[santababy52]

Sara62, thanks for your thought provoking post. We always need to look at issues from several angles. Addiction is all over my family, and there is one who is a professional that has been provided support from his profession. So I too have some knowledge of how the addicted healer feels. But how much worse would they feel if their drug use killed someone? Not probable but it is possible. Our jobs are to protect the patient, not the nurse. Yes we need to unify and help the addicted, recognizing it is a symptom of a disease. We need to be very certain before accusation. This is "tough love" but it must be carried out if we suspect a patient is in harms way from an addicted nurse.

Thanks for your ensight.

[santababy52]

God's speed to you in this journey. I am a nurse who uses within the parameters of the script, for chronic phantom pain from a BKA r/t MVA. I have recently been trying to get back to work since my amputation, so feel somewhat frightened about the aspect of being on pain medication and what my potential employer would do. I've been honest in my first interview and did not get the job. Am I fooling myself that I am not an addict if I stay with what has been prescribed? I don't long for it or think about it until I have uncontrolled pain. I do not get high from it, nor sleepy, no eurphoria or kick to taking it. Am I OK? Do I remain in pain? What should I do? I am working with a pain specialist and my goal is to never need it, knowing that there will be a withdrawal time. any suggestions from anyone?

Keep up the good work, and you have done a very good thing. I am proud of you.

[teeituptom]

Originally Posted by rn/writer

You are correct in saying that we nurses need to be more supportive of each other.

I do take issue with several of your statements, though.



It can be a career- and life-ruining event if the nurse is actually using and has not asked for help. But the reality is that the reporting didn't ruin things--the using did. Reporting can actually save both the nurse and anyone who may stand to be harmed by her actions--on or off the job.



I'm sure many nurses do exactly what you have described. Unfortunately, there are also many who divert from those who really need the meds. One way they get caught is when patients start to complain that their pain is not being relieved. Sad, but true.



In some cases, this is not the best choice. Addictive thinking can get hostile and ugly. It can also set the reporter up for retaliation or even entrapment efforts to shift the blame.

A nurse who has suspicions should report factual objective evidence--not what she thinks it means. Remember that from nursing school? Say something like, "I've had three patients complain in two days that their pain never decreased after their day shift meds. Alicia was the nurse that gave those meds in all three cases." Not, "I think Alicia may be taking patients' meds," or, "I think Alicia has a drug problem."



This one we agree on.

Thanks for your thoughtful post.

If there is the possiblity that someone is diverting drugs, funny how we call it diversion. When in all sense what we truly mean is theft, stealing, A Criminal activity. Yes I will notify administration and in the same breath I will also be notifying the police.Diversion aka, theft. stealing, is acriminal activity. If that nurse is stealing drugs, and giving her pts less medication so she can steal more. Then that nurse is causing harm to a patient or patients.

[LilgirlRN]

I may have already replied to this post but I don't think so. Recently I was at work when someone told the nurse manager that my eyes looked funny so they had me do a urine drug screen and gave me the day off. I ended up being off for 3 days, I had a small paid vacation. Of course the drug screen was negative. I had been complaining all day of being tired, I didn't sleep much the night before. Please be careful when making accusations of this magnitude. I work with several nurses who make wonder what in the hell they're taking, always so full of energy, always bouncing off the wall. They do their job though and many have patients that just love them, so who am I to judge?.... if I ever thought that the patients may be in danger though, I wouldn't hesitate to speak up. Most of us are overworked and underpaid, it's a real wonder that more patients aren't injured by us.

[subee]

You were lucky that your screen came back negative. Plenty of people have had positive screens from ingesting certain foods or legal drugs. That is not a pretty scenario.

[herbivorousRN]

A few years ago I worked at a SNF with an LPN that was OBVIOUSLY under the influence of narcotics. She would sometimes sit in a catatonic state at the nurses station, staring at the wall for an hour. She fell asleep STANDING AT HER MED CART on a couple of occasions. She fell asleep giving shift report, her narcotic drawer count was always off. When staff reported her to the DON---NUMEROUS complaints, by several different staff members---she would be sent home and she would be out for a few days. But she always came back, and the situation never changed. The DON would tell us that she had prescriptions for all the meds she was taking---and there were ALOT. (The nurse herself mentioned that she was on oxycontin,duragesic, and others.) I was under the impression that working as a nurse while under the influence of narcotics was ILLEGAL, regardless whether they were legally prescribed or not. This nurse was a danger to the 30 patients she was responsible for ,as well as to herself. She had a couple of car accidents leaving work because she "fell asleep" at the wheel at 3pm !!!! I and a few other employees considered going to the Florida BON because the DON was doing nothing, but we never did. I was so disgusted with the situation, I eventually left that SNF. A month ago, I happened to look at the obituaries in the local paper---and guess whose name was there? Yep---that very nurse. She was only 34 years old and left behind two young children. I can't help but feel a little responsible. If I had gone to the BON and reported her, I might have prevented it. I didn't want the hassle, and I chose to just walk away. And I regret it.

[BelleKat]

Originally Posted by herbivorousRN

A few years ago I worked at a SNF with an LPN that was OBVIOUSLY under the influence of narcotics. She would sometimes sit in a catatonic state at the nurses station, staring at the wall for an hour. She fell asleep STANDING AT HER MED CART on a couple of occasions. She fell asleep giving shift report, her narcotic drawer count was always off. When staff reported her to the DON---NUMEROUS complaints, by several different staff members---she would be sent home and she would be out for a few days. But she always came back, and the situation never changed. The DON would tell us that she had prescriptions for all the meds she was taking---and there were ALOT. (The nurse herself mentioned that she was on oxycontin,duragesic, and others.) I was under the impression that working as a nurse while under the influence of narcotics was ILLEGAL, regardless whether they were legally prescribed or not. This nurse was a danger to the 30 patients she was responsible for ,as well as to herself. She had a couple of car accidents leaving work because she "fell asleep" at the wheel at 3pm !!!! I and a few other employees considered going to the Florida BON because the DON was doing nothing, but we never did. I was so disgusted with the situation, I eventually left that SNF. A month ago, I happened to look at the obituaries in the local paper---and guess whose name was there? Yep---that very nurse. She was only 34 years old and left behind two young children. I can't help but feel a little responsible. If I had gone to the BON and reported her, I might have prevented it. I didn't want the hassle, and I chose to just walk away. And I regret it.

