Adjusting Interview Style to Meet the Circumstances with Cory Luper, Drug Diversion Analyst Atrium Health Wake Forest Baptist, and Jack Beckley, Criminal Investigator – Supervisor Office of the Indiana Attorney General
Two experienced investigators share their approach to interviewing a healthcare professional with a possible substance abuse disorder. Do they take a different tactic than they would if the theft was committed by a non-healthcare professional outside of a healthcare setting? How much does the possible presence of a mental health issue come into play when they strategize? Cory and Jack give us some food for thought.
Transcript:
Terri
Hello listeners. Welcome back to drug diversion Insights. Today we are going to talk about interviewing. This is a topic that really seems to have a lot of interest, and personally I find it fascinating. So I’m looking forward to learning more today. When I talk to people that participate interviewing and I hear what their confession rates are, it is clear that some interviewers are more skilled than others. They have a maybe different technique or different way to go about it. But that also tells me that with practice we can all improve. So always looking for ways to do better. And I have with me today Cory Luper, a drug diversion analyst with Atrium Health, Wake Forest Baptist, and Jack Beckley, criminal investigator supervisor for the office of the Indiana Attorney General. It’s pretty clear what Jack’s background is based on his current role. But I’m going to start by asking both of you to give us a bit of your background and a little bit about your current role just to lay the foundation for our conversation today.
Terri
So welcome to both of you. And Cory, let’s start with you. Give us a little bit about your background.
Cory
All right. My professional career began at the Winston Salem Police Department. It’s a city police department here in North Carolina. It’s actually from the same county I grew up in. And so I started there obviously with a local police department. You start as a patrol officer. I worked on some very specialized units to include a street crimes unit, which would be quality of life crimes, narcotics related investigations. Eventually got to first line supervisor, rank of corporal, and then made it to the Special Investigations Division, which had many names by the end of it. Ended up being a drug task force in the end, where I spent my last seven years in the narcotics unit is what we would call it. So in total, twelve years of law enforcement experience, and then my last seven were mainly just bison, narcotics crimes, mostly narcotics related offenses. So especially right through the rise of the opioid epidemic, that was kind of the primary focus of my career.
Through that work we actually partnered up with the State Bureau of Investigations, homeland Security, DEA, the alphabet soup of all the entities in our area, prosecutors, you had task force, different federal aid that came through the task force that were with. So I made a lot of contacts. I actually made contacts in my neighborhood through my family with some pharmacists that work in health systems. And they came to me saying, hey, you have contacts with DEA, SBI, those that we report certain medication events or drug diversion incidents through, can we use you as a resource to make those contacts? I said sure. Well, here Atrium Health Waste Forest Baptist. They started their drug diversion program, I believe in 2017, and they expanded it about two years ago. And so when that expansion happened, they actually reached out to me and asked if I’d be interested in coming on to the team. They wanted to add a different skill set.
I come from that narcotics background. I’d done hundreds of interviews, so they wanted to bring something new. They had a pharmacist, a nurse, pharmacy technician on the team. And I kind of call myself the oddball out, but they brought me in to join that team. So I’ve been doing that for almost two years now, where we’re pretty much drug diversion. Surveillance Analyst is the title, but we investigate when the medications go missing for the hospital and put controlled substance compliance policies in place and do the follow up from start to finish on those investigations. So that’s what I’ve been doing for about two years, and we’re speaking on interviewing here. I’ve continued that role. I either partner up with one of our team members or in the past, with one of risk management investigators, and we would be the two that would go and do the employee interview.
Terri
How hard was it for you to learn the clinical piece of it? Because obviously when you’re doing an interview, you need to know what you’re talking about.
