Canadian HR Reporter

CANADIAN HR REPORTER APRIL 2019 EMPLOYMENT LAW 5 Drug-stealing nurse at long-term care facility in Ontario reinstated by arbitrator Registered nurse had opioid substance abuse disorder and falsifi ed records, but employer didn't investigate accommodation before dismissal for cause BY JEFFREY R. SMITH An Ontario long-term care facility has been ordered by an arbitrator to reinstate and accommodate a registered nurse with an opioid addiction who stole nar- cotics and falsifi ed records to cover up her theft. e 50-year-old worker was em- ployed as a registered nurse (RN) at the Sunnyside Home, a long- term care facility in Waterloo, Ont., operated by the Regional Municipality of Waterloo. Hired in December 2002 on a part-time basis and moving to full-time in 2004, she was stationed in a build- ing that housed 263 residents. In 2012, the worker was pro- moted to team leader, a position that involved co-ordinating resi- dent care, administering medi- cation, and ensuring correct pro- cedures for handling and control of medication. The worker consistently re- ceived positive performance re- views over the years, including kudos for her professionalism and assessment skills. Sunnyside has a number of nar- cotic and controlled drugs on-site to treat residents. Each unit has a medication room with a triple- lock system where the drugs are kept, including a medication cart with regular prescription drugs. Registered practical nurses (RPNs) control keys to the medi- cation cart. In addition, each unit has an emergency cabinet with a double lock that can be accessed by keys kept by RNs. The standard practice for drugs that are no longer given to residents and are marked for destruction is to keep them in a locked box in the locked medica- tion room, separate from drugs still to be used, while used sy- ringes, used ampoules (glass or plastic bulbs) of drugs, and wasted drug tablets are kept in a sealed sharps container, also in the medication room. On July 25, 2015, the RN working the night shift in the worker's unit found an empty ampoule of hydromorphone — a fast-acting opioid medication that is five times stronger than morphine — in the staff bathroom sink. An RPN on duty also witnessed the ampoule and they put it in a paper cup. e worker arrived early for her shift and said she would pass the cup on to the manager of food ser- vices. However, when she did so, the ampoule was in a diff erent cup made of Styrofoam. Sunnyside reviewed the medi- cation room and found all nar- cotics accounted for. An investi- gation involving interviews and the card readers discovered the worker had been present during the time the ampoule would have been put in the bathroom, as well as the fact she had been coming in earlier than needed on a regu- lar basis. e worker admitted she had been coming in early and said it was a coincidence she had been there when the ampoule was found. Several months later, other nurses began noticing the worker would prepare medications in one unit and take them to another unit to administer. She also sometimes prepared a tray of medication in the medication room and then took it to her offi ce before admin- istering it to residents. On Aug. 24, 2016, an RPN told the manager of resident care that two days earlier she had found the worker sitting on the toilet in the staff washroom — after being in there for some time — with an ampoule of hydromorphone side- ways in her mouth. e RPN also said two weeks before that, she had seen the worker go to give a resident an in- jection of hydromorphone but the resident was asleep and instead the worker placed the syringe in her pocket. e narcotic record indicated that the drug had been administered to the patient. Sunnyside placed the worker on paid stand-down leave while it investigated. e manager of resi- dent care noticed that when she told the worker to go home, the worker's eyes were glossed over, though she said she was fi ne. Later that evening, the work- er — who had a kidney condi- tion causing an excess of kidney stones, of which the manager was aware – came back with a medi- cal note that said she should be off work for "medically substantiated reasons" for three days. e worker called the manager on Aug. 29 to report she had had surgery to remove kidney stones and had a stent put in. She said she would now be off work for two weeks. Worker admitted to addiction Two days later, the worker called again to say she was being admit- ted to hospital for severe with- drawal from narcotics. She admitted she had been abusing various drugs including Jeff rey Smith LEGAL VIEW DISORDER > pg.14

• Cover