1. DeVries, Corina RN

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"I've been fired," Janet sobbed into the phone. "Fired for stealing narcotics!"


I was outraged. Janet and I had been inseparable since nursing school. I knew her as a woman whose drug of choice was sugar and as a professional who regularly spent her break time comforting frightened patients. How could anyone believe she would take drugs intended to ease others' suffering?


"Janet is incapable of this," I told my boss, who knew both of us from nursing school. She agreed. Two weeks later Janet started a job at the long-term care facility where I'd recently begun working.


For the first month, our laughter rarely stopped. The absurdities of nursing-being spit on while giving medication, the funny things our residents said-became inspiration for hilarity. But our lighthearted camaraderie was soon dampened. One day, we decided to go out for lunch and I asked Janet to drive. I was shocked to find her new red sedan littered with empty soda cans, fast-food wrappers, and torn papers. Pushing some garbage aside to sit down, I uncovered an empty pill bottle of Tylenol 3. The name on the container wasn't hers. A strip of empty Percocet wrappers, still connected as if someone had removed all three doses at one time, lay nearby.


I was shocked. All I could do was hold up the empty strip and ask, "What's this?" Calmly, she replied that her brother had been hurt and an ED physician sent him home with Percocet because it was too late that night to go to a pharmacy. The Tylenol 3, she said, had fallen out of her daughter's diaper bag after a visit to her father's house. Wanting desperately to believe her, I let the subject drop. But the more I thought about it, the less I believed her. Two days later, I called her. "If you have a problem with drugs," I said, "I'll help you." She brushed off my concerns, repeating her explanations.


As weeks passed, I noticed Janet was liberal with narcotics, often dispensing them to patients with dementia and to those who hadn't taken them in more than three months. Narcotic consumption among residents increased substantially-at least on paper. I later found out that Janet's patients cried out in pain, yet when other nurses cared for them, they were unable to be roused for hours after receiving meds.


Even though Janet didn't seem impaired, I became increasingly troubled. Then an entire supply of Percocet disappeared from the contingency supply during her shift. Again, I confronted her, offering to help her get treatment. And again, she swore she was innocent, cooly reassuring me, "I would never steal drugs. I don't even get high off them like other people do."


Counts were often off by one or two pills during the weeks that followed. Although Janet was the only common thread in each of the discrepancies, there was no other evidence of her guilt. I was a coward. When offered an excuse to leave-a new job at a different facility-I took it. It was easier to leave and hope the situation would resolve without my input.


An air of suspicion settled over my old facility. Janet called often with details. Staff underwent drug testing and narcotics could be dispensed only when witnessed by two licensed nurses. Although Janet told me her drug tests had been negative, I heard from another friend that Janet's results were positive. The friend also related Janet's explanation: a prescription for Vicodin from previous ear surgery. In fact, I knew the surgery had occurred nearly six months before-could she still need that prescription?


Then Janet told me that an entire card containing 30 doses of Percocet had disappeared from the med cart of a 70-year-old nurse who'd been practicing for decades. Janet was the only other nurse on the floor that day. I could no longer deny her guilt. For the third time, I confronted her; for the third time, she denied everything. I hung up the phone and cried. Then I called Anne, Janet's supervisor, and told her what I knew.


Janet was fired a few days later. Anne called to tell me that an attempt to use video surveillance to catch Janet stealing narcotics had failed, and without evidence the facility was unable to terminate her for theft. They decided to fire her for divulging confidential information about the investigation-to me.


My heart sank. I should have shared my suspicions sooner. By trying to preserve our friendship, I had allowed my biases to determine my actions and share the blame for the suffering of our patients. And in the end, after all my efforts, my involvement was still the reason she was fired.


Since Janet's departure, the narcotic counts at the facility have been correct. Patients no longer cry out in agony. And I haven't heard from her.