My CRNA friends do illegal drugs

[DrugReptoNurse]

Two of my friends who are CRNA's take recreational ecstasy almost every weekend. They will take it on Saturday night...stay up all night....and then try to sleep it off on Sunday. When Monday morning comes around they go to their contract per diem positions and perform anesthesia mostly in private practice plastic surgery clinics.

I am worried that one day they may provide anestheisa while the ecstasy is still running through their systems.

A couple of questions for those of you who are currently CRNAs.

1. How do you approach a CRNA and tell them you are worried they might harm a patient while under the influence.

2. What else would you do to make sure they don't harm anybody? Should I contact the state board or should I mind my own business? For the record I am just a nursing student.

They have both been practicing for 8 years and have never had any problems in the past. I just know I wouldn't want to be patient under their care.

[dfk, RN, CRNA]

Would you get on an airplane knowing that the pilot did ecstasy less than 48 hours ago?

that's the point here i think... you just don't know...

waiting on the what-if could be more detrimental than acutally knwing

[wildmountainchild]

Take it from one who used to do ecstacy "back in the day" (about 10 years ago). You DO NOT want someone who has been doing ecstacy within the last 48-72 hours handling any life or death situations. PERIOD.

I remember getting some bad X once and for two weeks I couldn't maintain my line of thought for more than a few moments. I couldn't read a paragraph without forgetting what I was reading, I couldn't hold a conversation without trailing off and forgetting what I was saying. Now imagine me in that state trying to administer meds? Scary, huh? And I was like that for two weeks! My parents had to watch over me as if I was a two year old. Thank god things got better but that was a huge learning experience. You just never know what is in illegal drugs.

I saw friends go from intelligent, interesting people to bumbling idiots after using ectasy a few too many times. Of course that doesn't happen to everyone who uses the stuff but the point is.....you just never know.

Do the honorable thing.....tell your friends you are reporting them to thier employer and then go do just that. They will likely be fired but not repoted to the BON.

And the wake up call could save someone's life.

[pickledpepperRN]

As a licensed professional it is not acceptable to violate requirements of your licensure.

A registered nurse is required to advocate for the best interest of each patient. A licensed nurse must obey the law.

If a law is immoral, such as racial discrimination, work to change that law.

I would not trust the supervisor or facility to protect the patients. They may allow a resignation or terminate a drug user. The Board of Registered Nursing will investigate, then offer the choice of using ecstasy or holding a license. That will be their choice.

http://www.rn.ca.gov/enf/complaint.htm#who

http://www.rn.ca.gov/enf/pdf/cpltfrm.pdf

[Liddle Noodnik]

Please note: Focker, the above poster, and Roy Fokker, the moderator, are two different people. Easy to confuse the two.

(Might a name change be in order? Roy was here first! :) )

[Focker, CRNA]

how about.... no

[jewelcutt]

This is an excellent thread. It would definitely be one of those long discussions in an ethics class. And as such, I'm sure you aren't really going to have a definite answer to the absolute right thing to do. I am not giving my opinion by stating any of the following questions, I just like playing devil's advocate. Do you report someone's husband if you know they are hitting their wife? Do you report parents if kids have strange bruises frequently (not in the hospital)?, do you tell your friend's boyfriend that she's cheating on him?, do you go to the cops if you see someone smoking pot?, do you go to your friend's employer even though you don't work with them?, are you still friends with someone even though they do bad things?

I think the major dillema the OP is having is the fact that these two CRNAs are friends of hers, not colleagues she witnesses doing drugs. It is a very hard thing to turn in your friends, especially if you think it will ruin their life, even though it could save them in the longrun. I think that after all of these posts, the OP should react on her gut instinct and do what she thinks is right.

[kadokin, ASN, RN]

This is an interesting ethical dilemna. On the one hand, a person's off time is their own. They should be free to do as they choose. On the other hand, they (medical professionals) of all people, should know better.

Should you report or confront?

I had always thought that confronting someone that you know on a personal level would be a better first option than reporting them sight unseen. You know, give them a chance to make good, before you potentially deep six their career. For lack of a better analogy, if you know a friend is cheating on their spouse, who (if anyone) do you go to first, the spouse or the cuckold? (All things being equal, I suppose I would keep it to myself in the cheating situation). But a potentially impaired, critical health-care provider, don't know if I could hold it in.

Then, I went to nursing school. The dean of our program was dead-set against confronting people who you suspect of diverting narcotics. As she put it, "These are DANGEROUS people". At first, I laughed. I am no innocent, I grew up around people that abuse substances. These are people who have helped me when I needed it and that I consider my friends. On the OTHER hand, I happen to know that substance abuse can involve some STRANGE bedfellows. And people who use ILLEGAL substances must, of neccessity, be involved w/the STRANGE and DANGEROUS.

