[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.

[Jen911]

Okay, now a view from the other side of the fence. I have a chronic pain problem for which I have prescribed narcotics. I'm always careful never to take them on work days, never go to work impaired, and refuse to take them within 24 hours of the beginning of a shift (would rather suffer than to go to work impaired or call in sick which is very rare). I've asked my physician to change me over to a longer acting *non*narcotic pain med, but he doesn't feel it would work, and I would still need just as many narcotics as I currently do now for breakthrough pain.

Everyone I work with knows I have chronic pain. I'm always careful about my narcotic wastes because the LAST thing I want to do is be accused of diverting narcotics from the ER. I've had RN's sign off on wastes with me, then start to leave the med room before I actually waste the drug, I make them come back in and physically watch me waste that drug. Yeah, it's a pain for me (and for them) to do this, but I'm covering my butt. Once I remind nurses about my reasoning, they're very understanding. Perhaps in some places we make it just a little too easy for our co-workers to divert these drugs....

Just my own little 2 cents....

[nilepoc]

Yes it is common, I have personally been involved in four diversion cases, and know of several others. This is remarkable, as I have only been a nurse for four years. Keep yourself clean, and be aware of you co- workers.

Of the four, two died, this is a serious problem nursing and all healthcare proffesions need to address. The unfortunate part is, that we have ready access to some of the strongest drugs commercially availible. For some people this is too tempting.

BTW fentanyl was the drug of choice in two of the four, ativan the other and meperidine the fourth. The two persons who are still alive are doing well on rehab.

[Jood]

Hey Nilepoc, cool photos, let's see some more, especially like the bouldering one! Action man eh, in your spare time?!! That's how you get your thrill and pleasure system rewards...others do it with drugs, sadly.

At least in your neck of the woods you have a presitious institution that treats addictions and teaches other professionals all over the world to help people who abuse chemicals to recover from it. I was in Albuquerque 3 years ago to learn motivational interviewing skills at CASA and it has changed my practice and outlook forever with issues like this.

It is no good condemning people for their addiction, they need to be helped to talk about it, explore it thoroughly, want to change through resolving any ambivalence about it and grieve for it's loss in their lives as well learn new coping skills to live without it. We can be the instigators of change if we adopt this healthy attitude amongst our colleagues and friends.

Jen911 has shared her own experience and it shows how strong you need to be to deal with this kind of thing, even when you are not in a position of abusing these substances, good on you Jen911 for your expert and competent practice in modelling a good attitude to your peers and junior staff! More like this please!

And good an Teshiee for the opinions expressed to others...just because you have gotten into this kind of problem state doesn't mean you deliberately chose to do it and sod everyone else! People who need help need help and that's a fact, it's just that it's often easier to treat a broken leg than an addiction because you can see it and understand it.

[Jood]

Hey Nilepoc, cool photos, let's see some more, especially like the bouldering one! Action man eh, in your spare time?!! That's how you get your thrill and pleasure system rewards...others do it with drugs, sadly.

At least in your neck of the woods you have a presitious institution that treats addictions and teaches other professionals all over the world to help people who abuse chemicals to recover from it. I was in Albuquerque 3 years ago to learn motivational interviewing skills at CASA and it has changed my practice and outlook forever with issues like this.

It is no good condemning people for their addiction, they need to be helped to talk about it, explore it thoroughly, want to change through resolving any ambivalence about it and grieve for it's loss in their lives as well learn new coping skills to live without it. We can be the instigators of change if we adopt this healthy attitude amongst our colleagues and friends.

Jen911 has shared her own experience and it shows how strong you need to be to deal with this kind of thing, even when you are not in a position of abusing these substances, good on you Jen911 for your expert and competent practice in modelling a good attitude to your peers and junior staff! More like this please!

And good an Teshiee for the opinions expressed to others...just because you have gotten into this kind of problem state doesn't mean you deliberately chose to do it and sod everyone else! People who need help need help and that's a fact, it's just that it's often easier to treat a broken leg than an addiction because you can see it and understand it.

