Diversions

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    Have you ever had a coworker die on you? Yes, really die while at work with you?

    I have, more than once. Each and every one of them stayed dead despite our best efforts - until today.

    Once or twice the death was Mother Nature's way of reminding us who was boss. The other times it was narcotic diversion by a coworker; after all, how many professions have access to narcotics while working? Nurses, Docs, Law Enforcement and similar run the risk of not only using what they come into contact with on the job, but also thinking they know more than average about other drugs and eventually misusing them too. An article I read years ago called this 'pharmaceutical optimism'; I remembered this phrase as I found it so appropriate. Sometimes knowledge is a dangerous thing.

    Overdosing at work is usually related to stupid choices gone bad. When you overdose while working a healthcare job, you've been given a bit of grace by having the best possible chance to come back and survive. I've almost lost count of how many coworkers I've dragged from behind a locked bathroom door - cold, blue, with track marks unseen until that moment in time when I began CPR. My heart broke each time in the knowledge that I missed a sign somewhere along the way that could have brought about a different outcome.

    Funerals suck.

    Of course, the aftermath at work is usually along the lines of pretending the track marks and syringe next to the body didn't exist... it was a heart attack or something. I hate the lies. Who are they helping with these lies? Could this be a global denial so the survivors won't have to admit to their own issues with chemical dependency?

    *sigh*

    Today was the first time I coded a coworker and we got him back. It was a fluke actually. He had the department cell phone on him, and they knew he was in the bathroom, but not answering the phone or their knocks. They heard him gurgle and fall. They called for help. With the help of an ambu bag, some oxygen, skilled coworkers and the miracle drug Narcan - he came back. The timing here was perfect, so it's unlikely he will suffer any long term health effects from his respiratory arrest. He'll probably loose his job, and have issues associated with that. But he lives. He has a chance to change.

    I am a lucky nurse. I live in a state in which the diversion program is an option. Nurses don't have to have hearings in which they have to admit their chemical abuse issues for the public record. Confidentiality is honored. Licenses might be restricted, but the license is still there. The ability to work and make a living remains. There are things that must be done in the years that follow entry into the diversion program, but these tasks lead to recovery and health should the individual nurse agree to put aside their ego long enough to accept the help offered.

    I wonder if he'll take that chance he's been given, if he'll even recognize the gift he's received.

    I wonder if he'll change.
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    4 Comments

  3. by   laurelmae
    wow, it makes me feel naive to read things like this...i logically know medical professionals have probs with abuse and it effects work, but i have never seen it (or perhaps never noticed). i think it's terrific that there is confidentiality for those who seek help. those ppl can be successful nurses, docs etc after treatment, the same way a drunk driver can safely manage 2000lbs of car when sober. thank you for bringing this up.
  4. by   Hellllllo Nurse
    Very well written, very poignant, NMSane. I'm glad you wrote the article in kind of a gritty way. This type of article has much more impact and authenticity with some grittiness in the writing.


    I've been a nurse for 15 years, and I have only experienced a co-worker's OD one time.
    Last edit by sirI on Nov 21, '07 : Reason: unnecessary input
  5. by   hellerd2003
    [quote=NMSANE;2502769]Have you ever had a coworker die on you? Yes, really die while at work with you?

    I have, more than once. Each and every one of them stayed dead despite our best efforts - until today.

    Once or twice the death was Mother Nature's way of reminding us who was boss. The other times it was narcotic diversion by a coworker; after all, how many professions have access to narcotics while working? Nurses, Docs, Law Enforcement and similar run the risk of not only using what they come into contact with on the job, but also thinking they know more than average about other drugs and eventually misusing them too. An article I read years ago called this 'pharmaceutical optimism'; I remembered this phrase as I found it so appropriate. Sometimes knowledge is a dangerous thing.>>


    I'm curious about this, because I just completed a lit review on nurse substance abuse as part of completing my MSN, and all the empirically based literature demonstrates that nurses have no higher likelihood of using than do other professions, unless stress levels, burnout, and ease of access are high.

    Where do you work that there is such a high rate of use leading to code status? Has the hospital looked at reducing ease of access and/ or stress levels? If so many coworkers are dying due to narcotics diversion, I sure hope the hospital is addressing, at a MINIMUM, ease of access.
  6. by   NurseKymba
    Thank you for your comments and thoughts so far.

    Though it is true that research indicates no more use in the medical/nursing professions than other walks of life, those in the field do tend to misuse more prescription over street drugs as a result of our knowledge and comfort level.

    The particular hospital I worked at back when my coworkers were dropping like flies (Level one trauma center / ostrich-like administration / 4 codes while working over 2 years, but additional losses by suicide) did not address access or stress issues. Access was eventually addressed via DEA intervention/investigation as well as new educators w/ a proactive stance.

    The most recent event brought the past to my present and got me wondering. The recent case was an employee who 'borrowed' a coworker's used duragesic patch - he chewed it to release the fentanyl into his mouth and as a result stopped breathing.

    sigh

    It takes more heroin to make one develop a resp arrest than fentanyl.

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