Patients in pain
The consequences for patients can be devastating when nurses steal drugs from their workplaces.
In 2011, 25 St. Cloud Hospital patients came down with a bacterial infection after nurse Blake Zenner replaced their liquid hydromorphone with tainted saline, according to the U.S. Department of Justice. A Minnesota Department of Health report said that within two days of becoming infected, one patient died, three required surgeries and six needed intensive care. In 2010, nurse Sarah Casareto was accused of telling her surgery patient at Abbott Northwestern Hospital to “man up” instead of giving him pain medication she had kept for herself.
Those cases represent some of the most extreme examples of a growing problem both for employers of nurses and the Nursing Board.
Reports of Minnesota health care professionals who have diverted — the industry’s term for drug theft — jumped 325 percent from 2006 to 2010, the most recent data available from the Drug Enforcement Administration and state health department.
Health care facilities across the state have responded by tightening their protocols to keep track of narcotics. Yet addicted nurses figure out ways to get them, records show. They override dispensing machines, tamper with medications, get fake prescriptions, falsify records to hide their thefts, give small doses to themselves that are meant for patients, or take excess medication that’s supposed to be destroyed.
“Nurses have much more access to prescription medications and diversion of those substances than physicians do,” Seppala said. “It’s a major part of their job. They are really are at the highest risk for such diversion.”
The Nursing Board estimates that about 85 percent of nurses who admit to diverting have at some point lost their licenses. That’s what happened to Zenner and Casareto.
Most are given the opportunity to regain those licenses if they prove their sobriety and meet other conditions. Since 2010, the Nursing Board has licensed 94 nurses accused of diversion or illegally getting prescription drugs, the Star Tribune found. Of those, 71 have no limitations on working with narcotics. Those include nurses like Elizabeth J. Foss, who has a history of drug abuse, being impaired on the job, and allegations that she stole Vicodin for herself and her boyfriend, who was also one of her patients, according to a Nursing Board record.
Foss said in an interview that she has completed treatment and that “everybody makes mistakes. I’ve learned from them and moved forward.”
When presented with the Star Tribune’s findings, Deb Holtz, the state’s long-term care ombudsman, responded, “that’s horrific to me.”
Holtz said nurses who have stolen medications from patients should permanently lose their licenses due to the harm they have caused.
“We need to take a look at the language in our state and federal law that enable us to give people second chances, and determine if those are actually working to the best benefit for the patients, clients and residents,” she said.
Prescription drug abuse isn’t the only addiction that results in referrals for state monitoring. Twice convicted of DWI, Jane Conroy was a school nurse for South Washington County schools when in 2011, she drank eight to 10 shots of liquor one day, then went to work the next day and provided care to students while under the influence of alcohol, according to the Nursing Board. She enrolled in the HPSP in March 2012 but was kicked out after submitting three problem screens, failing to provide three others and failing to respond to the program’s attempt to contact her.
The Nursing Board allowed Conroy to keep her license and ordered her to go back to the monitoring program in April 2013. Conroy’s license was suspended in August after she started drinking again, the board report said.
High rate of failure