More than 600 health care professionals are enrolled in the state monitoring program. That number has grown by 15 percent in the last five years. About half of them are nurses, making them the largest group of professionals under monitoring.
Compared with doctors, nurses are more than twice as likely to fail the requirements of state monitoring, a Star Tribune analysis shows. Feider, the HPSP manager, said that’s probably due to two reasons: nurses work directly with narcotics and make less money.
“Nurses don’t have the same financial resources as physicians to seek treatment, to pay for treatment, to pay for screens,” Feider said.
Even after successful completion of monitoring, typically a three-year term, some nurses who handle narcotics can’t resist the temptation and relapse.
“It was like being a kid in a candy store,” said former nurse Melissa Anne Moir.
Moir said she entered the HPSP in 2006 after stealing powerful painkillers like morphine, Fentanyl and Dilaudid from Unity Hospital in Fridley. She successfully completed the program after three years but began diverting again in 2010 while working as a traveling nurse for a dialysis company.
According to the Nursing Board report, she took pain patches off her patients for her own use, abused medication that was supposed to be destroyed, and volunteered to give medications for other nurses, only to use them herself. She diverted from seven hospitals in two years before being caught, according to the report.
Moir’s license was suspended in February, about 10 months after she said she stopped stealing drugs. She said the HPSP was a good program, but added, “If it had worked, maybe I wouldn’t have reoffended.”
Another nurse, Ann Fleischman, took pain medications from hospital patients three years after completing state monitoring. Fleischman already had a history of diverting in 1990 when she worked at a Seattle hospital but was able to obtain a license in Minnesota in 1994. She stole morphine, Demerol and Fentanyl from intensive care patients while working at a St. Louis Park hospital in 2002 and 2003, used while on duty, and was charged with a felony drug crime, according to the Nursing Board report. Instead of imposing discipline, the board sent Fleischman to the HPSP, which she completed in 2006.
Three years later, Fleischman’s supervisors at a hospital in Robbinsdale noticed discrepancies in her documentation regarding pain medication. Patients said they never got the medication that Fleischman claimed she had given them. She admitted that she had taken the medications for herself, according to the Nursing Board report. This time, the board suspended Fleischman’s license. The board reinstated her license in 2011, then suspended it again two months later after Fleischman failed to contact the monitoring program.
Protecting the public?
Former nurse Jerold Mullins underwent three rounds of state monitoring but still managed to divert narcotics from his workplaces for 15 years before the board took his license away. Because Mullins self-reported to the HPSP, rather than being ordered to do so by the Nursing Board, nothing in the law required the monitoring program to tell the board about his dangerous conduct.
That case prompted a Nursing Board task force to examine the HPSP last year. The task force identified more than 30 issues it had with the monitoring program.
During one task force meeting, Judy Reeve, a nursing practice specialist for the board, said the monitoring protocols the HPSP uses are identified as “draft” and noted that “no study of the HPSP has ever been completed and we do not know if the protocols effectively protect the public,” according to meeting minutes.
Another issue identified: The HPSP has to trust what participants, treatment providers and employers tell it, because it doesn’t have the resources or authority to do its own investigation.
“For example,” a report said, “licensee may disclose diversion, but no investigation is undertaken to determine whether there was patient harm.”
One Nursing Board member, Deborah Meyer, said during a task force meeting that the HPSP didn’t “have the ability or the authority to protect the public from practice violations.”