[Thunderwolf]

Yes, it does happen to "one of our own"...an RN who was released because of taking opiates (liquid) from patient PCA pumps. They asked her for a urine, which she declined to give. When she was released from the hospital, she would often be found "visiting" patients (while wearing a nurse's uniform)...making "her" rounds sorta speak, until one day she nearly hit one of our security guards in the parking lot with her car as she was trying to flee...(the car was stopped...iv tubing/supplies and syringes were found in the car). Sad...very sad.
Looking back, nurses were able to piece backward her behaviors that should have raised flags earlier.

1. She spent beaucoup amounts of time medicating her patients for pain
2. She would case other nurses' patients for need for pain medication and PCA machine refills
3. Getting very upset with doctors over the phone for not prescribing pain medication for her patients
4. Requesting to come in to work extra, coming in to work, but requesting to leave to go home after working part of her shift
5. Having her co-nurse carry most of the patient load
6. Going out for frequent smoke breaks...way too frequent

Yes folks, it happens to our own too.
Opiates...the worst drug addiction out there.
______

[nursy swat]

I was reading the various comments regarding narcotic diversion and alcohol abuse among us and couldn't help but add a comment. I think we should recognize addiction for what it is. A progressive and debilitating disease. I don't know too many people who haven't drank too much from time to time whether purposefully or by "accident" not to mention the typical drug experimentation while going through adolescence and most of these people are not labeled alcoholics or addicts. When does a person cross the line? I also know of many respectable professional people who drink and drive afterwards. Aren't they putting themselves and others at risk every single time they engage in this type of behavior? It's almost as if this type of behavior is acceptable until they get busted by law enforcement and then it's, of course, frowned upon. I have observed some nurses treat "drug seeking" patients disrespectfully as well as look at me like I have two heads just because I am treating these patients just as I would any other patient. With respect, honesty and concern. I have no problem talking about the obvious with these patients and I also will dispense narcotics to these patients as per the MD's orders. Why is it so difficult for people to talk about addiction? I think it's about time we stop looking at it as if it is actually a choice these people make. Nobody says to themselves, "hey, I want to be an alcoholic when I grow up",or, "oh boy, I'd like to ruin my life and become a heroin addict" Of course, I firmly believe that with all the help available for addiction in this great country of ours, there certainly is a degree of self-responsibility to take advantage of what is out there. Typically, people don't like to take total responsibility for their actions. In the medical profession where doctors and nurses are held to a higher accountability than the average person, it's not difficult to understand why we would be rather sneaky with regard to narcotic diversion (not to mention it's illegal) but if we honestly look at it, these people would not do this if they truly didn't have a problem requiring help. Alright, I'll stop now...

[CrunchRN]

Very well said Nursyswat, and how about just giving people the benefit of the doubt. We do not know what they have been through in their lives. That said - do not enable, but provide support for changing if and when they can. They don't need to be condemned as I am sure deep down that they know what they have become and hate it which further lowers self esteem and keeps the viscious circle going.

[bail]

Last December, on the unit where I worked in a mental health facility, "they" said narcs were missing. We were all drug tested, mine was negative, as were others. However, because "they" couldn't find what they were looking for, they terminated three of us. Indiana is an "at will" state, so there is nothing that can be done except maybe a defamation suit. I guess the narc sheets were "altered" making it appear that narcs were "misssing".........no one saw anything, no one acted differently or "impaired"............so, no one is safe anymore. Beware.

[bail]

I disagree that "euphoria" creates an "impaired" nurse. Some people are on a natural "high" because they are happy, love their jobs, and their own endorphins have kicked in. An induced "euphoria" from drugs, yes, that probably could cause "impairment", but not necessairly.

[shawng007]

i am a recovering alcoholic. i never would have considered nursing until i was living in a halfway house for addictions and got a part time job at a hospital, i saw what the nurses did and thoroughly enjoyed it. while i was living in assisted facility i went to school and became an lpn. i have been sober for over three years and have no cravings or desire to drink or use drugs, despite the immense stress i have at work. many people want to get clean, but it is a disease and it takes more than want. often we have to reach rock bottom at least once, if not normally more times before we are able to maintain sobriety. it took me three tries, lost my family, wrecked my life and ended up homeless before i got treatment that worked. sometimes it is hard to detect use, especially someone who has been addicted for a long time because they know how to fool people, and are good manipulators. treatment should be given. people should not necessarily be fired because again this is a disease, and should be given the treatment as any other. yes, sometimes people dont admit they have a problem, and that is the first step, but a good CASAC can help, or other professional who is compassionate about their work. i know several nurses i work with who are in recovery, and for a while took part in a peer network for addicted nurses, most of which were found out while in nursing, i came into nursing after getting help, which is kind of backwards, but in doing so i have more ability to help addicted patients and often spend much time doing so. addicts should always be given aggressive options for treatment, sometimes it takes a lot of persuasion to get them to want treatment, but once they get it they stand better chance of staying sober.