Cory
I will admit I am still learning, but yes, that’s one part. Before we ever step into the interview room, I have to feel confident that I understand what’s going on, and I think that is a credit to the colleagues that I have around me. I sit right beside a pharmacist, a nurse, a technician, so I feel proficient at this time. But starting out, it wasn’t that way. So I definitely leaned on their expertise, their guidance, if they were doing the case or if I was investigating the case of the primary, we would have that meeting beforehand to really make sure I understood what was going on. We had the data, so definitely spent a lot of time to make sure I understood what was going on. And I work with these systems now day in and day out myself, so I’ve built up, I would say that knowledge base.
A lot of the medications, a lot of the controlled substances crossed over to the street level, too. I was familiar with a lot of what the trends are, what we’re seeing, if you want to break it down to simple categories of uppers versus downers, you try to understand what you’re looking at and pair that with what could be a possibility. If you see something strange with an amphetamine, they may not be targeting the opioids. So it kind of caters to your investigation. And I’ve had to learn a lot along the way, but I’m still learning, but I feel proficient at this time.
Terri
Yeah, that makes sense. So you were familiar with the drug names, and most of those, I think, are fairly easy to pronounce. Right. It’s not like a lot of the other drugs that we have out there. All right, Jack, give us a little bit of your background.
Jack
Yeah, I started out with the Hartford City Police Department here indiana. It’s, of course, municipal police force, started in patrol. I was a canine officer for a few years and then was promoted into investigations. And when I left there, I left as detective lieutenant. So part of that is to cover everything criminal. And then I was part of a multi jurisdictional, multiple county drug task force for five years. So I got familiar with drug cases in that sense. I was in a school administration for a few years overseeing school corporations here in Blackford County buildings, grounds and transportation services. But kind of miss serving. Right. I like the investigation component, and I just happened to hear about an opportunity with the office of the Attorney General in the Medicaid Fraud Control Unit. And within that unit was the drug diversion team and seemed like a good fit for me.
So I pursued that and was fortunate enough to get hired. And I’ve been supervising that team now for six years and probably kind of to jump on what Cory mentioned. The hardest part was the medical legal transition. I’m not dealing with street drugs anymore heroin or cocaine or anything like that. We bought a lot of pills, but nothing like the language. And really weren’t dealing with who we deal with today, which are professionals who almost certainly have some sort of an addiction problem. That was the hard part. But like with Cory, I work with the DEA drug diversion investigators who are familiar, and my coworkers and other deputy attorney generals who are familiar with the medical legal jargon and getting acclimated with the laws that pertain to nurses indiana because they do have statutory requirements that they need to follow when dealing with controlled substances.
But the transition, I think, has gone well. But I’m always seeking to learn more, and I’m eager to learn, and that’s kind of where I’m at today. We make the cases and do what we can.
Terri
Okay. All right, great. So two law enforcement backgrounds and hence the interview conversation. You guys probably have this wired pretty well in terms of interviewing. What type of training, if you can think back, did you get? Is it specific? I know there’s different techniques out there. So was there specific training that you were sent to learn how to interview? Was it more than one type of technique? Describe a little bit about what you learned in the past, and then we’re going to talk about how you maybe have catered it to the healthcare professional that you’re now interviewing because it’s a little bit different than bank robber or what have you. So let’s talk about that a little bit. Cory, what kind of training did you get in the beginning?
Cory
Okay, thinking back, that’s a good question. The basic law enforcement training BLET is mostly they refer to it. As has a block in it where they’ll teach you training techniques. So I’ll go over I believe even the read technique was one of the I don’t have the book with me, but one of the techniques. So they attempt to teach you through book learning. There’s not very many practicals that you could do to try to recreate that, but when you’re going through the academy, you get your first glimpse into that. Our department ran its own academy. When you got out to field training, I would call it, you would typically ride with up to five supervisors that would evaluate your performance as an officer over about six to eight month period, working all the shifts. And that is just hands on. You’re talking to people calls for service.