[lauralew]

My very first ICU boss, who was a Nam vet with lots of baggage but a great, great guy, didn't get caught diverting drugs until he about died at work. He was sent to rehab and cleaned up his act, and now is a productive nurse, although working in the insurance field instead of at the bedside. We all have problems, and some of us deal with them in more affirming ways than others.

[erdiane]

I knew of a nurse who was going into the bathroom with demerol syringes; instead of pain meds, her patients were getting NS, and she was taking the demerol.

we also had a registry nurse who came and worked one shift on the med-surg floor. We have a pretty crappy narc situation..no pixis for our cheap bosses. anyway, each rn has a narc key, and at the end of every shift, 2 rns have to count narcs and keys. This rn took 25 percocet, and took the entire page from the narc book. we have to sign out indiviual names, rm #, time, dr, and sign for each pill on these forms. By taking the form, I geuss she thought no one would notice that 25 pills were gone. she also did not have a current nursing license!

[Cubby]

I have seen numerous staff, both licensed and not, fall to the perils of drugs both legal and not. This is a problem in our profession of astronomical proportions. We are in this profession because of our insane need to be needed, at least initially, and when that no longer is enough we have to fill that void with something. For me it was alcohol.
I have been sober now for almost 7 months. I know that had it not been for the unbeliveable support of my facility I could not have beat this. They gave me time off so I could go to Therapy
("Valley Hope" Rules)
I cannot critisize anyone for having a problem with any substance. We are human and occassionally need help instead of always giving it. I need you all to help me stay sober today. Thank you for your support.

[DethOkay]

Drug abuse is very prevelent in our profession. I have had 3 people I have had personal and work experience sucumm to the temptation of drugs. The first was a woman who was my age, 29 at the time, and she had oriented me to the units and taught me well. when she went to the ICU/CCU she was caught stealing a bottle of codimal cough syrup. What mad it so bad was she was pregnant at the time. She quit when she was asked and she and her child are doing fine but she gave up her RN licene and has never looked back. The only explination I ever got from her was she was stressed out from the job...Sad because she was a REAL GOOD nurse....
The second person was a coworker who was in a poor relationship. Her husband was a drug user and she was too. The relationship was not abusive it was mutual. They both liked it. They got there drugs from the MD's legally. migraine meds, pill for chronic pain, and when that want enought she would have her claim her pills were STOLEN and file a report with security and get more in the moring.
I didnt catch on for 6 months but allmost all of my coworkers on nights knew what was going on. She was moved to days but never investigated, was never given a drug test for illegal drugs. And was allowed to care for patients. When she had an elective gallbladder and i took care of her she had me written up because she said I was holding her pain meds and not medicating her.( I didnt find out about it for 2 months our unit manager simply filled out the report and wrote she councled me without ever telling me thing.)
3 monts later she was fired for verbally abusing a patient, a month after that her husband ran over her in her car because they were wired on meth, and both were fighting over who was screwing whos boy/girl friend....She lived but lost 2/3 of her liver and a kidney, hubby got 25 years because thier kids were in the car when he ran her over and the kids were placed in foster care. Sad to say no one know what happened to them as she and her husband had no living realtives..........
the third is just something that happened...3 months after the above drama our hospital recived a pyxis med system. While the hospital didnt wish to start random drug screenings they bought the system to try to get a handle on the drug shortages.....many non narcotics (soma, ketoric, ect) were comming up missing. within 1 week of using the system our night nurse manager was caught stealing soma, and sleeping pills (ambien). She was the very last person who I would have thought was guilty of drug abuse. We had long talks about both of the above nurses, why they did what they did, what a waste. I to this day ( its been 3 years) have yet to talk to her. She left the hospital and have never been heard from sence.......

A lot has happend but this was in the middle of Kentucky, no where as we call it. in a town with a population of 18,000 more or less.. So i can tell ya be observent, watch you carts and ALL WAYS count the drugs.

[traumaRUs]

I currently (in the ER) work with a nurse who four years ago was caught not wasting morphine and instead taking it himself. He was placed in rehab and came back a year later. He apologized to all of us that he had hurt and now is doing well.

He would have us witness his waste, but what we were witnessing was actually NS.