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forgery, lies, and an unfortunate situation

bodonid

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    I work in a doctor's office, and today one of our nursing students (doing her "externship", kind of like an away rotation in a small doctor's office) forged the doctor's signature on a prescription. She would have gotten away with it, but she chose to go to the pharmacy next door. When confronted, she point blank said she had no money and was going to sell the pills. She said she "had a friend" like she had done this before.

    So, a couple of questions:

    1) Obviously if we told the school, she would be kicked out and would never be in the position to do this again. So should we even tell the cops?

    2) If prosecuted, what kind of sentence do you think these people get?

    It is just sad, because she has children & is actually very nice. I saw the inevitable confrontation and she cried like she was going to be locked up forever.
     

    ZagDoc

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      Ethically and morally (maybe even legally, not sure on that one) required to report this to the school. This is both falsification of a physician's prescription record and criminal intent to distribute a controlled substance. Her career is over. Unfortunate considering she had children, but there's some mistakes that are just too big. Drug dealers don't get out of jailtime because they have a family to support.
       

      WellWornLad

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        I'm torn on this one. I think I would end up telling the cops, only because this needs to be on record. Telling her school may get her kicked out, but the incident may not go farther than her school.

        I believe the penalties for prescription fraud vary by state, but you can certainly get jail time. In practice, much probably depends on the type of medication she was going for as well as her intended purpose. Admitting flat out that she was going to sell the drugs was not very smart, as intention to traffic controlled substances can now probably be tacked on as well, or at least would justify a harsher sentence.
         
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        ZagDoc

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          I have seen medical practitioners arrested and jailed for similar and even lesser offenses. Whether the school finds out and she is removed from the program or doesn't and she graduates with her degree, her criminal record will prevent her from ever getting a job as a nurse.

          If you don't report her at all... well, I just can't fathom why you wouldn't. Prescription drugs are now #2 on the drug related deaths list nationwide. We're talking about a massive social toll, with much of it targeting children. And that's not even touching the ethics behind forging a physician's signature.
           
          Pass the buck to the physician. When it's all said and done, it was his name being used for the prescription, and too many prescriptions could have put his *** under the fire. Let him make the decision of how to proceed.
           

          butiwuvu

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            I don't think you should get involved. Tell the doctors in charge of the practice what you know and then let them deal with it.

            The last thing you want on your mind is that you covered something like this up and helped a drug-dealing nurse gain other positions whereby she had access to prescriptions to forge, or worse, that she was stealing medications from the hospital or patients. She needs to be reported to the school at the very least.
             

            LizzyM

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              Who are you to tell? I would think that the pharmacist has a professional obligation to call the police to report this criminal act. The pharmacist also has the proof (the forged prescription). For the pharmacist, failure to report the act may make the pharmacist an accomplice.

              The physician may have an obligation to report to the police any suspicion that someone has obtained unauthorized access to prescription pads (lost or stolen). The doc you work for should know what the laws are in your jurisdiction or may want to put in an anonymous call to the cops to ask if a report is required.

              You have to be careful about damaging someone's reputation but it seems that the physician or supervising nurse has first hand knowledge that this student has acted in an unprofessional manner, then it is enough to tell the school that the student's traineeship is being terminated effective immediately and that the student will not be accepted back at any time. Let the school figure it out which they will when the student faces criminal charges.
               

              teachmed27

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                Even in a tough situation like this, you have the responsibility of reporting it to your superior. If you don't, you're putting yourself at risk for investigation of why you did not report it. As long as you inform your superior, you will be in the clear. It's unfortunate, but you have to cover your butt. You don't want to go down in flames by simply not reporting it bc you liked the person.
                 

                Gold 5

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                  I work in a doctor's office, and today one of our nursing students (doing her "externship", kind of like an away rotation in a small doctor's office) forged the doctor's signature on a prescription. She would have gotten away with it, but she chose to go to the pharmacy next door. When confronted, she point blank said she had no money and was going to sell the pills. She said she "had a friend" like she had done this before.

                  So, a couple of questions:

                  1) Obviously if we told the school, she would be kicked out and would never be in the position to do this again. So should we even tell the cops?

                  2) If prosecuted, what kind of sentence do you think these people get?

                  It is just sad, because she has children & is actually very nice. I saw the inevitable confrontation and she cried like she was going to be locked up forever.

                  What did she write the script for?
                   

                  bodonid

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                    I was just asking for information and opinions, as I am just a bystander. It is not "up to me", and I have no decision to make. I was just wondering what you all would do in a similar situation.

                    And if you want to know what it is for, I have a fax (the pharmacist just faxed it to us and the signature looks like a cartoon version of the doc's) and I see no harm in telling you, once I get back to the office.

                    Later
                     

                    BluePhoenix

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                      Who are you to tell?

                      Usually I agree with you, but that is just wrong. ANYONE working in a medical profession that sees something like this happen should be obligated to "tell"...perhaps not the police, as that's the pharmacy's responsibility but rather informing a supervisor if the OP saw the incident take place.

