Difference between substance abuse and substance use disorder, court says.
An Alberta hospital did not have to accommodate a nurse who stole drugs for her own use because the nurse wasn’t addicted and knew what she was doing, the Alberta Arbitration Board has ruled.
On May 22, 2007, the program manager of the emergency department at Edmonton’s Royal Alexandra Hospital performed an audit of recent drug withdrawals from a medical station after a Demerol syringe had been found in a staff washroom. The audit revealed Leah O’Neill, a registered nurse who had been at the hospital since 1987, had made several withdrawals of Demerol a few days earlier that had no doctor’s orders supporting them.
The manager and an HR representative met with O’Neill and asked her about the drug withdrawals. She denied taking the drugs and they told her she would be off work until an investigation was completed. After the meeting, O’Neill admitted to her union representative she did take the drugs but had a reason for doing so. She saw her doctor, who gave her a note placing her on “indefinite leave” because of health problems.
The hospital conducted an investigation and discovered O’Neill had withdrawn Demerol without proper doctor’s orders on 23 occasions between December 2006 and May 2007. She also took morphine on May 23, 2007 without approval. The hospital then sent a letter to O’Neill requesting more medical information to support her claim for sick benefits. It also notified her of what the investigation found and requested an explanation by July 6, 2007.The union provided a doctor’s letter saying O’Neill was being treated for medical issues and she was complying with her treatment plan. She was also diagnosed with a substance use disorder. The hospital took this to mean she was requesting accommodation and asked her for more information.
On Nov. 14, O’Neill explained she took the drugs because she had back pain and migraines at work, as well as stress from work and family issues. However, the hospital felt there wasn’t a link between her medical condition and stealing the drugs because it was a conscious and rational activity she did over a five-month period. It terminated her employment on Nov. 20, 2007.
The board found there was a difference between a substance use disorder and an addiction, and as a result the disorder could not be considered an illness. Neither O’Neill nor her doctor claimed she was addicted and her drug thefts were planned out and undertaken rationally.
“The evidence has not established that Ms. O’Neill’s substance abuse disorder and other psychological problems were such as to impair her judgment as to cause those problems to be a significant factor in motivating her to commit the thefts of narcotics,” the board said.
The board found there was no causal connection between O’Neill’s substance use disorder and her stealing of drugs, so her termination did not discriminate against her. As a result, the board said, there was no duty to accommodate.
However, the board found O’Neill was a long-serving employee who had a clean record before the drug thefts and good performance reviews. Though she initially denied taking the drugs, she later apologized and the board believed it to be sincere. It ruled termination was too harsh, particularly considering the College and Association of Registered Nurses of Alberta determined, after reprimanding her, she could return to work as a registered nurse after completing 960 hours of supervised practice, with 12 months of random drug testing.