[TMPaul]

Originally Posted by Teshiee

Before I became a nurse I use to work as a unit secretary L&D floor. I always admired one of the nurses that worked there. She was very knowledgeable, caring to her patients, and helpful to anyone who needed help. You would never thought she was abusing demerol. I was heartbroken I wanted to be like her someday. She did go to rehab and got cleaned up but the stigma of a drug addict was too much there and she quit. My vision of her didn't change I still thought she was a good nurse who stumbled along the way. I later found out she had some personal problems and needed some help. What was so bad was her fellow so called friends bad mouthed her stating how they could never do that. I stress to them that you do not know what road she has to ride on. You are not perfect and you will never be the nurse she is. They were shocked when I blurted it out to them because she is human who has a problem. I receive the BRN report and it is amazing most of the RNs who lose their license is for drug abuse. My dilemma is if you see a co-worker abusing drugs what do you do? Do you tell your charge nurse or confront that nurse in private? My psych instructor said no confront that nurse and my ADv Med/Surg inst says yes tell your immediate supervisor! Fortunately I haven't had to do it. But I think I would tell them to either get help take a leave of absence. If they refused then I would have to report them. In the long run you would be helping them and saving a patient from potential harm.

Check your state's Nurse Practice Act. Tennessee's states that if you know about a colleagues drus use/abuse and fail to report you are just as liable as they are and the BON can take your license as well.

[teeituptom]

Originally Posted by bail

I disagree that "euphoria" creates an "impaired" nurse. Some people are on a natural "high" because they are happy, love their jobs, and their own endorphins have kicked in. An induced "euphoria" from drugs, yes, that probably could cause "impairment", but not necessairly.

No Comparison in being stoned from drugs as opposed to be euphoric due to happiness in life.

Druggies are druggies and should not be allowed in the field of nursing

Diverting meds is still theft and against the law and they should be busted and dragged from the facility in handcuffs.

[steve0123]

A common theme throughout the replies to this thread seems to be that one of the "warning signs" for drug abusing nurses is that they dose their patients up frequently with narcotics, etc etc.
I totally disagree with this line of thought and am horrified at what my colleagues could think of me, being one who proactively seeks to resolve pain and "argues with doctors" for dose increases, etc etc.
The fact is that most of the time pain goes either unrecognised by nurses or is inadequately managed. A script for 5mg morphine here and there does nothing for people with serious pain. Sure, there are people out there who enjoy taking narcs, but who cares. Is it our job to regulate access merely because we suspect they aren't in as much pain as they say they are? Please don't automatically suspect a colleague of abusing narcs just because they are being diligent with their pain management.

[shawng007]

Your phrase druggies are druggies and should not be allowed in the field of nursing is quite insensitive and downright WRONG. I am an alcoholic, so by that i am a drug addict, aka druggie. i went to rehab and got cleaned up and went into nursing. i am a very proficient LPN and many units love to have me there, often i uncover med errors and other problems that the RNs do not, or that were made by RNs. to say that because i am a druggie i should not be in this profession is blatantly unprofessional, perhaps you should do some research on addiction. yes, being impaired and on the job is wrong, as is stealing or diverting drugs, but all in all, once you are an addict you are always an addict, whether or not you are in active addiction. i have been sober for three plus years, does that mean i will never use again, i nor anyone else can ever guarantee that, but for the time being it isnt in the picture. what you are saying is that i and people like me should not be allowed in nursing. Shame on you, ignorance is what causes problems, and surely you are ignorant of the facts about addiction. Ignorance has no place in the nursing profession, so perhaps ignorant people should not be allowed in the field. Also, busting someone and dragging them from a facility if they are in active use, while legally legit, is not necessarily the best way to approach the problem. give them a chance to come clean, to admit the problem and to get help, then provide alternative treatment, in new york we have SPAN which is peer assistance for addicted nurses. perhaps the only way to really understand addiction is to actually have one, which is why most good counselors have been in the same shoes.