You may have ten a day, so you’re talking to whether it’s the caller, the victim, suspect, whatever it may be, you have to talk to everyone. So you had a supervisor evaluating how you were doing that. So it’s a lot of trial and error of what works, what gets people to talk, what gets them to trust you into confiding with you. Because I tell people all the time you’re meeting them on their worst day of the year, most likely. And so you have to immediately build that rapport. And the uniform helps, but they want to know that you’re engaged. Listening empathetic all the basic traits of trying to build a good foundation for an interview. Start with that hands on, trial by error, really. And in law enforcement you have a unique opportunity. Jack could probably speak to as well. We have spoken to thousands of people in a non custodial interview setting, and then hundreds in an interview setting in custody.
So there’s a lot of experience there once you get a few years of experience and apply to specialized training. And when I became a detective, I did go to an interview and interrogation course. I can’t remember exactly which techniques they taught, but it’s similar concepts. A lot of like you would watch videos of interviews occurring and what they learned from it. A lot of learning from other case law and from other experience in law enforcement and what worked and what maybe doesn’t work, but there’s no one path to success. And then from that your training would build. I remember, police law institute would be another training. It wasn’t interview focused, but it was how to take that information and then apply it to legal search warrant applications, affidavits what the courts are looking for, and then how you apply credibility to yourself. Part of your court applications would be how much experience do you have in conducting interviews, or how many physical arrests have you made or investigations have you completed?
So that would be from the very basic level to the advanced level training I had. But really the experience comes from just spending twelve years doing it, 40 hours a week I couldn’t count how many interviews I’ve done in that ten years. So that’s where the bulk of my training has come from.
Terri
Right, and did you recently take another interview?
Cory
Two of my team members did take an interview course, and I was enjoying I think we talked about it once before, I was enjoying the material that they got from that interview, especially they had like, a wheel that explained if a person is acting a certain way, how should you react? And it kind of put on paper that law enforcement, when you engage with someone, there’s a different level of threat or concern. So how you react to someone could entice a certain response. So you learn real quick how not to escalate or agitate. And so it was very interesting to see a wheel of behavioral patterns and applying that to the new style of interview, the new, as Jack mentioned, the medical professionals that we’re actually talking today. I know that’s another part of your question we’ll get to, but how we adapt that approach.
We’re speaking to a very specific group through these drug diversion interviews, where a lot of that trial and error and experience, you could almost forego using certain techniques and just focus on what you’re going to do in a drug diversion interview.
Terri
Yeah. Okay. So there’s more than just remaining calm to control the interview. Okay. All right. Maybe you could give us some of those tips. All right, jack, what training did you get?
Jack
Well, with most police officers, of course, it started out in patrol field interviews. A lot of people forget that any encounter we have with people is an interview of a kind. Right. We are talking to people, trying to communicate what we need to them, and then elicit the information back. That’s critical. So that was part of it initially, right, is you just learn how to talk to people. But then when I got into investigations, it was kind of an array of different styles or techniques, so to speak. The Reed method is well known to every cop in the country. It’s very popular and used quite a bit. But your good investigators have to have more than one tool in the toolbox, so to speak. So where that may be effective for some, maybe it’s not for others. But on top of that, I was a polygraph examiner.
And then part of the training in that course is, again, interviewing. It’s different styles and reading the physiological responses that you can see and not necessarily even need the instrument. You can just kind of read their body behavior. I had a different technique with child molest victims. That’s a whole different set. Right. So it’s an interview where they’re not suspects, but you have to know how to approach them. It’s a thing called first witness. It was out of Minnesota. They kind of specialized on that with the goal of getting the interview done one time so you don’t have to ask this poor kid eight, nine different times from four or five different people, the same thing. You get a good interview off the bat and you don’t have to do it again. So you kind of have to, again, shift gears. It’s essentially the same.
We want information, but the children have different reasons for maybe not being forthcoming. Maybe they don’t think it’s important or they forgot until you remind them without suggesting or leading. But it’s just a variety of different ways to get to the same thing. It’s the truth. And I think Cory would agree. That’s the bottom line. Whatever you got to do and shift gears when you’re encountering people, at the end of the day, it’s the truth. And that’s what we seek.
