Healthcare workers taking pills? ‘It’s impossible to keep up so many night shifts’

Half of healthcare providers in the Netherlands sometimes use medication from the medicine cabinet in the department. They investigated this practice at the Northwest Hospital Group in Alkmaar and Den Helder and it turned out that more than fifty percent of the sleeping and tranquilizer pills did not reach patients.

A research agency compared the number of deliveries to the departments from the hospital pharmacy with the number of administrations in the electronic patient file. More medication was missing than could be explained on the basis of counting errors or waste. Benzodiazepines such as temazepam, oxazepam and lorazepam proved to be particularly popular.

The Northwest Hospital Group has hospitals in Alkmaar, Den Helder, Heerhugowaard, Limmen, Schagen and Texel. Houke Klomp is director there. She would like to emphasize that the image is not always correct. “The image that healthcare workers are thieves changes when you know what is behind it: a whole culture of people who like to take care of patients, but work a lot of night shifts. That is hardly sustainable.”

It is mainly sleeping medication that often disappears from the medicine cabinets. As much as 58 percent, says Klomp. “Those people work three to four night shifts, but have the same busy lives as you and I.”

The healthcare sector regularly hires the Hoffmann research agency when there are suspicions of theft. The agency has seen a significant increase in requests for investigations into missing persons, especially opiates and heavy drugs. “We had already received more than thirty assignments by 2024,” says Ron Nieuwendijk, senior consultant Fraud & Integrity. “I think the problem is much bigger than we see now.”

Nurse Marjolein Nijkamp confirms that there is a culture in hospitals in which people who work irregular hours easily reach for a pill. “Because they find it difficult to switch back to a day shift and their normal rhythm. But the threshold for doing so has now been raised. We also have much more discussion about it.”

The Klomp hospital had to fire one employee after the theft of larger quantities of medicine. Cameras were also installed. “If you catch someone red-handed with a lot of medication, this means immediate dismissal. We report this to the Healthcare Inspectorate.” The Inspectorate said today that someone is fired every two weeks after the theft of medicines.

ABS doctors, a support center for doctors with problematic substance use, see in studies that doctors and healthcare professionals in general are more often addicted to medicines than to other drugs and alcohol. The support center does not think it is a good idea to immediately dismiss such a person.

“Addiction is a disease,” says policy advisor to ABS doctors Marlies de Rond. “We can treat that. Employers should not immediately give up on people.” She sees that there is a huge barrier for healthcare professionals to seek help.

Not every theft is for personal use. People also take medicines for others. “Then you have to see what you can do without losing someone immediately. Because you need these people. You want to keep someone. They are not bad healthcare providers, but people with a problem,” says Klomp.

The hospitals of the Northwest Hospital Group have already taken various measures. The number of employees with access to the medicine rooms has been reduced by half. The hospital also reduced – where possible – the range of pills in stock. Where necessary, these medicines are now only supplied in the patient’s name.

According to pharmacist Suzanne van Lieshout, from the Northwest Hospital Group, the difference between delivery and administration has already dropped from more than fifty to 25 to thirty percent. “It will never be completely zero.”

Klomp: “We now see better what the stock is per department and what is going out.” Although it is also about a cultural change, she says. “It is very common for healthcare providers to take something with them every now and then, a kind of ‘secondary employment condition’. The problem is not only with nurses, but also with doctors. It happens across the board.”

Her hospital has still thought about a delivery point for sleeping medication. “Because someone may be entitled to a sleeping pill. Because we make people work so many night shifts. You don’t know what you are doing to them. Then we can control it so that they do not become addicted. But that delivery point was not allowed.”

With the motto ‘Fit through the night’, its hospitals are now using lamps, power naps, special chairs and yellow glasses that put less strain on the biorhythms. “It actually comes down to the fundamental question: how are we going to organize healthcare? That it remains manageable for our healthcare staff?”