In 2016, a nurse at the Sunnyside long-term care home in Ontario Canada opened the door to a toilet cubicle and found another nurse with an ampoule of the painkiller Hydromorphone sideways in her mouth, as if she had just injected herself.
It was soon revealed that the nurse had been stealing opioids for her own use for the previous two years and falsifying medical records in order to conceal the thefts.
She would file paperwork falsely showing a resident had requested a narcotic, then falsify charts to show they had received it, when in fact she used it herself.
She would also keep the unused portion of narcotics, rather than discarding them.
The nurse was a 50 year-old mother of three.
Confronted by management, she initially denied but later admitted her actions, which she said were caused by her addiction to painkillers which began when she was treated for a kidney condition.
She had subsequently become heavily addicted.
A month later, the care home sacked her for gross misconduct and theft.
What the nursing home argued
In appealing her dismissal, the nurse testified that she has not used narcotics since 2016, when she entered a residential rehab.
Her nursing licence was suspended for about nine months, and reinstated with a series of conditions including that she have no access to controlled substances and be supervised at all times.
Lawyers for the care home argued that she shouldn’t be allowed to return to work because these conditions would impose “undue hardship” on the care home.
Every nurse has access to narcotics and some patients are in advanced dementia, so they would not notice if a nurse removed their fentanyl patches.
Furthermore, the lawyers argued that nurses need to work independently, and not be supervised constantly.
The care home also argued that she was not fired because of her addiction, and that it played no role in the decision.
She was fired for theft and record falsification, abuse of residents and breach of trust, it claimed.
What the workplace arbitrator concluded
But the workplace arbitrator Larry Steinberg did not agree with the care home’s position.
He said the nurse’s actions were symptoms of the disease of addiction, and it is discriminatory to fire someone because of their disease.
Two experts testified that addiction is a health condition, and that “to view (addictions) as bad habits stigmatizes these conditions and makes it harder for people to get help,” Steinberg wrote.
In his ruling, Mr Steinberg said the care home had a duty to accommodate the nurse’s unquestioned diagnosis of severe opioid use disorder and mild to moderate sedative-hypnotic use disorder.
The disease had left her with “a complete inability or a diminished capacity” to resist the urge to feed her addiction, he concluded.
The outcome was different in other similar cases.
In one, a nurse who stole painkillers from an elderly terminal cancer patient, was convicted of theft, suspended as a nurse for five months, and eventually resigned after the College said she shamed the profession.
Another who stole medicine from a dying teenager was stripped of her nursing licence and spent 18 months in jail for theft, drug charges, breach of trust and impaired driving.
Another was sentenced to two years in prison.
What the experts say
George Calderon said the nurse was lucky to win her job back.
“Putting aside the issue of her addiction, she is clearly guilty of theft and falsifying records, which in most cases would constitute serious misconduct warranting instant dismissal,” he said.
“In Australia, we would have a hard time defending a nurse who had stolen drugs for personal use, however, employers do have a responsibility to provide support to employees who are suffering with addiction issues.
“Apart from making sure the worker and other staff members are safe in the work environment, an employer can encourage or even pay for counselling or rehabilitation sessions for the affected person.”
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