Louisiana RN recently "caught". Need Advice

I suggest you go to
Louisiana's peer assistance information website (RNP)


Go ahead and call them and tell them what happened, and find out what you need to do. I know this is a scary time, and it seems like you have a lot of responsibilities. IF you want to keep your nursing license, I suggest you do EVERYTHING that RNP tells you to do,, and start recovery right now.

Hey - I am also an RN from Louisiana. I was put into our state's RNP in 1999. Mag is right - our state board does appreciate it if you call and self report instead of them finding out from the employeer and then have to contact you. If it is a first offense, they do what they can to give you another chance. As far as inpatient rehabs in the state, they do have a list of approved facilities they will allow you to seek treatment in.

I was working in a busy hospital when I started using and was going through a messy divorce. I started out taking Adipex during the day to stay awake, and then Ambien at night to be able to sleep. I was like you, and when my MD wouldn't authorize any more refills, I knew I held the key to the "candy shop", so to speak.

Some days I was so high, I don't remember even going to work or leaving when they sent me home because they thought I was sick. God only knows how many people I could have killed while driving. I started dozing off while standing in the hall charting. I started "giving" pain meds to other people's patients even without them asking for any. I was stupid and careless to say the least.

I still remember how horrible I felt when I got caught. I thought my life was over in every way. I was so embarrassed when I had to tell my parents what I had done. It took a long time for me to realize that I was not alone in my addiction, that there were others in the same boat as me. The nurses peer weekly meeting helped a lot.

Please know you aren't alone today in this situation. Get the ball rolling and talk to the BON before you are reported by the facility. Feel free to pm me anytime if I can be of assistance. Good luck to you.

Anne, RNC

Please feel free to start going to some meetings now before you go to the rehab facility. This will give you another support system.

In our area, the daily newspaper has a listing of all the AA and NA meetings, even CA, GA, ect. They are usually at halls, churches, that kind of thing.

We were also required to attend a weekly aftercare meeting, and that is usually assisgned when you go to treatment. Some people do get to go to outpatient treatment. I was fired when I got caught and with the job went my health insurance, so I had to go to one of the state run rehabs in La. I feel like it did benefit me to go there, and I was not charged a dime. Some of the others, private, and that kind of thing can really run high, and I just couldn't go to one of the others - I could barely buy groceries.

They have a aftercare for professionals meeting - cadeusus (I'm not sure of the spelling) that I attended for a year and it was a great benefit for me, and also my dh who is a nurse and was in the RNP too. I am not sure how to find out about that one, other than to ask the BON. They will be able to tell you specifically where and the support staff that will be running the meetings.

Just make sure that whenever you go to the meetings, take the calender with you for the moderator to sign so you get credit for them. I do still have extra blank copies of these, and they might be available on line at their web site.

Good luck to you - we will keep you in our thoughts and prayers. It's not an easy time, but just do what you need to do every day and you'll get through it.

Anne, RNC

I looked after I finished my post at the BON web site Mag included, and you can get the calenders and recognized treatment centers. I attended Red River in Pineville. When I was there, I was able to be d/ced after 28 days and did not have to go to a halfway house. Some places do include that as mandatory when you are d/ced.

Like I said, feel free to contact me any time if you have any questions, ect.

The important thing is for you to get help. Everything will fall into place. Hang in there and best of luck to you.

You are not alone.

Tweety - you are SO right! The biggest thing you need to concentrate on is you - getting physically, emotionally, and spiritually healthy. A good sponsor will be a godsend. Sometimes it may seem hard to find one that suits your needs, but there will be one that will help you. We found temp sponsors while in rehab and then after d/c I found a permanent sponsor closer to home. My first permanent one relapsed after I had been in recovery for about 4 or 5 months, so I had to find another one, but she has really helped me so much.

Try not to get discouraged - we are here for you if you need.
Anne, RNC

My heart skipped a beat just reliving the anguish that you are going through...

First and most important: YOU ARE NOT THE FIRST TO BE WHERE YOU ARE!!! If you were, then they wouldn't have a state program, RIGHT? Yes the shame, guilt, helpless feelings...We have ALL been there!

Might want to talk to an attorney. Did you get fired? Did they say they were going to call the DA? DEA? Are they willing for you to "self-report" and settle with that? My hospital, was "very displeased with me, but would allow me to join my state's recovery program" That way, they aren't liable, can let you be dealt with by the program, and basically wash their hands of you. Some employers, although not mine, are willing to let you get help, and try to find you a job in their hospital when you have met the requirements. Guess it depends on the "higher ups". If they don't, then it wasn't meant to be. You might find a GREAT job that doesn't make you have anxiety when you walk in the doors

I know there are other's that may disagree, but be honest (only if they aren't going to threaten legal action, because then they could use it against you) and humble. Does your hospital have an employee assistance program? Call them that's what they are there for.

You WILL make it through this. There are several of us here that have done it, and are here to give you support.

Keep your chin up. You screwed up, but don't we all?
Good luck, and keep us posted. Get the help you need! Try not to stress too much about it, and remember you are NOT alone.

Tipselu,

You've received some excellent feedback and suggestions, so I'm going to focus on the disease.