That's so sad. Maybe it would've changed if you had stayed there but it sounds like the DON dropped the ball in addition to enabling her mightily. The DON might have thought she was doing her a favor by not reporting her and having her possibly lose her job but she just enabled her to be sick and finally die from her disease. It's no different from letting someone in DKA work without treatment. That DON should have some consequences for her failure to act.
It seems like you did all you could without outright calling the police. I don't know if that would've worked either.
That's sad.

[sara62]

Originally Posted by herbivorousRN

A few years ago I worked at a SNF with an LPN that was OBVIOUSLY under the influence of narcotics. She would sometimes sit in a catatonic state at the nurses station, staring at the wall for an hour. She fell asleep STANDING AT HER MED CART on a couple of occasions. She fell asleep giving shift report, her narcotic drawer count was always off. When staff reported her to the DON---NUMEROUS complaints, by several different staff members---she would be sent home and she would be out for a few days. But she always came back, and the situation never changed. The DON would tell us that she had prescriptions for all the meds she was taking---and there were ALOT. (The nurse herself mentioned that she was on oxycontin,duragesic, and others.) I was under the impression that working as a nurse while under the influence of narcotics was ILLEGAL, regardless whether they were legally prescribed or not. This nurse was a danger to the 30 patients she was responsible for ,as well as to herself. She had a couple of car accidents leaving work because she "fell asleep" at the wheel at 3pm !!!! I and a few other employees considered going to the Florida BON because the DON was doing nothing, but we never did. I was so disgusted with the situation, I eventually left that SNF. A month ago, I happened to look at the obituaries in the local paper---and guess whose name was there? Yep---that very nurse. She was only 34 years old and left behind two young children. I can't help but feel a little responsible. If I had gone to the BON and reported her, I might have prevented it. I didn't want the hassle, and I chose to just walk away. And I regret it.

Hi,

Please don't put the burden of a colleagues death on your shoulders. It is her fault. Ethically, the management and the BON are responsible. I was never impaired at work period. If I exhibited any one of those behaviors at work my employer would jump all over it right then and there and I would have to take the burden of proving that I was or was not impaired. The BON would receive the complaint and take action ASAP. I don't really know what to think about your situation but I am certain of one thing" it had nothing to do with you"

sara62

[subee]

In my state, the DON is obligated by law to report any nurse suspected of impaired practice, regardless of the cause, in the case of a nurse who refuses to enroll in an alternative treatment program.(.when available).. EVERY nurse has the responsibility to step in when a colleague exhibits bizarre behavior. You don't have to diagnose the problem and it doesn't have to be caused by chemicals. Its someone else's responsibility to diagnose. If this nurse had a decent intervention, maybe she could have been saved, but experience tells me that she was so far along in the disease process that maybe no one could have helped. Chemical dependency usually ends in death - suicide, car crash or accidental overdose. Please everyone, don't delay to take a colleague to the ER to be evaluated immediately. Its a hard thing to do when you're young or inexperienced, but trust your gut and deny your denial.

[bossynurse101]

Originally Posted by herbivorousRN

A few years ago I worked at a SNF with an LPN that was OBVIOUSLY under the influence of narcotics. She would sometimes sit in a catatonic state at the nurses station, staring at the wall for an hour. She fell asleep STANDING AT HER MED CART on a couple of occasions. She fell asleep giving shift report, her narcotic drawer count was always off. When staff reported her to the DON---NUMEROUS complaints, by several different staff members---she would be sent home and she would be out for a few days. But she always came back, and the situation never changed. The DON would tell us that she had prescriptions for all the meds she was taking---and there were ALOT. (The nurse herself mentioned that she was on oxycontin,duragesic, and others.) I was under the impression that working as a nurse while under the influence of narcotics was ILLEGAL, regardless whether they were legally prescribed or not. This nurse was a danger to the 30 patients she was responsible for ,as well as to herself. She had a couple of car accidents leaving work because she "fell asleep" at the wheel at 3pm !!!! I and a few other employees considered going to the Florida BON because the DON was doing nothing, but we never did. I was so disgusted with the situation, I eventually left that SNF. A month ago, I happened to look at the obituaries in the local paper---and guess whose name was there? Yep---that very nurse. She was only 34 years old and left behind two young children. I can't help but feel a little responsible. If I had gone to the BON and reported her, I might have prevented it. I didn't want the hassle, and I chose to just walk away. And I regret it.

Hmmm . . I think I worked there (seriously). The two kids were adopted? Yeah, and everyone used to laugh coz the liquid ms wd go from dk pink to light pink after she worked. But noone stepped up to the plate. Noone wanted to get involved or possibly be wrong for that matter. I did go to the DON and I did report it to the BON. Problem is, their hands are tied as well without substantial proof (like an employers' report!) But hey, Im not talking out my *&ss on this one. I was intervened on in 2001 and every nite of my life I thank God for that nurse who did. She saved my life and last month I celebrated seven years in recovery. There is no judgement here, but if she isnt diverting then no sweat. Same with kids you think are being abused. Do the consequences outweigh the benefits?