                      Just because you're not highly ranking doesn't mean you're unable to call people out for doing unethical things. However, I do recommend going through the proper channels (i.e. telling a supervisor) and not just calling the police unless it's an emergency.
                       

                      LizzyM

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                        Usually I agree with you, but that is just wrong. ANYONE working in a medical profession that sees something like this happen should be obligated to "tell"...perhaps not the police, as that's the pharmacy's responsibility but rather informing a supervisor if the OP saw the incident take place.

                        Just because you're not highly ranking doesn't mean you're unable to call people out for doing unethical things. However, I do recommend going through the proper channels (i.e. telling a supervisor) and not just calling the police unless it's an emergency.

                        IMHO if the pharmacist fax'ed the physcian and the OP knows as a bystander in the office who saw the fax, then the OP should leave it to the physician and pharmacist who have certain professional and legal obligations that may require them to involve the police. The person supervising the student's externship should inform the school.

                        If hypothetically, a shadow or volunteer or office worker saw the extern writing a script and asked about it and the extern explained how easy it is to make money doing this then I think that the "innocent bystander" has an ethical obligation to inform the extern that the behavior is wrong and then to report the incident to the physician-in-charge or to a nurse-supervisor.

                        However, if the OP saw the fax before delivering it to the doctor, then it is not the OP's place to call the school, the cops or anyone else.
                         

                        Perrotfish

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                          Pass the buck to the physician. When it's all said and done, it was his name being used for the prescription, and too many prescriptions could have put his *** under the fire. Let him make the decision of how to proceed.

                          Second this. If the entire office is dealing drugs and splitting the profits then, maybe, you need to contact the police directly. That, however, doesn´t seem to be the case. Your first responsiblity here, is to tell the physician. It´s his lisence, it´s his office, let him handle it. Trust me, probably wouldn´t even risk he career for a senior nurse that he´s close friends with. He definitely won´t risk his career for a drug dealing nursing student.

                          It´s not so much a matter of it being wrong for you to call the school, as a matter of it´s wrong for you to preempt the doctor. It makes him look dishonest just because he took slightly longer than you to respond, and could needlessly hurt his career.

                          It is just sad, because she has children & is actually very nice. I saw the inevitable confrontation and she cried like she was going to be locked up forever.

                          Wow that sucks.
                           
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                          kedrin

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                            Usually I agree with you, but that is just wrong. ANYONE working in a medical profession that sees something like this happen should be obligated to "tell"...perhaps not the police, as that's the pharmacy's responsibility but rather informing a supervisor if the OP saw the incident take place.

                            Just because you're not highly ranking doesn't mean you're unable to call people out for doing unethical things. However, I do recommend going through the proper channels (i.e. telling a supervisor) and not just calling the police unless it's an emergency.

                            maybe you should actually read the thread before hitting that reply button
                             

                            dd128

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                              Usually I agree with you, but that is just wrong. ANYONE working in a medical profession that sees something like this happen should be obligated to "tell"...perhaps not the police, as that's the pharmacy's responsibility but rather informing a supervisor if the OP saw the incident take place.

                              Just because you're not highly ranking doesn't mean you're unable to call people out for doing unethical things. However, I do recommend going through the proper channels (i.e. telling a supervisor) and not just calling the police unless it's an emergency.

                              This wasn't OPs question though, he was taking a real life situation and asking a hypothetical question. I have little doubt that between the pharmacist and physician someone would report the nurse. You may need to think about the fact that sticking your nose somewhere it doesn't belong isn't always a good idea by the way.
                               

                              BluePhoenix

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                                maybe you should actually read the thread before hitting that reply button

                                I was responding to the original post, and in that post, the OP doesn't say what happened after the incident or who in the hospital knew. And as I said, I would feel obligated to let my supervisor know about the incident, if they didn't already know. Reporting someone for doing some unethical is not sticking your nose where it doesn't belong, but hey...you follow your moral code, I'll follow mine.
                                 

                                paranoid_eyes

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                                  i *think* the doctor can actually file a lawsuit against the person for forging his/her signature. but honestly, if she needed the money that bad, it would be futile.

                                  the bad thing about our system is that once you get caught doing something like this, it's the end for you. She will probably get thrown out of nursing school (if it gets reported). This will then cause her to commit further crimes and eventually she might be incarcerated. That's one of the interesting paradoxes of the criminal system. If you screw her over now, she'll just end up overburdening the already stretched out prison system.

                                  then again, if you don't do anything, she may repeat the crime because she thinks that she'll get away with it again.

