Controlled substances

  1. Recently, a student nurse anesthetist was found dead in the on-call room of a drug overdose. People I know who work in PACU, OR say there is NO accountability for controlled substances. That pretty much, the 'ologists have quite a stash in their jackets, "just in case" they get called for a stat intubation. I would imagine that becoming a CRNA might be an attractive proposition for an impaired professional. What's the concensus?
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  2. 27 Comments

  3. by   cdoncrna
    I would say that the handling of controlled substances in that institution is very sloppy if all of those anesthesia providers are carrying controlled medications around in their pockets. JCAHO would love to hear about that. However, regardless of the controls in place, impaired persons will find a way of diverting the medications they need. I have heard of all types of ploys to get their controlled medications. I have worked in a department that used a Pixis (sp?) so that all dispensed medications were for specific patients and not just many pockets full of drugs. Medications not given to the patient had to be turned back in to the pharmacy for random analysis. Anesthesia providers do have access to many controlled substances, but all of us have access as nursing professionals to a wide variety of addictive medications.
  4. by   TJCRN
    CRNA's have the highest percentage of impaired professionals in healthcare. I believe dentists are second on the list.
  5. by   Brenna's Dad
    I was uner the impression that anesthesia providers as a whole had the second highest rates of impaired professionals in healthcare.

    Chubby, I can't imagine that someone with a drug addiction problem would be together enough to be accepted, let alone, finish a CRNA program.

    The administration and dispensing of controlled substances is a trust. If you want to break that trust, you will do so regardless of the safeguards in place.
  6. by   ragingmomster
    Wow, can anyone point me to reputable sources for these generalizations about who is addicted most? NOT GROUSING, just wondering.
  7. by   JSB
    This is a pretty bizarre example of an anesthesiologist's addition that I heard from one of the anesthesiologists at the hospital where I work. He said that he knew of this anesthesiologist who apparently had some Fentanyl mixed up in a Foley bag - to get a "hit" during surgery he would put the bag under his arm (in his jacket, I guess), and had the catheter in his rectum for absorption through the mucus membranes. One day he just fell out in the middle of surgery - must have squeezed the bag too hard?! Of course, this is just the story I heard, and I can't say whether or not it's true, but talk about strange!
  8. by   TJCRN
    I just finished my RN program...I'm just stating what we were taught in the lecture on substance abuse and the impaired professional. CRNA's #1, Dentists #2
  9. by   zrmorgan
    Quote from ragingmomster
    Wow, can anyone point me to reputable sources for these generalizations about who is addicted most? NOT GROUSING, just wondering.
    Lundy & McQuillen: "Narcotics & Anesthetists: Occupational Hazard"

    Ward-Saidman Study- retrospective study:
    289 training programs (247 return)
    68% indicated 1 suspect: 80% confirmed
    30 suicides (among 235 identified abusers)
    80% recognized by staff MDA/CRNA


    General public with a relapse rate of 80%


    ...Just a cut/copy/paste from a lecture by Diana Quinlan last semester.

    peer assistance hotline: (800) 654-5167

    also check out these sources:

    http://www.aana.com/peer/read.asp

    hope this helps...its a reality.
  10. by   RoxyBen
    Quote from Brenna's Dad
    I was uner the impression that anesthesia providers as a whole had the second highest rates of impaired professionals in healthcare.

    Chubby, I can't imagine that someone with a drug addiction problem would be together enough to be accepted, let alone, finish a CRNA program.

    The administration and dispensing of controlled substances is a trust. If you want to break that trust, you will do so regardless of the safeguards in place.
    Actually many addicts are extremely intelligent, ambitious people so I'm not at all surprised that they would chose and finish a CRNA program. Most don't develop their addiction until they have ready access. This ready access to anesthesia providers has been one of the most significant causes, among others, of their addiction.
  11. by   Anjoplasty
    I'd once work with a Cardiology Fellow in his last year of residency and he had a serious prob. He was forced to take a leave of absence for tx. of his habit. Noone would have ever thought to suspect him of being a serious user... Guess you can 't be too careful or assuming
  12. by   ctbsurf
    I thought dentistry was #1 and anesthesia was #2
  13. by   deepz
    Quote from zrmorgan
    ....from a lecture by Diana Quinlan ......

    It seems to be getting worse. In years past the risk was said to 1:7 that an anesthesia provider would have a chemical dependency problem at some point in their career. It is a complex issue, beyond the easy availability.

    This year Diana Quinlan says the risk is currently 1 in 5.

    deepz
  14. by   athomas91
    i have heard similiar stats - and have been told by instructors of the problem...addicts come in all shapes/sizes/ages and professions...anesthesia being highly ranked due to the access...however - most of the places i have seen you do have to account for what is missing from your assigned bag at the end of the day (just like a drug charge sheet) - still i am of the firm belief that if someone is that determined to use - they will find a way....unfortunately.

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