Originally published on KevinMD
This is based on a true story. The name and some details of the events have been changed.
She was the smarter nurse who floated to ICU, to CVRU, to CCU. She could handle any crisis: balloon pumps, CRRT, open-heart patients, respiratory distress, code blues — anything.
Sandy was quiet. She didn’t really have any nurse friends. She was a loner.
But we could depend on her to take the most difficult assignments.
She was our brightest star.
We delivered our babies two weeks apart from each other. I remember when we both got back from maternity leave, she proudly showed all of us 8 x 10 pictures of her family and of her new baby. I felt inferior. Like I was the bad mom because I had no pictures.
Both of our babies went to the hospital daycare. And every day that we worked together, the daycare would call Sandy on the phone. Her baby was frantic and having tremors. Something was wrong. And Sandy would have to leave our ICU and walk to the nursery and hold and rock her baby and breastfeed her. Her baby would eventually sleep into a beautiful toxic slumber.
Before the age of computers, narcotics were counted by a day shift nurse and a night shift nurse. Narcotic papers were signed and eventually sent to the pharmacy.
Sometimes the numbers didn’t add up. Sometimes a morphine ampule would have a crystallized gel wrapped around the scoring of the ampule — it was just clear nail polish.
Sometimes her patients would have unusually high blood pressure or high heart rates as if they were in pain. But they couldn’t be in pain. Sandy’s notes were meticulous, and her narcotics were well documented.
How did we miss this? Where was that cry for help?
What we didn’t know was that Sandy was being watched by management and by the pharmacy. The pharmacists were aware of the discrepancies, the missing ampules of morphine and the uneven levels of medicine in the Valium vials or the crystallized solution gluing the top of the ampule to its body.
They moved Sandy around a lot. One day she’d be in the progressive care unit, the next day in CVRU, to ICU and CCU. And she never complained.
She was confident that she had this act of deception down to an art.
But she left a trail. The obsession, the perfection of covering her tracts became sloppy, and that’s how pharmacy picked up a trend.
Calls from the daycare, her baby screaming, her patients in excruciating pain but could only express themselves hemodynamically, as they couldn’t talk since they were on ventilators, restrained, balloon pumps and CRRT.
She’d fade in and out from unit to unit. And there was never any eye contact.
We watched in disbelief as two security guards escorted her out of our ICU. A syringe and tourniquet found in her scrub pocket.
She sobbed and denied ever doing drugs.
She denied ever failing to medicate her patients.
She denied the fact that her baby was addicted to the morphine that flowed through her breast milk.
She tested positive for fentanyl. But she still denied.
We were all devastated. How did we miss this? Where was that cry for help?
The state board of nursing offered rehabilitation. They offered her help. She refused. Eventually, her nursing license was terminated.
DSS removed her children.
And we never saw Sandy again.
The perfect nurse.
The perfect mother.
Hidden by a mask that she wore each day that she clocked in.