Another headline about narcotic diversion.

WriteStuff · Nov 3, 2001

Drug and alcohol abuse consistently ranks high on the list of complaints filed with the state nursing board, said Marsha Straus, compliance manager. In the last fiscal year, 322 of 1,085 complaints related to drug and alcohol abuse.

This is just the state of Ohio. Thirty per-cent of complaints received are drug and alcohol related. Yes, it is a very serious problem.

As I read this article it was impossible for me to keep my emotions out of it, for obvious reasons. At first I felt defensive and even angry that Riverside Methodist Hospital would choose to single out Ms. Moreland and make this headline "news." I was particularly disturbed by Dr. Michael Hindman's statement: "I'm really outraged. We put our misguided trust in a person and, as a result, some of our patients suffered pain."

I certainly do not deny the fact that laws were broken, hospital policy and procedure was breeched, and that the Nurse Practice Act was violated, not to mention ethical standards.

Is Dr. Hindman "outraged" because he views Ms. Moreland solely as a Nurse with a "criminal bent?" He informs the press that "Moreland's alleged thefts apparently began in the spring of 2000,".......without mentioning that the reality is - her disease of addiction began long before that. This is a Nurse who did not suddenly decide one day to steal narcotics just for the hell of it. By the time she had stockpiled "more than 400 vials of hydromorphone at her house" she was far along the road of addiction. She will suffer the consequences of the laws and ethical standards she has breeched. She will be held accountable.

How do we view Doris Moreland? A low-life criminal? Should we lock her up and throw away the key? Or is there far more to this picture than we care to understand?

Dr. Hindman, by virture of his position, (Senior Operations Officer), has to "save face" for Riverside Methodist Hospital in the eyes of the public it serves, so he freely informs that same public that he has rooted out a criminal from their midst ,.......that "person" in whom he put misguided trust."

The whole story left me with a bad taste. Probably because I too was once a Nurse Doris Moreland. The "bad taste" I feel is not because Doris Moreland broke the law........it is because of the way she is being portrayed to the public at large........as a criminal.

I know exactly how Doris Moreland is feeling right now. I know what it feels like to be trapped in the prison of addiction, that place that over time destroys your very soul, and without help will claim your life.

Perhaps Doris Moreland would not have had to reach this place if Dr. Hindman's institution had a plan and procedure in place to recognize impaired health professionals and intercept the late stage of addiction in such a way as to afford "that person" the opportunity to get the help he/she truly needs. And I'm wondering if Dr. Hindman would have treated any of his impaired physicians on his staff in exactly the same way he has Doris Moreland.......because he DOES have impaired physicians on his staff.

Bonnie Creighton, RN, MHCA

Mental Health Consumer Advocate

WriteStuff · Nov 3, 2001

It's probably not hard to figure out what any of them "perceive."

Anger, outrage, being violated, for starters.

It is my personal opinion that hospitals should be held liable if harm came to patients who did not receive the pain medications they requested and thought they were getting, and it can be proven.

I say that because it is the hospitals DUTY and RESPONSIBILITY to understand the disease of addiction, recognize it in their employees, and have a plan in place for seeing that such employees get the care and treatment they desperately need.

Bonnie Creighton, RN

debbyed · Nov 3, 2001

We as nurses have a responsibility to our patients and our co-workers to be aware of behavior consistent with the behavior of an impared nurse (or physician). Too many times we see hints (as well as red flags) pointing to nurses with problems but we choose either consciously or subconsciously to ignore those warning signals. I speak from experience.

Many years ago I worked on a floor with one such person. She was well liked and respected as a nurse. One day we came to work and there was a nurse therapist there to talk to us prior to report. This nurse we had all worked with for many years had been caught taking and using patient medication and she was there to discuss it with us. She herself was a recovering "impaired nurse" and used her experiences to help others.

At first we all were "Shocked and amazed" that such a thing had happened right under our noses without us noticing, but as she encouraged us to talk we found that everyone of us as seen, not just one, but multiple signs that there was a problem.

Little things like co-signing wasted narcotics because the plastic top had been popped. Not just once but each of us had done it several time a week (the narcotic count book was witness to this). We had all commented previously that it was weird that this nurse always worn a long sleeved lab coat with fitted wrists that were, more often than not, taped, with her watch outside the sleeve (we thought it was just a "quirk"). Several of us had, unknown to each other, found used med locks in the staff bathroom (which were never reported as a strange occurance). Once a few blood splatters were found on the wall (we had asked each other if someone had injured themselves and this nurse said she had a nose bleed). We all knew she was always volunteering to answer our call lights and medicate our patients (which we gladly took advantage of). She never called out sick, never took a vacation, ofter came in early and worked late (a perfect employee). Nurses on other shifts had even noticed that their patients were medicated more frequently on her shift (as well as having patients asking for pain medicine prior to the time it was due), but they never brought this to anyone's attention.