Terri
Yeah, that’s kind of fascinating. Being a polygraph. You can see it on the thing, but then you learn to identify it’s, like, oh, that’s going to raise it. I can see it and confirm. That’s kind of an interesting thing. And you also touched on something which I think is important that we should recognize is that we don’t have to be in an official interview situation to improve on our interview skills. Right. We don’t want somebody to feel like we’re interrogating them when we meet them or we’re sitting over dinner or what have you, but we can start practicing that, listening and asking good questions and kind of start working on some of that stuff. Like you said, every time you had a conversation with somebody, it was an interview because you needed some information. So we actually can work on some of those basic skills just in everyday life, I think.
Cory
Absolutely. To speak on that, we contact the managers for most of our reviews of employees obtaining that information. And like Jack said, when the truth is the goal, you don’t want to laser focus yourself towards a confession as the goal because you might not ask the questions that exonerate the person that may be under review. And then when we go to the unit floors and talk to the staff involved in an event, you may not know if any wrongdoing has occurred in our world, if medication has gone missing, it could purely be an accident. And so you’re having to talk to multiple people, and maybe one of the five is someone who is diverting. So you’re very correct and you get a lot of practice in obtaining the information you need in a way that’s going to elicit the factual response, even if it’s outside of a formal interview.
Terri
Right? Yeah. Daily skill sets that need to be developed. So talk to me about how you guys would approach a healthcare professional. Number one, is it a different approach? And number two, if you have somebody that has a substance use disorder, obviously there may be people who are diverting and theft for resale and other things. So we’ll just kind of push that off the table and focus on those that are using it for self use. So substance use disorder. How does your technique change then with somebody like that? Cory, we’ll start with you.
Cory
All right. I’ll start a big part of, I guess, our structure that I like to employ. Obviously, we already spoke to the preparation beforehand. That happens before you’re ever talking to the individual. And then we attempt to have steps for the leadership. We don’t go remove them. We don’t have security to go remove them from patient care. We try to have the leader discreetly pull them. We understand it’s a stressful transition. As a medical professional, you’re being removed from patient care and you don’t know what’s going on. So from the get go, we’re already encountering a situation where we’re trying to be as accommodating and respectful as possible. In law enforcement, sometimes safety supersedes that comfortability. So exigency kind of trumps it. So in this setting, we try to control that environment and make it as less stressful and less, I guess, accusatory or causing shame or undue attention to that employee when they come to the interview room.
I have a couple of steps. I know, Terri, we presented on it before in the past, the beginning of the interview, we talk about, you want to try to build rapport, get to know the person. And I’ve created templates to kind of filter that conversation because not many people know where to start. And so I’ve kind of created a system where we get to know the person and make it kind of standardized, explain that we have a standardized process. We’re going to ask about your background education, your background experience, where you’ve worked in the past, your job knowledge, and your onboarding in our facility to get them comfortable with that Q and A and talking and any kind of conversation that can generate off of that to build rapport and get to know the person is encouraged. And then from that step, we usually guide into I call it hypothetical medication events.
We talk about their actual workflow that they’re doing. We walk through hypothetical events trying to explain to the individual that ours could have been a review of their entire practice. They may not be there for a specific incident. It may not be prompted from one tablet went missing. Their mind is racing, trying to understand why they’re there. So we keep it hypothetical and try to get a baseline for what their process is. See a lot of truthful answers, get them talking. And really, the first 30 minutes, I would say, of an interview is that background and that gathering of info before we even go into the facts of what we found from the case as the interviewer. In that moment, while you’re listening, you’re not trying to correct them on their processes. You’re trying to hear what they’re saying because you’re going to apply those differences and what they say they do with the facts of the case and what you found.
