirl2000: RT @rnchat: T1 Follow-up: So what the noblest way for facilities to approach nurses
caught diverting? #RNchat REFER 2 TREATMENT!!!
bthenextstep: @rnchat noblest way is open and honest communication toward helping those who need
it. period. #rnchat
RoRod101: RT @ocdgirl2000: #rnchat T1 sorry for typos, LOL! ~ I'm not at work :0 #RNchat
chuymatt: @EllenRichter suspension? laying off? I have no clue. Tx must be in the plan or we will
be out much needed RNs. #rnchat
AnthonyBurich: Does the ANA or some other governing board have protocol regarding diversion? #rnchat
Geek2Nurse: @RoRod101 T1 In my case, it's not really a "false" positive. Adderall is an amphetamine;
Valium is a benzo. #rnchat
EllenRichter: T1 We let a staff nurse leave an hour early once a week to make her AA meetings. Thats
what I mean by help & support, too! Very impt #RNchat
bthenextstep: @rnchat i forgot how fun these chats are Phil. You DA-MAN #rnchat
ocdgirl2000: #rnchat T1 well, what did you expect me to say? I get paid to say that!LMAO!!
bthenextstep: @EllenRichter that's awesome. #rnchat
RoRod101: @Geek2Nurse Got it :) #RNchat
chuymatt: RT @bthenextstep: "@EllenRichter thats awesome." Indeed. #rnchat
InfusionNurse: Thanks Phil! Good chatting with everyone! Good night, till next chat! #rnchat
rnchat: Thank you everyone! Wonderful chat tonight! Transcript will be up in a bit. Next tweet will
tell you when the next #RNchat will be.
RoRod101: Great chat all! Nice to chat with fellow nurses. #RNchat
Geek2Nurse: T1 Ironically, @RoRod101, I've never done any kind of illicit drugs, don't even drink
alcohol. :) #rnchat
ocdgirl2000: @RoRod101 #rnchat I'm not at work either, lol!although sometimes it's hard to leave
there!typos I'm sooo tired get up at 4 am..
bthenextstep: RT @nursingpins: Good noct all - now that there's funny. LOL #rnchat
AnthonyBurich: @rnchat Thanks Phil for hosting another awesome chat. Really fun with so many great
participants! Thank you all - and good night! #rnchat
EllenRichter: T1 Very interesting topic. Thanks for all the great conversation, people! :) #RNchat
bthenextstep: FYI I hope I didn't miss anyone - I tried to add all the new faces to my Twitter acct.
rnchat: Next #RNchat - 11:30 EST (15:30 UTC) Wednesday 11/4
EllenRichter: @ocdgirl2000 you were our specialist tonight! Thanks for your thoughts on this subject!
bthenextstep: have a great night everyone #rnchat
RoRod101: RT @AnthonyBurich @rnchat Thanks Phil for hosting another awesome chat. Really fun
with so many great participants! Thx all! #rnchat
chuymatt: goede nacht, all. #rnchat
ocdgirl2000: #rnchat @AnthonyBurich: Does the ANA or some other governing board have protocol
regarding diversion? prob suspension! report to AADA
EllenRichter: RT @AnthonyBurich @rnchat Thanks Phil 4 hosting another awesome chat. Really fun
with so many great participants! TY & good night! #RNchat
ocdgirl2000: #rnchat here's a good link http://www.samhsa.gov/