Another concern: the HPSP doesn’t report to the board until after three to four problem drug screens, and participants are allowed to skip drug screens too often.
One nurse, Dayton D. Carlson, gave three unusable screens, missed seven others and then tested positive for narcotics in January 2013.
He told the Nursing Board the skipped or unusable screens were intentional because he was using drugs, according to the Nursing Board report. Carlson remains licensed after completing treatment and telling the board he would stay sober.
Feider said claims that the HPSP isn’t protecting the public are “inaccurate.” While no study has been done of the HPSP, Feider said studies of similar monitoring programs in other states showed the programs are effective.
She said steps can be taken to improve state monitoring, including adding another case manager to the program. The five case managers handle about 100 to 120 cases, “higher than we’d like,” Feider said.
Feider said the HPSP doesn’t just rely on drug screens to determine whether nurses are still using, but also tries to learn that information through reports by nurses’ employers and treatment providers.
And, she added, “even though it may seem absolutely crazy, sometimes when a nurse who has diverted reports to our program, and I talk with their supervisor, the supervisor will say ‘They were my best nurse.’ … Being chemically dependent does not necessarily mean being impaired.”
Still, the Nursing Board wants to ensure that it’s notified when nurses divert drugs. Next year, the Legislature is expected to take up a bill that would require employers to tell the licensing boards about diversion cases. The Nursing Board supports the measure.
‘Addicted to the excitement’
Even if that bill passes, it does nothing to help the HPSP stop nurses like Qualick, who stole and used drugs on the job while under state monitoring.
“It was really easy to get away with,” she said.
Qualick, 59, of North St. Paul, got her license in 1986 and a year later began working at hospitals in St. Paul. But she struggled with alcoholism and underwent treatment in 1995.
In 2000, while working at Regions Hospital, she said she took Percocet from a patient who didn’t want it. Qualick knew it was wrong, but she did it “just too see what would happen.” The theft went undetected.
Eventually, “I became addicted to the excitement of it,” she said.
She would use daily and sometimes during her shifts. She left Regions Hospital and went to work for United Hospital, stole drugs and got caught. She realized she had a problem and entered drug treatment and reported to the HPSP. She was hired again at Regions, which she said didn’t know her drug history.
Qualick successfully completed drug treatment and state monitoring by 2004.
She went back to the HPSP in 2007 after she was worried she would start diverting again while battling pain from a broken arm. It didn’t help. A few months later the pain drove her to take extra narcotics out of a dispensing machine.
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