Chemical dependence (also known as addiction or substance misuse disorder) is a DISEASE. It's chronic, progressive, and fatal when untreated. While you did some things that were "less than desirable", you did them as a result of the changes that occur in your brain as a result of genetics and chronic exposure to mood altering substances. These changes alter your emotional and psychological response to your internal and external environment. They also alter your decision making abilities and the ability to learn and retain information.

Unfortunately, our society still doesn't fully accept that addiction is a disease. They still see it as a lack of "moral fiber" and lack of willpower. What's REALLY frustrating is the "cognitive dissonance" of the nursing profession. While the profession "officially" says addiction is a disease, a majority of nurses don't really accept it as such...especially if it's a colleague.

Why is this so? Simple. Nursing programs don't provide adequate education regarding the pathophysiology of the disease. Nursing programs don't provide an adequate base of science for their students...PERIOD.

I spoke at Northern Kentucky Univerity's nursing program last Wednesday (along with my fellow peer advisor). Some very bright students in that class. Yet, when I asked them which parts of the brain were adversely affected by this disease, one person knew it was the mesolimbic system. When I asked her which class provided that information, she said, "None of them." She learned it on her own because her father is a recovering alcoholic. By not teaching the science of this disease, decisions are made based on the "3 Ms" of addiction: Myth, Mis-belief, and Misinformation.

When we lack a solid understanding of science, we are forced to blindly follow policies and protocols developed by someone else. What if that person had no idea what they were talking about when they developed the policies? How can we make appropriate decisions if we have no idea why we're making them?

Many people think we are giving the addict an excuse by calling this a disease. It means they don't have to take responsibility for their disease and the things they do while the disease is active. The addict ISN'T responsible for the disease. While initial use is a conscious decision, the development of the disease is not. No one wants to become an addict! If there is a genetic predisposition, the right substance, in the right "dose", for the right amount of time will lead to addiction. HOWEVER, once the addict receives appropriate treatment and the disease is in remission (commonly called recovery), maintaining remission IS our responsibility.

This is the only disease that convinces the person they don't have it. While there can be denial when a person is diagnosed with other diseases, most people will accept they DO have that disease and seek treatment. Almost all addicts must experience an intervention before entering treatment. There are several different kinds of intervention. The one we're most familiar with is the kind you see on the show "Intervention" on A&E. Other interventions include, but are not limited to:

• DUI
• Divorce
• Being arrested for criminal activities (Domestic violence, robbery, assault, etc.)
• Accidents (car accidents, falls, etc.)
• Accidental overdose
• Hospitalization for ailments due to substance abuse. Examples include:
  • Cirrhosis
  • Gastrointestinal disorders (ulcers, esophageal varices, pancreatitis, oral cancers, etc.)
  • Respiratory disorders (cancer, COPD, aspiration pneumonitis, etc.
  • Cardiovascular (Hypertension, fatal dysrhythmias, stroke, MI's, etc.
  • CNS (seizures, brain damage due to anoxia resulting from airway obstruction/aspiration, psychiatric disorders [paranoia, hallucinations, dementia, etc.)
• Death (also the only "cure")

You are NOT a bad person trying to become good, you're ill and trying to recover! The stigma associated with this disease:

• Prevents the impaired nurse from seeking assistance
• Delays early recognition by colleagues
• Allows an impaired nurse to continue practicing, placing everyone she is in contact with in danger
• Allows a fatal disease to progress making treatment less effective and relapse almost inevitable
• Makes re-entry to nursing practice extremely difficult
• If the nurse does re-enter practice and the staff doesn't accept addiction as a disease, the subtle and not so subtle attitudes of nursing colleagues can make recovery more difficult to maintain, increasing the risk of relapse.

The ANA Code of Ethics speaks directly to the issue of impaired nursing practice in Provision 3.6: Addressing Impaired Practice

I went through all of this to help you see you aren't evil, weak, stupid, or any other negative term used to describe this ugly disease. I felt the same way then as you do now. Today, I know I wouldn't be who I am if not for all this crap. Others here feel the same way.

Start attending AA or NA meetings until you can enter treatment. Keep a record of every meeting you attend. Include day, date, and the signature of the person leading the meeting. If you are seeing a therapist, document visits. Anything you do that relates to you trying to get well should be documented.

If you don't have an attorney, I strongly urge you to hire one (familiar with addiction and dealing with the board of nursing). Contact the American Association of Nurse Attorneys for info and a referral. I know you're worried about money and don't think you can afford one, but can you afford to lose your license? Many attorneys will work with you on payment options. The board of nursing is not your friend, they are there to protect the public from unsafe nursing practice. Anything you say can, and will, be used against you. Don't allow your shame and guilt prevent you from obtaining the help you need and deserve! You wouldn't represent yourself against criminal charges. The same applies for nursing board investigations. Here's an excellent blog by a nurse attorney. The title of this blog is Counselors, Social Workers, and Chemical Dependency Counselors Cannot Provide You With Legal Advice

Things will get better, one day at a time.

An excellent article describing the disease can be found here

Prayers and hugs from Cincinnati!

Jack

Hey - Just wanted to check on you, and see how you were doing. I know all this hits hard, and it was a crappy thing to deal with at a crappy time ( Easter holiday) but please know we are all here for you. You aren't the first person to have to deal with this, and unfortunately won't be the last - please feel free to pm me if you need to.

Good luck - Anne, RNC