                                  (this is why im not going into law...it's just so darn complicated)
                                   

                                  CubaLibre

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                                    this is only peripherally related, but I know of a pharmacist who owns his own pharmacy who actually got into deeper trouble after he reported misconduct at his own store. Another pharmacist who was an employee had been ordering and stealing controlled substances for a while. When the owner finally realized this was occurring (he owns multiple stores so it's more difficult to keep track of), he notified the appropriate authorities and after the police dealt with the perpetrator, police and the IRS came after him. sucky situation.
                                     

                                    Perrotfish

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                                      the bad thing about our system is that once you get caught doing something like this, it's the end for you. She will probably get thrown out of nursing school (if it gets reported). This will then cause her to commit further crimes and eventually she might be incarcerated. That's one of the interesting paradoxes of the criminal system. If you screw her over now, she'll just end up overburdening the already stretched out prison system

                                      She´ll have plenty of opportunites for less glamerous, lower paying jobs. Around 75% of our nation does those jobs and gets by just fine (or, at least, not so bad that they go to prison). There´s a lot of space between medical professional and cell block D.
                                       

                                      WellWornLad

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                                        She´ll have plenty of opportunites for less glamerous, lower paying jobs. Around 75% of our nation does those jobs and gets by just fine (or, at least, not so bad that they go to prison). There´s a lot of space between medical professional and cell block D.

                                        Glamorous is not a word I would associate with the medical profession...unless it's a clinic in Beverly Hills, perhaps.
                                         

                                        bodonid

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                                          Yeah, my intention with this thread was to ask people what they would do in the position of the doctor in my office, but obviously some people understood that.

                                          Okay, I said I would tell you the medications:
                                          There were two (doh!): oxycontin and xanax
                                          As an interesting sidenote, many of you know that pharmaceutical companies stick the names of medicines on almost anything in an attempt to get doctors to prescribe them. I have a xanax (anti-anxiety) coffee mug (causes anxiety). I just thought it was funny/ironic.

                                          Have a good morning and a wonderful (or maybe bearable?) day!
                                           

                                          bodonid

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                                            Is there a legal obligation to report her?

                                            Again, I am no expert, and I would like to know, but the people here (including the doc) say yes. I am forced to think that this might be justification of their (already justified :rolleyes:) actions and therefore this might not be true, and I would have a hard time believing that anyone could get in trouble for not reporting.


                                            The PA told me a story about the last time that this happened, 8 years ago:
                                            She said that the doctor that she worked for back then used to go out of town a lot, maybe 3-4 days a month or so. Patients don't stop getting sick, so the doc would leave blank, signed prescriptions for them to use for emergencies. Only the "real" nurses knew about this (not students or trainees), so it worked for a long time. Apparently one of the nurses was injured and started taking pain medication, then when she ran out she just ganked a whole pad of signed prescriptions, using them for about two years until she was caught.

                                            (I don't know any of these people, or where it happened.)
                                             

                                            LizzyM

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                                              Again, I am no expert, and I would like to know, but the people here (including the doc) say yes. I am forced to think that this might be justification of their (already justified :rolleyes:) actions and therefore this might not be true, and I would have a hard time believing that anyone could get in trouble for not reporting.

                                              I'm getting the idea that you liked this nursing student and feel sorry for her given the circumstances and you worry about the penalties that she'll face. That's a normal feeling.

                                              On the other hand, you seem to think that the physician and pharmacist could have kept this quiet and warned her not to do it again.

                                              If a physician or pharmacist had knowledge of illegal acquisition of controlled drugs with the intention to resell the drugs, you can bet that the Drug Enforcement Agency (DEA) expects the professionals to report the illegal activity. I don't know if failure to do so is a criminal matter but it could trigger an audit of the practice and/or store to determine if there is a pattern that involves the doc and/or pharmacist. Even (or especially) if you are innocent, an audit can be a major pain in the practice.
                                               

                                              bodonid

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                                                I'm getting the idea that you liked this nursing student and feel sorry for her given the circumstances and you worry about the penalties that she'll face. That's a normal feeling.

                                                On the other hand, you seem to think that the physician and pharmacist could have kept this quiet and warned her not to do it again.

                                                If a physician or pharmacist had knowledge of illegal acquisition of controlled drugs with the intention to resell the drugs, you can bet that the Drug Enforcement Agency (DEA) expects the professionals to report the illegal activity. I don't know if failure to do so is a criminal matter but it could trigger an audit of the practice and/or store to determine if there is a pattern that involves the doc and/or pharmacist. Even (or especially) if you are innocent, an audit can be a major pain in the practice.

                                                And again, you are focusing on specifics. I sympathize with her, but I don't care whether she is prosecuted or not, because the only person with any choice in the matter was her. The pharmacist and the physician reported her; they had to. I never had any role. My only purpose in starting this thread was to determine the opinions of others on the way that these offenders are treated, and to measure them against my own. I don't need advice, and I am not being critical of my superiors.
                                                 

                                                PanicAttack

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                                                  Another unfortunate consequence (as if all that isn't bad enough), is that this might leave a sour taste in the physician's mouth about letting students do internship/externship/shadowing in his office, maybe from your school, or maybe in general.

                                                  Obviously that's the least of anyone's worries who is involved, but still; that sucks.
                                                   
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