Student Nurse Addiction

  1. Wanted to get some input from those that have experienced an impaired RN before. Is there any other signs I could look for in an RN that would indicate a substance abuse problem other than the obvious of slurred speech, lying, etc? I have a fellow student RN that I'm concerned about. When we first started our ADN program 2 years ago, one of the first reasons she indicated of being a RN was to "get some narc's". Of course, we all thought she was joking, but some of us wonder if this is not true now. She shows no classic signs of impairment or problems, in fact, a really good student it seems, but she does seem to be preoccupied with the notion of RN's that divert narc's. She has even talked to other RN staff on clinical rotations about it. It's like she's gathering info so when she graduates she can do this. She even wrote a paper about it. Some of us are concerned that she may not have a problem now, but will in the future. Or maybe has had a problem in her past. Her pre-occupation with the subject just seems odd to many of us. Just wondering if anyone has other 'signs' we could watch for? We have never observed anything unusual from her so its not like we could talk to anyone about her, but we are young and probably nieve to this area of nursing? Just wanted some thoughts from the veteran's here. Are we just being paranoid? Thanks!
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  2. 11 Comments

  3. by   P_RN
    Interesting question.....do a search here...it's been covered.

    http://allnurses.com/forums/search.p...der=descending

    When I was in school I was obsessed with diabetes.....I know people got tired of me harping on that.

    I hope your friend turns out to be in that categoryand not that of an impaired nurse.
  4. by   Agnus
    I am answering because we had a simular situation.
    The problem in this case is not narc but does involve very serious criminal behavior.

    In school this student made what we thought was a joke. Very innocent not anywhere as incriminating as the one your student made.

    I do not wich to go into detail here for confidentiality reasons.

    Anyway, there was something I thought was a bit unusual about this student. It was an unusual degree of personal confort concerning an aspect of nursing that other people are not as comfortable with.

    I was able to dismiss it because of this students personal experinece and background with the subject matter. I even admire the comfort level displayed.

    Hind site is 20/20. These were clues that the student was giving. We did not pick up on them. Until we found out what this student was up to there was really nothing to pick up on. Only some years practicing revealed the criminal activity. Many people were seriously hurt by this nurse.

    Take you concerns to you faculty. You can bring this post with you if you like. Follow your gut. The instructors LOVEd this student. STUDENTS LOVED this student. Very charming very personable very popular very likable. Apparently very noble.

    VERY Criminal and VERY troubled. WE were all SHOCKED.
  5. by   memphispanda
    I would go with your gut feeling on the person. I wouldn't try to get them in trouble, but I sure wouldn't be buddying up to them either.

    We had a student in my first clincial course who was Mr. Personality. But something about him really turned me off. I just got a bad feeling about him. He lived in the dorm and everything. The police came and picked him up about halfway through the semester, and he hasn't been seen since. Trust yourself to pick up on those wierd vibes some people send out.
  6. by   Agnus
    symptoms. Well many of my symptoms would apply more to a practicing nurse. Like volunteering to take the really sick patients.
    Frequent absence, in the case of alcohol abuse. An apparence of an unusual level of stress with this nurse, with poor coping abilities. Loss of control (emoational).
    Blamer.
    Yes these are all non specific and could apply to any of us. But when there is a consistent pattern of many of these things together. Like the inability to cope with stress and volunteering to take only the very sickest patients. That would be a red flag to me. (you take the sickest patients because often they can't really rat on you when you take their narcs, and because you have more justification to sign out narcs for these patients.

    But if you handle stress poorly or seem to be under a lot of stress it is inconsistant to ask to take these patients.
    These folks are sometimes Blamers as a addicted person does not take personal responsibility. But some are skilled enough to hide this.
    So you see I think a lot of it is follow your gut. Really since you are a student this needs to be discussed with faculty. They are in the best position to assess this.
  7. by   SmilingBluEyes
    Originally posted by jfpruitt
    Wanted to get some input from those that have experienced an impaired RN before. Is there any other signs I could look for in an RN that would indicate a substance abuse problem other than the obvious of slurred speech, lying, etc? I have a fellow student RN that I'm concerned about. When we first started our ADN program 2 years ago, one of the first reasons she indicated of being a RN was to "get some narc's". Of course, we all thought she was joking, but some of us wonder if this is not true now. She shows no classic signs of impairment or problems, in fact, a really good student it seems, but she does seem to be preoccupied with the notion of RN's that divert narc's. She has even talked to other RN staff on clinical rotations about it. It's like she's gathering info so when she graduates she can do this. She even wrote a paper about it. Some of us are concerned that she may not have a problem now, but will in the future. Or maybe has had a problem in her past. Her pre-occupation with the subject just seems odd to many of us. Just wondering if anyone has other 'signs' we could watch for? We have never observed anything unusual from her so its not like we could talk to anyone about her, but we are young and probably nieve to this area of nursing? Just wanted some thoughts from the veteran's here. Are we just being paranoid? Thanks!
    She either is looking for a reaction from people by saying all this, she is plain nuts or she means what she says, Any way you look at it, she is one to WATCH like a HAWK. She sounds scary. If she is any of these things, I hope she does NOT graduate and become a nurse, because she has ISSUES. If not addiction ones, emotional ones. Either way, she won't be much good to herself or future patients as a nurse, if she makes it.
  8. by   Agnus
    And Yet.
    Some years ago when I was a CNA and had the misfortune of having serval patients die in sucession. 2 one night 3 another night. I was clocking out and made a off handed remark about my killing patients.

