Using Servant Leadership to Facilitate Healing After a Drug Diversion Experience

Abstract

Although much has been written about substance abuse in nursing, little attention has been paid to the reaction of a nurse's coworkers after he or she has been caught diverting drugs. The remaining staff members may enter into a grieving process, which can have a serious effect on the delivery of patient care and staff satisfaction. Devoting time and energy to addressing the challenges faced by staff members after a drug diversion experience is essential to reestablishing equilibrium in the department. Using the servant leadership model, managers can exemplify the characteristics of commitment, persuasion, awareness, and foresight to facilitate the grieving process and solidify staff cohesion to help ensure quality patient care.

Diversion of Controlled Drugs in Hospitals: A Scoping Review of Contributors and Safeguards

“…33,40 Assigning patients to specific HCWs may increase accountability and traceability of drug administration. 33,55 Reduce opportunities for diversion between drug withdrawal and administration Define a specific interval within which drugs should be administered after retrieval. 40 Ensure that the number, size and location of ADCs is appropriate for the clinical unit (ie, no more than 30 m from patients' rooms) to support usability, efficiency and compliance.…”

“…47 Falsification of patient documentation HCWs may document complete administration of a drug when some or all of the dose was diverted, 4,22,31,37,39,41,50 and/or may falsely report pain scores to support apparently higher dose administration. 48,55,56 Wastage, returns and disposal Visual confirmation of wasting cannot detect drug content Individuals diverting drugs may replace the contents of a syringe with saline before requesting a witness. 12,57 Falsification of drug expiry Prematurely expiring valid drugs allows them to be transferred to a separate area; 20 these drugs may then be less frequently audited thereafter, and at higher risk of diversion.…”

A critical review of knowledge on nurses with problematic substance use: The need to move from individual blame to awareness of structural factors

“…In the early 1980s, the rise of ‘Alternative to Discipline’ (ATD) approaches challenged the punitive policies that conceptualized nurses with PSU primarily as an issue of their moral failing (Heise, ). An ATD perspective instead viewed nurses with PSU as having a health issue and emphasized treatment and rehabilitation (Monroe, ; Ramer, ; Trossman, ) to ultimately enable a return to practice (Monroe, Vendor, & Smith, ). It involved voluntary participation, temporary suspension of licensure, supervision of an individualized recovery program, and workplace monitoring upon return to work (Smith, Krinkle, & Barnett, ).…”

Compassion Fatigue: A Heavy Heart Hurts

“…In bearing witness to or discovering drug diversion by a coworker, nurses often feel anger, betrayal, and grief (Ramer, 2008). It is important for them to seek assistance themselves-to turn toward, and acknowledge, the problem rather than turn away from it.…”