March 08, 2018

Suspect medication diversion? Speak up for patients

Medication diversion always poses a high risk of physical and emotional harm to patients. If you have any suspicions that a colleague may be stealing and/or using a patient’s medications, it’s time to advocate for your patient by speaking up. When you do, you are playing an important role in protecting the safety and well-being of your patients.

“When you suspect medication diversion, your first thought should always be for the patient,” says Anne Coghlan, CNO's Executive Director and CEO. “Your patients rely on you to protect them from harm.”

Medication diversion poses a high risk of harm for several reasons...

Medication diversion always poses a high risk of physical and emotional harm to patients. If you have any suspicions that a colleague may be stealing and/or using a patient’s medications, it’s time to advocate for your patient by speaking up. When you do, you are playing an important role in protecting the safety and well-being of your patients.

“When you suspect medication diversion, your first thought should always be for the patient,” says Anne Coghlan, CNO's Executive Director and CEO. “Your patients rely on you to protect them from harm.”

Medication diversion poses a high risk of harm for several reasons.

  • Patients who do not receive their prescribed medications can experience unnecessary pain and anxiety.

  • Patients who receive tampered substances or other drugs instead of their prescribed medications are at increased risk of an adverse reaction. It can also make it difficult for the health care team to determine the cause of these unusual responses and safely manage the patient’s condition.

  • Patients being cared for by a nurse who is impaired are at risk of receiving substandard care. An impaired nurse may be distracted and focused on their own needs, rather than the needs of the patient.

“Because medication diversion puts patients at risk, you need to be their advocate,” says Coghlan. “Speak up by telling your manager, supervisor or CNO about your suspicions. When you do, you are demonstrating your commitment to safe patient care, and meeting your accountabilities in the Code of Conduct.”

Speaking up could also help your colleague. While nurses are accountable for ensuring their health issues do not affect their ability to practice nursing safely, those with substance use disorders may not be aware of the impact their illness is having on their ability to practice.

One resource that can help is the Nurses’ Health Program. This new, voluntary program encourages nurses to seek treatment for mental health disorders and/or substance use disorders that could affect their ability to practice nursing safely.

A duty to protect patients from harm

The Code of Conduct states that nurses must work together to best meet patients’ needs and promote their patients’ well-being. It also states that nurses have a duty to report any error, behaviour, conduct or system issue that affects patient safety. If you are suspicious that a nurse may be stealing, using or diverting medications, talk to your manager or supervisor, or reach out to us. You can learn more about reporting at www.cno.org/reports.

To learn more about your accountabilities to provide safe patient care, read:

 

About CNO

The College of Nurses of Ontario (CNO) is the regulator of the nursing profession in Ontario. It is not a school or a nursing association. CNO acts in the public interest by:

  • assessing qualifications and registering individuals who want to practice nursing in Ontario.
  • setting the practice standards of the profession that nurses in Ontario are expected to meet.
  • promoting nurses' continuing competence through a quality assurance program.
  • holding nurses accountable to those standards by addressing complaints or reports about nursing care.

The College was founded in 1963. By establishing the College, the Ontario government was acknowledging that the nursing profession had the ability to govern itself and put the public's well-being ahead of professional interests.

For the latest information, please see our Nursing Statistics page.

Anyone who wants to use a nursing-related title — Registered Nurse (RN), Registered Practical Nurse (RPN) or Nurse Practitioner (NP) must become a member of CNO.

Frequently Asked Questions

Go to the public Register, Find a Nurse, to conduct a search for the nurse. Contact us if you can't find the person you are looking for.

All public information available about nurses is posted in the public Register, Find a Nurse, which contains profiles of every nurse in Ontario. Publicly available information about nurses include their registration history, business address, and information related to pending disciplinary hearings or past findings.

Unregistered practitioners are people who are seeking employment in nursing or holding themselves out as being able to practice nursing in Ontario, but who are not qualified to do so. They are not registered members of CNO. Only people registered with CNO can use nursing-related titles or perform certain procedures that could cause harm if carried out by a non-registered health professional. CNO takes the issue of unregistered practitioners seriously. See Unregistered Practitioners for more information.

To ensure procedural fairness for both the patient (or client) and the nurse, the Regulated Health Professions Act requires that information gathered during an investigation remain confidential until the matter is referred to the Discipline Committee or Fitness to Practise Committee. CNO will not disclose any information that could identify patients (or clients) or compromise an investigation. See Investigations: A Process Guide for more information.

Information obtained during an investigation will become public if the matter is referred to a disciplinary hearing. If a complaint is not referred to a hearing, no information will be available publicly.

See CNO's hearings schedule, which is updated as hearing dates are confirmed. Hearings at CNO are open to the public and the media. For details on how to attend a hearing, contact the Hearings Administration Team.

A summary of allegations and the disciplinary panel outcomes can be found on the public Register, Find a Nurse. Full decisions and reasons are also available.

Where a disciplinary panel makes a finding of professional misconduct, they have the authority to reprimand a nurse, and suspend or revoke a nurse's registration. Terms, conditions and limitations can also be imposed on a nurse's registration, which restricts their practice for a set period. Nurses can also be required to complete remedial activities, such as reviewing CNO documents and meeting with an expert, before returning to practice.

For detailed information see the Sexual Abuse Prevention section.

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