February 2019

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.

  • 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:


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