And then that’s where I would say the read technique has those in the first two stages of the read technique, they then call the interrogation that third section where you’re actually then confronting with the what is the person they are accused of? What is the situation? Obviously, that could vary, but in this instance, it may be missing medication or certain metrics lead to think they have a substance use disorder. And so that same structural build from the read technique is pretty much what I just described that leads into what they call the interrogation. We wouldn’t refer to it as interrogation here is still part of the interview to us. We have to cover those questions. And so that’s where obviously there’s a lot of techniques from there as far as empathy statements and how you ease into that information or broach the subject. But I like to eventually present enough that I’m aware of enough to where the person by the end of it is like, oh, I see what this looks like of their own accord.
Innocent or guilty, it’s good to make sure you’ve conveyed enough information, that enough facts that you don’t reveal everything, but you reveal enough as to what it’s looking like and then you start to discuss that.
Terri
Yeah, now. Jack so Cory has to stay within the guidelines and the procedure that the hospital has set. Right. And I think Cory is pretty happy, from what I can tell, with what his hospital does. There may be other hospitals they don’t subscribe to the drug test after or you have to conduct the interview in a different way. So you’re really kind of locked into what the hospital leadership and the decision has been made. So Cory works within that. Jack yours is a little bit different, right? Because you don’t see this healthcare professional at the beginning. Am I correct in assuming that you get them later? Like maybe somebody like Cory or somebody else has already interviewed them and either got to the truth and it involved a confession, or maybe they didn’t and they were still reported to their licensing board for something, and now you’re coming in.
Terri
Is that a correct statement?
Jack
Yeah, that’s right. We’re never there in the beginning, if it’s a diversion case involving a hospital, people like Cory have already been involved and have talked to them, or most hospitals today have their own police force. So maybe if it’s not a corporate investigator, it was an investigator in that police force, nursing homes, it’s usually going to be your HR and your director of nursing and probably the executive director of the facility. They’ve probably already approached the provider and talked to them in that regard. And then it’s a matter of how quick they file complaint. If it’s a reportable offense, however long it takes for Department of Health to send it to us, or if it’s a consumer complaint directly to us. It’s got to be screened. So it’s usually several weeks after the incident before we even see it in our queue, and then we get on it very quickly. We have requirements within our unit that once you get it, then let’s get going on it. So you have to start the process like that.
Terri
Okay. So is your approach any different with considering that they’re a healthcare professional that might have a substance use disorder? Would you approach them differently than, you would, say, somebody that went into a store and stole something off of the shelf of a larger dollar value type of thing? Do you approach them differently?
Jack
Yeah, I think that’s fair to say. Every encounter is different, kind of. Right. I hate the term in law enforcement routine. It was a routine traffic stop, or it was a routine this. I think our job as cops is far from routine, and I think the nurse that is stealing hydrocodone is in a different place than the violent armed robber or someone who molest children. Right. They’re all different animals, so to speak, and you got to just be able to, again, adapt, adjust, and approach them in that manner. And they are professionals. Right. Most of them are college educated, so they should be articulate. Right. They should be able to talk and communicate and not just tell you, I don’t remember 1516 times about something that happened a day ago. But when they do that, it provides you, I think, some grounds to pursue because they’re obviously being evasive, and I think investigators look for that evasiveness that’s trying to distance themselves from the event. It’s trying to create that time barrier. I don’t recall or I don’t really remember that. Everybody else seems to remember it. So you have to, again, dive into that and make them explain themselves, if they’ll even talk to you.
Terri
Right. Do you consider at all in your approach that mental health piece of it? If you suspect that there’s some impairment at the time, if you’re thinking that they have a substance use disorder, then they’re continuously medicating themselves or potentially in withdrawals. But some mental health issues that led to the substance use disorder, do you take any of that into consideration in your approach, either one of you?
