know it all

Nurses General Nursing

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Let me make this point.... if we were educated about addiction in nursing school, would as many nurses as do, actually become addicts? If properly educated could they see it coming? If properly educated could other nurses spot their coworkers before they were in trouble? For those of you who smoke, if you knew it would be so incredibly hard to stop, and if you knew the physiology behind the addiction would you have started in the first place? As far as my "know it all attitude", I've worked with several nurses who have been through rehab. One of my best friends is a nurse who is disabled form an injury at work and became an addict because of her pain. She was addicted to oxycontin, her pain specialist talked her into going to detox and then to rehab. The rehab center that she went to made her turn herself in to the BON even though she wasn't working. So, now she is in their monitoring program. She is my best friend, I knew she had pain all the time, I knew she was addicted to the medicine but I didn't know how to help her. Since getting off the meds, she's had a spinal cord stimulator put in, it helps with the pain. She loves being a nurse and she is an excellent on, she doesn't know if she will ever be able to work again but keeps hope that she can and that's why she's going through all this to keep her license. I even go with her to her mandated 12 step meetins from time to time. You'd be surprised how many nurses are there, how many doctors, veterinarians ... all very intelligent people. All of them will tell you that they knew pracitcally NOTHING about addiction. I used to be judgemental about addicts too. I work in the ED, so I see drug seeking behavior all the time. I used to think that they were scum too, until it happened to my best friend. Yes, it begins as a choice, but if you take enough, long enough, you're hooked and then you'll do whatever you have to to not go through withdrawl. I hope this helps explain my "knowitallness".

Specializes in Critical Care, ER.

Well I only speak for myself but I had been cognitively well educated about the perils of smoking before I started. After 10 years, the only thing that got me to stop was getting pregnant. Haven't had a smoke in over 3 yrs, tho.

The situation with your friend sounds just tragic. Hopefully science will catch up and develop some real solutions to chronic pain so that your friend and others won't have to go through addiction h**l. A few weeks ago there was a thread started about Rush Limbaugh's situation that led to some great insights into the mechanism of addiction. I think StevieLynn started it.

Tweety, BSN, RN

34,248 Posts

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Sweetness, you didn't have to explain yourself.

You do bring up some good points. Nurses and the general public don't have a grasp on what addiction is. The "they did to themselves why should I feel sorry for them" attitude is so prevalent in nurses and the general public. I'm sure we've all heard a nurse say that coming out of an alcholics room.

To answer your question that would education stop nurses from becoming addicts in the first place? Probably not. Addiction doesn't discriminate against the uneducated vs. the educated. Perhaps though being educated as to what resources there are available, what the symptoms are, and to talk more about it they might seek help quicker.

Let me say loud and clear again. Nurses who divert narcotics should have their licensed revoked and should be removed from patient care. They are a danger to their patients.

I feel strongly however, that at their own expense, or through their employee assistance program, they should be given the chance for treatment and the opportunity to eventually practice again. A nurse is a terrible thing to waste.

An addict isn't a good person gone bad. Treat the addiction and the good nurse can be a productive memeber of the team again. In my not so humble opinion. :)

Agnus

2,719 Posts

Help me out here. I was taught that genuine physical pain is not adiction. One does eventually build a tollerence to pain meds and increased doses are needed.

I was taught if one is truly adicted it is a psycological issue. They just like (crave) the feeling they get from the medication.

It sounds (to me) like your friend has physical pain. Just because it requires incresed doses for the med now to work does not = addiction. Just because the cause of the pain is unknown does not mean it is not physical and does not have a physical cause.

A lot of physical pain is genuine. But when we become ineffective at treating or finding the cause our own frustrating leads us to blame the pt. and acuse them of being addicted, mlingering etc.

If she is needing a spinal stimulator this suggest that this in not psycological craving for the way the med makes her feel. It suggest real pain that needs to be acknowleged and addressed.

Too often people have unrealistic expectations of us to cure them. AND too often we have unrealistic expectations of our ability to cure. If our treatment/ cure does not work we (the medical community) are too big headed to admit that maybe we failed and don't have all the answers.

ktwlpn, LPN

3,844 Posts

Specializes in LTC,Hospice/palliative care,acute care.
Originally posted by Agnus

Help me out here. I was taught that genuine physical pain is not adiction. One does eventually build a tollerence to pain meds and increased doses are needed.

Agnus is right-we have talked about this before-the problem that I see is in lack of knowledge regarding pain control....
Specializes in ED staff.

I meant to put my know it all post on the stealing drug thread, I didn't mean to start a new thread. Please put your replies on that thread, sorry.... Wendy

Agnus

2,719 Posts

Please, do not get me wrong. I do not sympathize with those who divert, nor who are in denial about adiction.

I do not sympathize with anyone who shows up for work under the influence etc.

I do too often see situations where we take it upon ourselves (medical folks, MD, nurses etc) to deside while this person is in the hospital we are going to detox them, against thier will.

I see situations werer known addicts are not given proper pain control because of their addiction. It seems a hard concept for our professions to swallow that addicts need more pain med to control pain and not less.

I also see situations where a person who has long term geuning pain is kept of or weaned down on dosage because it is considered an addiction.

I have NO tollerance for nonsense displayed by addicts And I have a problem with ever MD or nurse, social worker etc who pronounce people with chronic pain issues as an addict not deserving of pain medication. Because you do not see a reason for the pain does not mean it is not real. Does not mean it is an addiction.

Yes I understand addicts say they have pain. In a sense they do but it is not physical it is psycological. (we are not talking psycosomatic here)

Howerver, a certain amount of carful sensitive observation can often sort out what is pain and what is not.

And we know that taking someont off med s because we believe there are addicted is not compassion unless it is done with thier consent and undrstanding and agreement.

I see too many alcholics dried out against thier will only to head to the nearest bar on discharge. We are doing society a disservice wasting money on this AND we are inflicting the discomfort and risks of withdrawal on this soul without thier informed consent and to no purpose other than to make us feel superior and to demonstrated this person is not worthy of help "becuase look what they do."

When it comes to this we are far too paternalistic. And to questions our self proclaimed athority meets with rath and indictments.

In life in general I have come to learn that when some one starts acusing and blaming is when they themselves are ineffective. It is a defensive mechanism used to distract attention from the fact that they cannot fix something, don't have the answer, or failed. My God don't admit that maybe we don't know! It is easier to blame the other person.

I used to be married to a man who admitted that he truly believe that if I asked him a question he had to KNOW the right answer. (he admitted this in a discussion after the divorce. During the marriage I had told him it was OK if he did not know the answers. Just tell me and I would stop asking for clarification)

When his answers did not make sense he began acusing me of being too stupid to understand.

It took me years to figure out what was going on. He could not explain it effecitively because he simply did not know the answere and could not admit it.

Since then I have been able to recognize this same behavior in others.

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