Do we need to take drugs.. in order to do our job?

MunoRN, RN · Mar 3, 2012

I realize you saw this on 60 minutes.
HOWEVER
It's not "studies" it's one study. Second of all, this one particular study is extremely controversial, and the American Psychiatric Association has basically slammed the study for being "irresponsible and dangerous", and the results of the study have already been discredited by the FDA and the European Medicine Agency.
More info here: http://www.psych.org/MainMenu/Newsroom/NewsReleases/2012-News-Releases/60-Minutes-Segment-on-Antidepressants-Irresponsible-and-Dangerous.aspx?FT=.pdf

The 60's minutes story was about a single study, however there are others including a meta-analysis from 2010 that concluded "The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial."

Every study, including this meta-analysis is bound to produce criticism, particularly when you consider that anti-depressants are a $19 Billion industry in the US and $80 Billion worldwide, which doesn't even include the money made by those orchestrating their use. That doesn't mean all the criticism is quackery, some is certainly legitimate. But based on the current evidence it certainly seems appropriate to ask if we are over-utilizing medications and under-utilizing other effective means of treating depression such as diet, exercise, lifestyle changes, and therapy.

SuesquatchRN, BSN, RN · Mar 3, 2012

I was on an anxiolytic and antidepressant long before I became a nurse.

Aurora77 · Mar 3, 2012

I was on an anxiolytic and antidepressant long before I became a nurse.

Ditto. Accepting the fact that I needed medical intervention for my depression changed my life. Some of need help. It infuriated me that old prejudices still exist, even in the medical community.

perfectbluebuildings, BSN, RN · Mar 3, 2012

Some people need antidepressants to function at their best. Some people need insulin. Some people need seizure medications. Etc, etc. Why is there such a stigma with antidepressants? I have multiple relatives from all walks of life who have or had obvious issues with depression and it goes back decades that I know of; it's NOT a new thing or a nursing-related thing, and it can be fatal, period. I'm glad that advances in medicine have made it so that there are effective treatments and more recognition for these illnesses now than ever before. I am really surprised by how against medication so many medical professionals in this thread are. I know I'm not the first to say this here, but it's stigma like this that makes people not want to seek help in the first place.

P_RN, ADN, RN · Mar 3, 2012

I am Bi polar, I was diagnosed at age 13. Thanks to medications I can lead a normal, productive life. Beginning meds changed my life for the better, it felt like this cloud of haze was lifted and I could think clearly. Racing thoughts were gone, mood swings were eliminated, and I no longer felt compelled to harm myself.
Psych medications are vital to treat illnesses, but like antibiotics they can be overused.

Violet, I agree. Taking a prescribed med to get you to a "normal" baseline is certainly acceptable. Having a benzo or 3 or 6 is not. Prescription meds should be taken carefully and for the process indicated. SSRIs have saved many a life IMHO.

subee, MSN, CRNA · Mar 3, 2012

People on benzos cannot pass a drug screen - prescribed or not, you will fail the drug screen. If you have to take a mood-altering substance that interferes with performance (don't take my word..read up) to make it through an shift is too sick to be going to work. Ultimately, you are a liability to your employer and you can end up having to surrender your license for 90 days while waiting for the designated number of clean urines. There are better drugs for anxiety while you're working as a nurse.

Everybody on a psych med deserves to have the original prescription to come from a shrink and not from a PCP - there's some really bad medicating going around.

Fuzzy · Mar 3, 2012

I take pysch drugs. I take a mood stablizer, non typical antipsychotic, and have a benzo, SSRI, and a couple of other medications available to me. I have type 1 bipolar disorder and have been involuntarily committed twice. What's even better is that I'm not on diability (I've been told numerous times that I need to apply). I still hold a job that I work 40+ hours weekly.

This is not your typical low stress job. I'm a veterinary technician. I have to work with not just the animals (patients) but the owners (clients). I don't have to tell you which enitity is more difficult to work with either. This job has a lot of stress including euthanasia. End of life euthanasias aren't so bad. What hurts are euthanasias that involve healthy pets due to life circumstances, like euthanizing the really sweet, loving and well loved three year old kitty because the family is moving and cannot find pet friendly housing. The shelter refused to take the cat because it had too many in residence. Yes it's things like these that rip your heart out.

I can tell you that medication will help take the edge off of that emotional roller coaster. What helps me are coping skills that I learned from talk therapy.

I have had to learn to balance my life. This has taken both medication and therapy. Without that balance, I can lose my job, my home, my freedom, and/or my life.

I feel that people need to do what works best for them. They are not me. I am not them. I cannot judge the original poster for her decisions or her feelings.

Fuzzy

RiverNurse · Mar 3, 2012

And another two cents' worth from the peanut gallery...

In all the posts I've read, there seems to be a common thread, like a proverbial "elephant in the middle of the room" - stress from being in the nursing profession. It seems to me that if this is the biggest cause for one to be on anti-depressants, etc. then it's the profession itself that needs to be examined - not the nurses. It's a systemic issue - that places unrealistic expectations on nurses, turning hopes and dreams into liabilities.