    It was a stress releaser for me to say this but it got a reaction and I was told not to say or kid about such things. That was good advice but I blew it off at the time. I guess I needed the release pretty bad.

    On the surface I seemed to be unaffected by this. I had stated that I knew a certain patient would die when none of the nurses knew this. (CNA's are much closer to patients in nursing homes than the nurses)
    I was really setting myself up for susupicion with this remark.
    Fortunately, I guess everyone who heard it understood.
    But really they should have been suspicious based on the advice I have given you.
    So just be aware. We can't prevent everythhing (see my example about the criminal nurse) and please, let you instructors know your concern. Keep your eyes and ears open and that is about all you can do.
  9. by   Peatness
    jfpruitt, Have you thought of bringing your concerns to your instructor? Instructors always have a different view of students than do their peers and she may not be seeing the warning signs that you do. Make sure you weigh the benefits and consequences of your involvement. It may be smarter for your nursing career if you let things take their natural course which they no doubt will. Having said this I think you have a responsibility to say something if you feel that the patients wellfare is at stake. Think this through and word your concerns carefully. Don't let this student take you down with her. Good luck and I'm sure you will do the right thing. Peat
    Last edit by Peatness on Feb 25, '03
  10. by   jfpruitt
    Those of us that are suspicious are VERY reluctant to mention this to any instructor simply because there is no real evidence behind our conclusions. If there were missing narc's, wrong counts, weird behaviors, we wouldn't hesitate. However, the only real concern is her preoccupation with the subject. I know that diversion in nursing is a major problem from what I do hear, however, I'm still unsure how this is done. I know that it can be done, but it seems so risky and hard to do b/c of the constant counting and recounting of these drugs.
  11. by   CCL"Babe"
    I have worked with several impaired nurses during my career. Most did not divert drugs from patients.

    One in particular used to carry a vial of "saline" in his pocket. He would routinely take 100 mgm of Demerol out when only 25mgm was ordered. When he would relieve me for lunch, he would seek out narc orders for my patients, who had never told me they had any pain. He would hover behind people when they were going into pyxis. He would faithfully have you watch his "wastes".
    After a particular shift where he had signed out over 1000mgm of Demerol, I went to someone in administration with my concerns.
    His drug screen was positive. He did have a problem with chronic pain and did have a prescription for narcotics. The hospital allowed him to resign.

    Even though it was never made public that I was the one to "turn him in", I did catch a certain amount of flack with some of my co-workers who suspected that I had. Many of them had been clueless to his behavior and thought that he had been unjustly treated.

    This year (10 years later) he lost his nursing liscence for drug use while on duty.
  12. by   LilgirlRN
    Just another thought here... could this person have an older sibling that was caught doing this, or maybe a good friend and she just wonders how it could happen?
  13. by   Rapheal
    Please be very careful on how you react to your suspicions. We had a student who ended up dismissed for psychologica reasons. It appeared that this student was friends with a group of other students. They were all very involved with each other's personal lives. When they had a falling out with this student they started complaining that he had psychological problems. They had a meeting with school official and dx of bipolar. How can a student, who was not present at this meeting be diagnosed as bipolar just on what the other students had said? Most other students believed that there was no EVIDENCE of any manic behavior. I never saw any. Anyways, his career was ruined. I am not saying he was impaired or he was not impaired. Perhaps more to the story.

    But the best thing to do is to concern yourself with you and not other students unless you see evidence of inappropriate behavior. I am not trying to be mean or anything like that-but someones career may be at stake.
    Last edit by Rapheal on Feb 26, '03

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