Cory
I’ll speak briefly on that to kind of bunny hop on what Jack’s saying about how it differs in what we’re approaching, whether it’s a suspect of an armed robbery. This incident Jack alluded to that armed robbery suspect is going to distance himself from the event. We’re talking to medical professionals that are signing their name to medication events. They are putting their fingerprint on a machine to attest that they’re the one dispensing it. So they have a different I guess they’re coming from a different origin. They’re not able to go to those typical I’m going to deny distance and completely refute so that being said, they’re medical professionals that have to account for their actions officially to do their job. And so when you one challenge to the read technique that we do hear a lot is what about the young or the mentally? Maybe you have a 25 year old who has the mind of a five year old.
How do we account for that? In law enforcement, you have to make that assessment possibly on the fly in the medical field. We go in with the understanding that this is a medical professional that’s been certified and trained and should have the cognitive and mental capacity to perform their job if they happen to be impaired in an interview. And we could observe that. We have to be concerned on patient safety. We have policies for that responding to impairment immediately. So we do take that into consideration. But as far as their ability to perform at the level we’ve hired them for or that they’re certified for, we go into the interview with that baseline understanding that they need to account for their handling of controlled substances, and that’s what we have to discuss. So that does change your strategy and how to get people to talk, because that’s why I use the hypothetical. Those are the events we’re going to talk about. And so it gets that conversation flowing. They have to answer to their actions.
Terri
Good point. Jack, do you have anything you want to add?
Jack
No, I think Cory is right. You have to just go into it with that understanding that they should be able to explain. They are required to. And that was all part of their training. Right. They agreed to it when they were trained in their field. And if they are diverting and they develop the scheme to divert and try not to get caught, then that there suggests some ability to think and comprehend and understand their crime. Right. They’re putting together sometimes fairly elaborate schemes to try to cover their tracks. They’ve got possible substance abuse issues, but we go at the approach that as long as we’re seeking the truth, we collect the facts, we let judges and juries make decisions, then sometimes they have to be compelled to get the help they need. And if that is at the urging of a judge, then so be it.
Then if they seek it for themselves, that’s even better. But at the end of the day, it’s to get them that they need. And our attorney General places great emphasis on patient care. That’s the first and foremost. If they’re stealing medications from patients who need it, that’s unacceptable at any level, no matter how, whatever issue is. And if they’re impaired while they’re trying to provide this care, that’s even more dangerous.
Terri
Right.
Jack
So our goal is patient care first and then get the care that they need if they have issues too. So we look at it as kind of hopefully a win, right. We’ve helped the. Nurse who’s entered into some sort of distress or problems. And we are protecting, first and foremost, patients who are just trying to get better and have somehow become involved with a nurse going through certain things. So we want to catch it quick and make sure that there is no public emergency or people are putting at risk.
Terri
Right, yeah, those good points that you make. I mean, they’re skilled professionals that theoretically are highly functioning. If they weren’t, it’d probably be a little bit different approach in terms when you interview them because there’s a lot of performance issues going on here. But for the most part, I don’t know if your experience is the same, Cory, but most of the time the response back is, oh, no, they’re my best employee. So these are highly functioning, skilled people that even if they do have a substance use disorder with chemical changes in the brain, they still manage to perform and function. Because I think some people get caught up on the mental health issue and they’re struggling. Yes, that’s true. And the disease is very much so, I’m sure, driving their actions and their deceptive every maneuver that they do to get away with things. But you’re right, they are very highly functioning underneath that.
Terri
And so it’s kind of a different it’s a little bit of a dichotomy kind of thing. It’s like, well, they’re not in control necessarily, but yet they’re in control enough to perform and to function. So it’s really kind of an interesting yeah.
Cory
And to add another layer to that, Terri, you got a good point. They are medical professionals who deal with these medications, whether they’re the prescriber or just the one administering them. We’re noticing in healthcare that they’re at a mental state where they think they can control the meds for themselves. And so they have that extra layer of, oh, I can medicate other people. I could definitely manage this for myself. It won’t become a problem. Knock on wood. I’m sure it’s possible. I haven’t met someone who came into the medical field with the goal of gaining access to medications. Whether it’s a mental disorder or substance use disorder or however it manifests, it’s not usually the goal of why they got into this occupation. They’re intelligent professionals who, for whatever reason, got into this situation. And a lot of times we all take training. We don’t pay attention to every block as closely as we should.
