By Debbie Moore-Black, RN

1986. I graduated from LPN to RN. And I was immediately offered a new job. Manager of a six-bed ER.

This hospital had three surgical suites — 50 inpatient beds and 2 L&D suites. This was a private Catholic hospital run by the nuns. The computer system was new and a foreign object.

Sister Ursula* (name changed) of medical records was so overwhelmed by the volume of paper charts that she hid many charts underneath her bed in the nearby convent. The nuns ran around during dayshift praying for all the patients and sprinkling “holy water” on those that requested it … or didn’t request it. There were crucifixes everywhere.

Our truly beloved CEO had just retired. He was a good, honest family man that knew everyone by their first names. We actually liked him!

But he quickly retired and moved himself and his wife to the mountains.

We were a small hospital out in “nowhere land” where you’d find farms loaded with cows, goats and chickens. Miles and miles away from any “real hospital.”

But we had it all in that ED!

Young women coming in with abdominal pain, only to find they were ready to deliver a non-prenatal care baby. The one ED doctor at hand did the delivery … while I caught the placenta.

We took care of gunshot wounds, stab wounds and cardiac and respiratory arrests, child abuse and rape cases, “done fallouts” during church services, diarrhea and constipation and runny noses and coughs from little kids.

We truly got it all.

We were a smorgasbord of every possible diagnosis. One nurse, one doctor and one secretary in that ED.

I thought I was hot stuff.

The CEO that retired gave me carte blanche to order EKG monitors and defibrillators, surgical equipment, crash carts. Beyond taking courses on “how to be a manager.”

I also took those CEUs on emergency nursing, staffing, public relations, and public education.

I was young and on fire.

I loved the code blues, emergent deliveries, chest tube insertions, intubation, calling medics to transfer a patient to a larger hospital, writing protocols, dealing with JCAHO. The list was endless.

And then we were notified by human resources that we had a new CEO.

He was 35-ish. Seemed like a baby. But apparently, he had experience and came from a much larger hospital.

He had shiny shoes and a perfectly starched shirt. I was always on guard and suspicious of shiny shoes.

He was our new CEO.

Immediately, I could feel the difference in this small-town hospital. The family atmosphere was disappearing. The staff was on guard and on edge. At any given time, especially at night, the CEO would come to visit us to make sure everything was OK.

It seemed odd, and he’d drop in at random hours in the middle of the night.

Our pharmacy was closed at night. Only the nursing supervisor had a key for meds that were needed stat throughout the hospital. Meds that hadn’t already been stocked.

But he had a key to the pharmacy.

He would tell us that he had to make sure the pharmacy was locked and that there was no suspicious activity. No one said anything out loud, but if you could just hear our thoughts.

Month after month and the same routine.

Rumor had it that the CEO started to fall asleep during executive meetings, board meetings. He’d visit us nightly in the ED. Slurred speech. Incomplete sentences.

We knew something was wrong.

We also knew if we said or mentioned anything, we could get into big trouble.

Every day the pharmacist clocked in. The pharmacy techs would assist the pharmacists in filling carts, restocking code carts, checking on the narcotics. The pharmacist knew something was missing. The Percocets, the Ativans, and Xanax, the morphine injectables. There was a dent in the narcotics. The narcotic inventory was reduced but without rhyme or reason.

The pharmacist called the pharmacy company (separate from the hospital), and cameras were installed.

And there he was some nights with a paper bag in his hand. Taking whatever he needed.

He was caught on camera. Immediately whisked away to some rehab facility.

And we never heard from him again.

He was a tormented soul thinking he could get away with stealing and using narcotics because his cover was being the CEO.