One post discussed how in the past nurses were required to have a face to face interview as part of the application process of getting into nursing school. The implication is that there are those that are probably not cut out for this profession who are in nursing school or are working in that capacity. To that situation, I'd like to tip my hat to Johnson and Johnson for their illustrious campaign on the nursing shortage several years ago for one of the most vague and misleading descriptions (and deceptions) of nursing I've ever seen. I'll give a hearty "right-oh" to the thousands of nursing schools that cajoled well meaning and kind hearted people into their halls with the premise of "caring" for patients, not only consuming students' money, but their altruism as well. Finally, I'll give the royal bird to the profession itself, driven by profit, shuttling patients through on a conveyor belt of loosely named "care", skimming the cream off DRGs while the juices of its victims - both nurses and patients - dribble from its ravenous lips.

It is a systemic issue that almost forces - actually creates - the perception of nurses as Oedipal, profane and sacred - simultaneously - and perpetuates it. The expectation is for the nurse to be, unequivocally, all things to all people at all times. It's also a systematic model that has driven nurses - the center point of care - to bear an unrealistic burden of responsibility: higher acuity, co-morbidities, and an aging boomer population afflicted with more chronic/degenerative disease processes than in the past. It is this drive for profit that has also pushed the potential for error to a razor's edge, with long term fatigue, sleep deprivation and burn out being the tipping points.

It is ironic that the debate on this thread is regarding the use of antidepressants/anxiolytics while at work - meanwhile - an exhausted, overworked nurse that may be sleep deprived due to stress could exhibit behavior similar to that of a person who had consumed alcohol with the “impairments” being “…equivalent to or greater than levels of intoxication deemed unacceptable for driving, working, and/or operating dangerous equipment” (see link below – I’d use proper APA format but I’m too tired and I’m not writing a college paper). I find it interesting that some of the posts insist on taking time for cognitive and behavioral therapy to address the issues of depression and anxiety instead of medication. While this might be the ideal, it appears prohibitive in the sense that the rate of progression using this method would most likely be eclipsed by the continued stressors encountered by the system of nursing as it currently exists.

These issues cannot be taken lightly, nor can the nurses be judged harshly. The system of nursing has become the product of profit driven corporations or government regulations. The economy of human stamina has a short shelf life physically, mentally and emotionally. To push nurses beyond a functional capacity is the equivalent of putting too many mice in a cage. Eventually they turn on each other and consume one another due to the stress of that environment. A system that would subject its most valuable resources to stresses and fatigue to the point of implosion is a dysfunctional one at the very least – and at most - a Leviathan with jaws gaping, poised to receive its next meal.

As I said, two cents’ worth from a sleep deprived insomniac.

Rivernurse

The Effects of Fatigue and Sleepiness on Nurse Performance and Patient Safety - Patient Safety and Quality - NCBI Bookshelf

wish_me_luck, BSN, RN · Mar 3, 2012

I just discussed this thread with my mom, who is a nurse. Her reply disgusted me. She said that if nurses have to take anti depressants or anti anxiety drugs to work, then whose to say that they wouldn't steal the patients drugs. I was mad when she said that because in my opinion, there is a huge difference in someone who is on anti depressants and someone who is on addicting drugs such as narcotics or cocaine or heroine. It sickens me to think that with all the advances made in the medical field, including mental health, that people are still so prejudice against mental illness of any kind. The worst are people in the healthcare field.

MN-Nurse, ASN, RN · Mar 3, 2012

I realize you saw this on 60 minutes.
HOWEVER
It's not "studies" it's one study.

Actually, I saw this 4 years ago. I know 60 minutes recently did a piece on it.

MN-Nurse, ASN, RN · Mar 3, 2012

i realize you saw this on 60 minutes.
however
it's not "studies" it's one study. second of all, this one particular study is extremely controversial, and the american psychiatric association has basically slammed the study for being "irresponsible and dangerous", and the results of the study have already been discredited by the fda and the european medicine agency.
more info here: http://www.psych.org/mainmenu/newsroom/newsreleases/2012-news-releases/60-minutes-segment-on-antidepressants-irresponsible-and-dangerous.aspx?ft=.pdf

there are far more discussions of the subject than the [color=#333333]1998 and 2002 irving kirsch and guy sapirstein meta analyses, which you appear to be referring to above.

here is a very balanced view of the issue:

antidepressant-placebo debate

xoemmylouox, ASN, RN · Mar 3, 2012

I don't even know how to respond. The horrible things I am hearing have left me speachless. The fact that nurses are judging each other because some need help is INSANE. I cannot believe that nurses keep the stimga that the general pop. keeps. These comments are the same reasons people do not get the help they need, be it therapy, medication, etc. Telling someone to just get over it is the most absurd thing I have heard in awhile. SERIOUSLY. :icon_roll