How did we miss all these signs. Well one thing is that none of us had ever experienced working with an impaired nurse (at least not that we knew of) but it was mainly because we didn't talk to one another. We all eventually admitted having little suspicions but were all afraid to voice these concerns.

The hospital did this nurse a dis-service by firing her outright without any intervention but they did the rest of us a great service by bringing in the woman who could help open our eyes so that next time (and yes there will be a next time) we would be more confortable discussing our concerns with the appropriate people. This allowed us to acknowlege and understand the signs and symptoms of an impared nurse. Personally I think this type of course should be taught in all nursing school and be part of mandatory inservicing.

Drug and Alcohol addiction is a medical problem that needs intervention for both the caregiver her/himself and the patient that dependes on that caregiver. We must all be aware of it's existance and when and how to report suspicions for the sake of everyone involved.

As to the article above, in my personal opinion it should have never been published in the way it was, but the incident should have been use to educate rather than to lay blame.

WriteStuff · Nov 3, 2001

debbyed,

Thank-you for all you had to say in your post. I am a recovering impaired Nurse as well and because the employer I had understands addiction for what it is - a fatal disease if left untreated - I celebrated six years drug and alcohol free on August the 8th of this year.

My employer saw me for the very sick, and suicidal human being I was when they intervened. They understood that my criminal and unethical behavior was the result of the late stages of my disease of addiction. They did not call in the news media and parade me before the general public so I would be tried, judged and sentenced in the press. They intervened in such a way as to be certain I received inpatient treatment within the next 24hrs. of their intervention. They understood the importance of confidentiality for all involved. They understood the inherent risk of their intervening because an impaired Nurse like myself, and Doris Moreland, is suicidal at that stage of addiction.

I too was one of their most respected Nurse's on a large Oncology Unit and had been voted by my peers as "Nurse of the Month" only weeks prior to the intervention.

Because they handled my situation correctly, I found the care, treatment, and help I needed. The statistics available are very grim where successful recovery from drug addiction is concerned. No one knows how grateful I am that my employer understood this disease for what it is.........a killer.

Because I have walked in her shoes, it is my prayer that Doris Moreland finds the right help and is able to come to terms with her disease. Because of the way she is being portrayed to the public she will have a higher mountain to climb. My heart goes out to her.

Bonnie Creighton,RN, MHCA

Mental Health Consumer Advocate

majic65 · Nov 3, 2001

Does anyone know any more about the nurse whose husband posted here some time agbo because he suspected she was diverting drugs? Think he signed in as :Lawyer"--but was in major denial about his wife's illness.

Sure wish I knew what happened there--I still worry about them, and don't even know them! :confused:

P_RN, ADN, RN · Nov 4, 2001

We had several incidents very similar to what you (Bonnie) and Debbye mentioned.

One I recall was a medical resident's 7 month pregnant wife. Always there, always volunteering to help, would give up her seat at the desk and go check on her patients.......I guess what bothered me so much is EACH of us thought that we were the only one who noticed these things.

What else bothered me was the baby! It had severe birth defects related to ITP that this girl developed. They said her liver was damaged by the drugs. The hospital fired her, and last I heard she had moved to California and had left the baby in SC. Her husband dropped out of the residency program. I don't know what happened to him.

I wish now that I had deleted the Ohio nurse's name. What got me is all that NYC has gone through that the NYT would pick up on an out of state occurrence!

And I totally agree that impaired physicians are not crucified in the same manner! I've even seen one come to make rounds bringing a bottle of whisky to share with his patient!

mustangsheba · Nov 4, 2001

How I wish the understanding and compassion I see here were more prevalent. I too have wondered about the husband that posted here previously about his wife. I can't comprehend how awful it must feel to be in a drug diverting situation, and I admire those who are able to continue their careers after going through the scrutiny of their personal lives. I do abhor the thought that patients may have suffered needless pain because of drugs they didn't receive. However, I'm not sure that is any worse than pain medications that are not administered because "that person has a history of drug addiction" or "she's a whiner" or even "I saw her laugh, so she can't be in pain." Our prisons overflow with people who have committed drug related crimes and with the mentally ill. What is wrong with this picture??? And why can't we "get it?" I have a very good friend (MD) whose license was impaired - not because he was caught drinking on the job, but because he sought treatment for the third time. He never saw a patient when he was under the influence. He was penalized for recognizing his impairment and seeking treatment. GO FIGURE! By the way, nurses deserve the same rights of confidentiality as any one else. I appreciate all of you who share your experiences here. Hugs.

debbyed · Nov 14, 2001

Bumped up for Luanne