Many hospitals use a Pyxis machine to dispense medication and use the information from the Pyxis to spot trends in the medication of patient as well as diversion of narcotics. Over the past several years, I often get telephone calls from nurses accused of diversion when their dispensing of medication to patients exceeded the norms of other nurses. Nurses' medication habits differ. Some nurses tell me that they aggressively dispense pain mediation in accordance with doctor's orders as they do not want their patients to suffer from pain.
I spoke with a nurse today who was fired from his job for diverting narcotics. His use of pain medication started with a legitimate back problem a few years ago. At that time, he used Percocet as prescribed. When he had recent back problems, he again began using Percocet and he remembered how he thought it also helped with his life problems. He described to me that when he took Percocet all was right with the world. He felt that he had more energy, more motivation and could function at a higher level. Stressful situations often seemed more manageable. Within a matter of months, the Percocet was no longer giving him the feelings that he initially had. He needed higher doses to achieve the same affect. This led to diversion of Percocet, which quickly led to diversion of morphine and dilaudid.