They didn’t get trained at the beginning to all the resources available. If they hit those hard times or maybe they did receive treatment or training, they just didn’t pay attention to that. They didn’t think, oh, that’ll never happen to me. And so a lot of times we’re finding these medical professionals at this point don’t know where else to turn. And so you talk about strategies and how do we adapt this and how does it change from law enforcement to here? A lot of our strategy is to go back to those foundations of these are the services available to you. This is the help you could get. This is what the process is through whatever board entity that you go through, whatever next steps. Because educating them on I call it the light at the end of the tunnel or the carrier on the stick. They’re medical professionals that need to be honest and admit to themselves that they need help and that the resources are there.
A lot of them just forget that. Or maybe they’re too prideful to ask for that help. And so that’s a lot of our once we get to that moment I talked about, there’s a lot of routes you could go with empathy statements and where that part of the interview goes, that’s usually where those conversations direct. And even if they deny, I still want to educate that person I’m talking to as to those resources available if it becomes a problem in the future or maybe they don’t trust to be honest with me that day, it’s still a win if they seek that help the next day of their own accord. So you’re right. There’s a lot of layers, a lot of interesting parts to make this field of personnel different than the rest of society.
Terri
Yeah, and you’re right. Good point on making sure they have the resources because I’ve seen that happen actually several times is they deny. But then within the next 48 to 72 hours, they are talking to somebody and saying, okay, I need help. So we can’t forget that last piece of it to make sure they have that. Just curious. So would you have an approach or what would be your thoughts on if you’re interviewing somebody based on the data, no performance or behavioral things that have been identified by their supervisor or anyone else that works with them. But you’re seeing some things in the data that concern you. You bring that person in, they can completely speak to the policies. Not only can they speak to the policies, but their process. No, I always do this. I always do this. I always do this. But the data tells you something different, right.
So then when you confront them with, but this is what we’re seeing in the data, they’re still holding or you’re drilling down. So I wouldn’t see you doing these types of things then because this is your process and it wouldn’t lead to this. Let’s just say lots of waste. And they say, no, you wouldn’t see that. You wouldn’t see that. But we know we’re seeing it. So you get to the end here and then you tell them what you have which doesn’t match what they’re saying that they do and they are still holding to that line. Well, I don’t know. This is what I do. This is what I always do. I guess sometimes I make a mistake and I’m not perfect and that’s it the end do you have any thoughts on how you would handle something like that? It just comes down to I don’t know.
Cory
Yeah. And that happens. That is very common. Of course. Truth is the main goal. And some of our interviews, I don’t keep up with a confession rate because some of our interviews, they can account for everything they’re doing. It does line up. And then the situation you’re talking here, it’s not lining up with what we’re seeing. We have the facts, whether it’s on camera or through our data. What I typically do in that and this is a hypothetical, is typically explain exactly what it looks like to me, pose that alternative like they’re standing true to. I don’t do that. I will then take a step back and say, well, to me, it appears like these medications are not ever reaching the patient or this waste is not what you’re saying it is. I do not believe based on our facts, if you’ve made your facts credible enough, you as the interviewer make that statement of alternative outcome.
I believe this is the case. And then if that is the case, that’s when I usually guide into there are a couple of paths that I would encourage you to take, whether it’s seeking treatment, help, being honest on the forefront. And I’ll tell them during the interview, if it’s risen to the level of an interview, our process usually ends with a forefalls drug screen. And so I will reveal maybe at that point it’s another tool in the tool bag. The screen is coming up. You may have to answer to the results of that. And then if the conversation keeps going, these actions are not without consequence. Our institution zero tolerance policy up to including termination. So we’ll speak to the fact that this may not be the only entity they have to answer to. Like, you may have to talk to someone, like in Jack’s role or another law enforcement entity or a board entity, the line of explanation, if it doesn’t match the facts, I’ll explain to the individual.
