As one nurse who stole narcotics has firing overturned, others have … – National Post

A nurse who stole opioid painkillers and other drugs from a Toronto hospital for seven years, then risked harming patients by doctoring their records in the cover-up, has been ordered rehired by the facility.

The just-released arbitration ruling is one of the most dramatic in a string of cases nationwide involving health-care workers caught pilfering narcotics —  but with starkly different outcomes for the employees.

While many have returned to work after rehabilitation with their records relatively unblemished, others have been disciplined, fired or even prosecuted criminally.

In the Toronto case decided last week, arbitrator Norm Jesin concluded the serial thefts were motivated by addiction, a disability he said gives the nurse human-rights protection.

In overturning the unnamed woman’s dismissal, Jesin also cited the fact she eventually sought professional help, was in remission and will return to work under a set of conditions designed to protect Sunnybrook Health Sciences Centre.

Nurses elsewhere have had their dismissals or suspensions overturned on similar grounds.

Yet just last month another Ontario nurse was handed a two-year prison term for similar crimes.

“She was devastated,” said Mark Ertel, the lawyer for Laura Denouden, who was sentenced for theft from the palliative-care ward of a Kingston, Ont. hospital.

“For somebody with no criminal record at all, and who seems otherwise rehabilitated, a mother of a young child, it’s a heavy-duty sentence.”

Whether a health professional faces the full force of the law often depends on whether the employer reports misconduct to police, who are then obliged to investigate it as a potential crime, he said.

When law enforcement is not involved, the cases are usually dealt with as addiction and health issues, which makes much more sense, said Ertel.

“It’s like an occupational hazard to get addicted,” he said. “It’s like a kid in a candy store for a health-care professional who has ready access to this kind of stuff.”

But one leading expert says those drug-purloining workers should not emerge unscathed.

“To absolve someone of something like that, I find very difficult,” said Dr. Harry Vedelago, a prominent addictions physician at Homewood Health in Guelph, Ont., who treats nurses and others in the field. He stressed that he was not commenting on any specific case.

“Those individuals have to make some kind of restitution, have to accept the consequences of their behaviours … It’s much like somebody who drinks alcohol and assaults somebody or gets into a car accident.”

Vedelago also cited research that indicates health professionals are no more likely than others to have substance-abuse problems, but tend to stand out because they are in a position of trust.

Jesin found the Toronto nurse regularly stole the opioid painkiller  hydromorphone – also known as Dilaudid – as well as sedatives like lorazepam from Sunnybrook’s Holland orthopedic centre in 2005-13. She often hid the thefts by indicating on charts that the drugs had been administered to patients recovering from orthopedic surgery.

The nurse denied she ever deprived patients of the painkillers they needed, but admitted there was no way of proving that.

She blamed her abuse problems on longstanding anxiety, a 2005 diagnosis of attention-deficit hyperactivity disorder, and a finger injury in 2011 for which she was prescribed the opioid Percocet.

Sunnybrook dismissed her, but the union filed a grievance.

Jesin cited a psychiatrist called by the hospital who argued addiction is a choice, not a disease, but said most experts believe it is an illness. That means that disciplining the nurse over the thefts would be discrimination because of a disability — and contrary to the human-rights code.

In the Kingston case, Denouden had stolen hydromorpone for more than 2½ years from supplies used for dying patients at St. Mary’s of the Lake Hospital, sometimes replacing what she took with a saline solution, and altering patient records.

Witnesses suggested palliative-care patients may have suffered from pain needlessly as a result.

She is also grieving her firing. In the meantime, her employer reported her to police, and she was convicted of theft, forgery, mischief and possession of morphine.

A Nova Scotia paramedic was similarly convicted of theft and fraud in 2014 for pilfering morphine and changing patient records.

Though no criminal charges were involved, Alberta’s top court took a hard line in a 2012 decision upholding the disciplining of two drug-stealing nurses. Excusing such behaviour because of addiction could have “far-reaching” consequences, the judges warned.

Yet most of the regulatory agencies that oversee nurses say their goal is to get help for addicted, drug-stealing employees, and assist them to eventually return to work.

In an echo of the recent case, another Ontario labour arbitrator ruled in 2013 that a London, Ont., hospital’s decision to fire an addicted, narcotic-pilfering nurse was “entirely rational and understandable” – but still discrimination on the basis of disability.