So, anyway, my point is: Do you really want to get on the bad side of someone who is involved w/illegal drug traffiking? (Ecstacy qualfies).

If you feel it is a safety issue, don't put your own bad self at risk to help others.

Food for thought.

[jackstem]

the american association of nurse anesthetists has a website: aana.com which offers peer assistance to crnas with substance abuse/use problems. perhaps, you could encourage your friends to access the 800 hotline. from what i gather, they are very supportive not punity.

this has been an interesting thread.

my name is jack, and i'm a recovering fentanyl/sufentanil addict. i became addicted in the early 90's when i was dealing with spondylolisthesis and increasinglt severe chronic pain. i eventually had a spinal fusion which significantly relieved the pain.

i am the peer assistance advisor for the ohio state association of nurse anesthetists (osana). my duties include speaking about the risks of addiction in the crna (10-20%), assisting in the development of policies and procedures regarding suspected abuse, investigation, intervention, treatment, re-entry into practice issues, contracts for re-entry, aftercare issues, and to participate in interventions if requested.

i have 11 years clean and voluntarily surrendered my license because i determined it would be dangerous for me to return to practice.

if these 2 crnas are ingesting an illegal designer drug, they are violating the nurse practice act. the decision to use/abuse an illegal substance is very concerning. while they may not be addicted to the substance, their use shows a less than rational thought process. and, if they are willing to use illegal drugs, they are an increased risk to divert meds from the hospital.

for additional information please feel free to contact me by phone or email (go to my website for email address and phone number: http://jackstem.com/ohio-peer-assist.htm)

or go to the aana peers assistance page:

http://aana.com/resources.aspx?ucnavmenu_tsmenutargetid=154&ucnavmenu_tsmenutargettype=4&ucnavmenu_tsmenuid=6&id=191&

another excellent site is called allanesthesia. they have produced a series of dvd's entitled "wearing masks" that deal with substance abuse and addiction in the anesthesia professional (the dvd is free!).

http://allanesthesia.com/

if these crna's practice in california, i can help you get in-touch with the peer assistance advisor in that state. she is more than willing to talk with you about this and may have some advice for you. or, you can follow this link to get the information on california's peer assistance adviro.

http://aana.com/peer/directory.asp?state=ca

here's the link to the alabama peer assistance advisor:

http://aana.com/peer/directory.asp?state=al

finally, here's the hotline number: 800-654-5167

please don't hesitate to contact me. see my profile for email information.

jack

[rukarma2]

maybe this site will help you with the consequent of this drug. http://www.nida.nih.gov/Infofacts/ecstasy.html

[BSNtobe2009]

I'll give you a HUGE piece of advice.

Do you know that background investigations companies can order a "drug history" report on you and this is 100% legal information to pass onto future employers?

I swear if it were me, I would find a way to have them reported without someone knowing it's me. Those drugs are heavy duty...we aren't talking about a little pot here whose affects go away in a couple of hours. When you are dealing with anesthesia, that is the most important part of the surgery next to the surgery itself. How would you feel if you found out a patient ended up brain-dead after one of your "friends" spent a night out on the town? This happens with the most minor of surgeries.

If it is discovered that they are doing illegal drugs, and they show up positive on a drug test, the hospital can and should forward this information to future employers and it is 100% legal to do so. The reason is, a drug test is considered to be "3rd party verifyable"...either you passed the drug test or you didn't, and isn't subject to individual interpretation or opinion.

Anyone who will risk their entire career for drugs to me, needs to be in rehab.

I hope you will do the right thing.

[BSNtobe2009]

Thanks for the advice. I've already spoken to both of them previously and told them I think they have a problem. They disagree and wouldn't consider any form of intervention or rehabilitation. I think I'll keep this matter between us and keep the BON out of it. I've known both of these women for 5 years and hope they know what they are doing. For the record....they do not practice in Alabama. They practice in California.

Remember your training...people that have a problem abusing drugs rarely admit they have a problem and one of the SYMPTOMS is "putting your work or career unnecessarily at risk."

[BSNin2007]

I am "only" a nursing student as well, but it seems to me that you display better judgement than the two CRNA's of which you speak. I am not minimizing their "commitment" as I can only imagine the difficulty of the programs and boards they have succeeded in passing, and I don't know how I'd handle the situation either. There is one thing that I can say for sure, I wouldn't want someone with a drug habbit to anesthitize one of my loved ones. That being said, aren't most patients someone's loved one?