Suffering from rheumatoid arthritis, a seasoned nurse participated in a pain-management program under the supervision of her PCP. She works full-time in a case management-type position. A co-worker on the same pain-management regimen asked the nurse several times for some of her pain medications because he had either run out of his own or had to wait to get his prescription filled. The nurse complied with his requests. The experienced nurse decided to retire, and when she gave her two weeks notice, her co-worker's behavior became erratic and he constantly begged her for more pills. Troubled about this development, the nurse shared her concerns about this behavior with her supervisor and said she had supplied him with some of her medications. The co-worker was terminated immediately and the supervisor informed the nurse she was considering reporting her to the state board of nursing. The nurse, thinking that she was just helping a friend, is now anxious, worried and afraid she may be disciplined by the state board. The nurse's apprehensiveness is well-founded. It is not acceptable to share any medication with another co-worker, whether it is from one's own prescription or from another source. This prohibition includes any medications, including over-the-counter ones. Was the co-worker truly on the same regimen or did he simply say this so a compassionate fellow nurse would believe him? Whether the co-worker was on the same regimen or not, her conduct enabled what appears to be this co-worker's addiction/abuse to this medication or several medications. Another concern that arises from this nurse's experience is the potential impact it might have on other nurses in the facility who are on a legitimate pain-management regimen and continue to work with the facility's knowledge and approval. If administration raises concerns that such an incident could happen again, or fears it is happening without its knowledge, its policy and procedures governing employees on a pain-management regimen while at work may be altered drastically. In addition, this nurse administered the medication to her co-worker without an order from an APN, physician or other licensed healthcare provider with the authority to prescribe medications. The nurse, who is administering a medication to the co-worker without a legally authorized order, has placed herself in the position of practicing outside the scope of practice. The nurse also knows very little, if anything, about the co-worker's state of health and other medications he is or might be taking. If the co-worker is addicted to or abuses this or another medication, he might be ingesting other medications that are clearly incompatible with each other and/or with the rheumatoid pain medication. His very well-being may be at stake. It is unfortunate that this nurse, whose actions were well-meaning, has placed herself in this position. She is to be commended for reporting her concerns to the supervisor and this may help her if she faces disciplinary proceedings before the state board of nursing.
Your turn
What would you do if confronted with helping a co-worker with this request? Note: Nancy Brent's posts are designed for educational purposes only and are not to be taken as specific legal or other advice.