Cory
You have to present this and explain this to multiple other investigators.
Terri
If I don’t understand it, they won’t either.
Cory
Yeah, it’s not like you get to like a kid, like my children, if they try to slip something by with a little bit of a deceitful answer and run away to get a piece of candy, it doesn’t end there. And so they’re professionals. They understand the severity of it at that point to start, and I slow down and let them consider the option of maybe we start over unless I recommend the truth. Let’s start with what’s happening and let’s get it out there and go from there. So posing what it looks like as opposed to just letting them, I guess, think that their answer is fine enough, I guess would be the short version of that answer.
Terri
Right. Okay, jack, you want to add anything to that scenario?
Jack
No. Unfortunately there are cases we just can’t solve. Right. It doesn’t work out that way. We do operate under the presumption of innocence and there has been cases where it probably just is one of those things and they likely didn’t divert medication. That’s why we don’t ever base our investigations completely upon those anomalies right. 115% higher pull rate than others, or that. Sure, that’s all great information to have, but at the end of the day, that’s usually not enough for us. But we move on. And sad to say, if they are diverting, we’ll probably see them again. And the evidence in that situation is perhaps more compelling and better. But again, we operate under the law and sometimes you just can’t quite solve it.
Terri
Yeah, we want it all to be tied up in a neat bow right. If somebody does have a problem we want to get them out of the patient care and get them to where they can hopefully get some help and if they don’t, we certainly don’t want to destroy their lives by doing that and we then want to get them back to patient care. So there’s a lot on the line like I guess it is with every guilty or innocent verdict people have their lives turned upside down if you get it wrong.
Jack
Yeah, it is and certainly people have issues maybe with the criminal justice system in America and they didn’t receive satisfactory conclusions in cases where they’re involved or engaged in some other way but I do believe it is the best criminal justice system in the world by far. It’s not perfect but I do believe it is the best one and eventually I think people get the help they need in some way or another whether it’s through church and spiritual well being, whether it’s through the court system where they’re compelled to do it, whether it’s family finally reached them and says you’ve got to stop. At the end of the day, again, our goal is just the truth what happened, where did it go? And then to get everybody the help they need. Patients are safe and if nurses are in turmoil internally get them the help they need.
I mean, at the end of the day it’s like Cory and I have said it’s just the truth, what happened? And then let other people decide where it should go from there. Because we employ a team concept with our unit where we have licensing attorneys involved, we have criminal prosecutor, criminal Dags involved, data analysts involved, and we all discuss these cases. So it goes through a very rigorous system and process, more than what Cory and I would have been used to as police officers. It’s just you trying to make the case and present it to a prosecutor. We handle these cases seriously and there’s a lot of people involved with eyes on and the expertise needed. Again, because it is kind of a unique type situation. It’s pretty effective. But again, I think, like we’ve said, sometimes you just can’t quite reach that beyond a reasonable doubt. And that’s what we strive for, right?
Terri
Yeah, all of that makes sense. And you’re right, it is a collective. And I’m sure for Cory too, there’s a group, and I think that’s an important piece, too. It shouldn’t be left up necessarily to one person, but we have different perspectives. We see different things and bring different things to the table and make that collective decision because it’s a patient care issue and it’s a healthcare professional issue with their livelihood as well. All right, great. This is great, I think a lot of great information, some things to think about and different perspectives. And I appreciate both of you taking the time to share your history and your experiences with us.
Jack
Thank you, Terri, for everything you do. And, Cory, thank you for what you do. It is a team effort, right? It’s going to take everybody involved to help with this problem. And I appreciate what you guys do.
Cory
Yeah. Thank you all. And thank you, Terri, putting this together. Thank you.
