When Speaking Up is Caring

You believe you’ve just seen a case of suspected diversion, but you stay silent. Why?

The reasons are common: 

  • You’re the manager, and lately, you’re stretched thin. You’re thinking, “I can’t lose this employee, they’re filling a needed shift, and after all, they hustle and are usually willing to pick up extra shifts for me…” 
  • You don’t want to think badly of your fellow employee/team member. After all, you’ve heard they’ve been having “a tough time at home lately.”
  • You fear if others find out it was you who spoke up, you’ll be labeled “a snitch.” You also fear losing your team’s respect.
  • You worry, “What if I’m wrong? How can I insult them that way?”
  • Cutting corners has just become more acceptable lately. “We’re all under a lot of stress, you know? Can I really blame them?”

It’s true, the reasons behind the reasons – fear of not staffing well for patients, fear of adding to somebody’s burden, fear of losing respect, and fear of conflict are all strong motivators. 

We much prefer control, the status quo – even the illusion of it sometimes. “Why rock the boat on an already troubled sea?”

The problem is, we think all the above reasons are caring – but they’re not. So how is staying silent actually not providing the care we’re meant to give?

Consider these 3 important ways (or people):

1. It’s not caring for yourself. 

You impact your own ability to perform well by allowing suspected diversion to go unaddressed. If your team member is in fact diverting, the very nature of a team means it can’t help but affect the work of all the others. 

Maybe you were the one who was assigned to provide their “double-check,” but they abused your trust when they failed to waste properly. Maybe they performed a “Cancel remove” from the medication dispenser, and sought to deceive you by diverting “right under your nose.” How do you feel?

Additionally, if they are working while their brain has been hijacked by a drug, it’s likely that they’ll miss something important. You or another team member will have to pick up the slack.

2. It’s not caring for the suspected diverter.  

You allow or “enable” a possibly addicted co-worker to stay trapped in their addiction. Why be a willing party to their possible death? Why not apply your caregiving skills to aid their recovery? Why not go anonymously to management and leave it in their hands?    

If you’re a manager, be willing to say “No, this is a big deal and must be addressed. I might end up being short-staffed, but they simply can’t work tomorrow. We must prioritize the interview – for their sake, but also for everyone else that they’ll impact.”

3. It’s not caring for your patients. 

Here’s the ultimate reason, and it’s the opposite of what you are called to each day: bring healing, and promote patient well-being and care. 

Here’s the bottom line: diversion is a patient safety issue, period. 

If a patient needlessly suffers because their meds have been withheld, substituted, or reduced – and you could’ve prevented it – wouldn’t you want to? Or, if a medication error made by an impaired co-worker negatively impacts a patient – and you could’ve stopped it – how would you feel?

Speaking up is caring. Let’s learn to do it wisely and well.

Terri Vidals
Terri Vidals

Terri has been a pharmacist for over 30 years and is a drug diversion mitigation and monitoring subject matter expert. Her years of experience in various roles within hospital pharmacy have given her real-world insight into risk, compliance, and regulatory requirements, as well as best practices for medication and patient safety.

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