The Warm Body Phenomenon
In the military there is an aphorism that suggests that when you are up to your neck in alligators, it is hard to remember that your objective is to drain the swamp. It's a way of saying that sometimes the day-to-day hassles keep us from realizing our long term goals. Nowhere is that more obvious than in the case of an Indiana nurse who used her knowledge of nursing and the sloth of nursing home administrators to feed her addiction.
Amy Retz, according to published reports, lied to a hospital and two nursing homes in order to continue to have access to narcotics. This after she was convicted of a felony for stealing drugs from a nursing home. Some form of substance abuse is either the direct or indirect cause of most licensure problems. In one unofficial study I found that of the 25 respiratory therapists disciplined by the California Board for Respiratory Care, substance abuse (meaning drugs and alcohol combined) accounted for 67 percent of the disciplinary cases, and were a contributing factor in 20 percent of the remaining cases (domestic abuse predominating).
Addicts do what they need to do to get a fix. They do not think long term, they think about the next fix. For that reason even though it is likely that they'll be found out and fired, they will frequently lie in order to get hired and get access to drugs. If they get fired, they simply move on to another facility and try again. Time after time, they work hard to ensure they have access to drugs. The only thing that stops this is jail time, and sometimes (but rarely) a treatment program.
This is why every nurse hired by a facility needs three things. First, the nurse needs a background check and should not start work until one is completed. Second, the nurse needs to have references from their last employer, or an explanation for why they can't give that reference (some facilities will not provide references on former employees). Third, the nurse needs a urine drug screen.
I know what the arguments are with respect to these precautions. They cost money, and they're not 100% accurate. A nurse can give a false name. A nurse can sometimes cheat a urine drug screen. But, without such precautions when a drug-addicted nurse injures or kills a resident, the facility is left hanging for the damages, and insurance costs skyrocket.
Sometimes its possible to be too careful about costs, and wind up being penny wise and pound foolish. A warm body is important, but a facility should never opt for a warm body that hasn't been vetted with a background check and drug screen. Doing so is a free ticket to significant liability.