New grad seeking "low abuse risk" specialty advice

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    Hello all,
    I recently graduated from nursing school and am preparing to take the NCLEX in February. In the meantime I've been giving a lot of thought about what specialty to go into and was hoping some of you out there could help. I have struggled with an eating disorder for the past 8 years with intermittent bouts of alcohol abuse and chemical dependency. I am 28 now and when I was 20 I used to order Norco through my dad's office...I also find myself drawn to medicine cabinets of homes I am invited into to look for other narcotics. While I am not actively using now I have a tremendous fear that the stress of being a new nurse mixed with exposure to narcotics might make me do something I will regret. I guess my question is are there any specialties out there that do not involve narcotics or at least are "low risk" for potential abuse. I love floor nursing so I am hoping to avoid going into management...I've heard dialysis and pre-op ambulatory care could be options. Any advice you guys could give me would be so greatly appreciated. I can't believe that I have these feelings about potentially diverting medications...it is so shameful ....I just want to be sure I do not run into any trouble or worse yet, harm any patients. Thanks for any advice!
    fiveofpeep likes this.
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    Hello shopgirl44.
    Let me first say welcome and you are not alone. Your shame is something that will be very hard to work through but you are only human and it's your disease that caused you to take the risks you did. I freaked out because after 6 months of clean time I was still thinking/obsessing about drugs and that if I had a loaded needle I would want it in my arm. Now this doesn't mean that I would act on those urges (and I knew that) but to have them in my head at all is a hard thing to understand. My group members told me that it is completely normal to have these thoughts. We are addicts so our brain will always want the drugs/alcohol but what is most important is that with recovery tools we can refocus our thoughts and not act on those urges. Sorry, I am probally getting of what you are posting. :typing Are you involved with any recovery program? By saying that you want to make sure that you are in a low-risk area of nursing is great because it shows that you are aware of your feelings and are not in denial. Many people say that dialysis is very recovery-friendly. You can also look at psych. Just remember that being in recovery does not mean that you need to limit yourself. With a strong program you can one day return to areas of nursing where you are around narcs but a strong foundation is key. I would not suggest doing it without the support of a program though. I hope I helped in some way. Good luck and keep comming back!:wink2:
    sallyrnrrt likes this.
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    Thank you so much for your response! It is hard to hear that we will always have a desire to use drugs/alcohol, but deep down I know it is true. I guess there is no "wishing" away an addicted brain...I suppose accepting this addiction and taking proactive measures to keep it from getting out of control is the most we can hope for. I am really bummed because I love dressing changes and burns, but I know that everyday would be a battle for me if I took a job on the burn unit...I would probably be more focused on staying away from the drips than I would be on my actual patient, which is not only unsafe but also really sad. I've been trying to brainstorm more areas which don't involve narcs (it is really hard to get information on this subject w/o divulging the reason for inquiry!), but what do you think of dermatology, pre-op ambulatory care? Is there any specialty that involves wound care that doesn't involve pain medications? I guess all wounds are painful and we as nurses are supposed to be able to relieve that pain with medications....sometimes I wonder "what was I thinking going into nursing when I have a substance abuse problem?!" I had so many other options, but I chose nursing because I feel it is one of the few professions that actually makes a difference in the lives of others. Then I think, "well if you care so much about others, why are you even considering taking their drugs?!" I hate all this inner-turmoil that constantly runs through my head....I wish it would all stop which makes taking drugs all the more appealing...at least it helps short term. Sorry for rambling....I thank you sooo much for responding...it is so comforting to know that I am not alone with this.
    Thanks again!
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    29 years sober and I still can taste the vodka going down and the fog set in that makes everything else go away. I live in a dry county but I walked into a convenience store a few months ago and saw a rack of smirnoffs and just knew I would love to swim around in that bottle again. It never goes away so you can never let down your guard. There are lots of options that don't put you in harms way. Better safe than sorry.
    HM2VikingRN likes this.
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    Thanks Pollyanna83,
    I think the "making it all go away" is the hallmark of addiction...this world is not the kindest place and using substances can mitigate the emotional pain that is so strong is some of us. You are right....at least for now, I need to choose a field that doesn't put me in harms way. I need help brainstorming what kind of fields these would be and was wondering if you could give me some ideas. So far I have: dialysis, psych, staying in school and going into management, possibly pre-op ambulatory care, research....I'm just having a hard time because I know there are tons of job options for nurses out there and I know I am missing some. Like SassyErRn said I figure I should go into a low risk specialty while establishing a support network so that one day I can do what I truly love. Thanks so much for all your help and support!
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    Good options are assessment nurse for geriatric rehab facilities, (to maintain compliance) many facilies have med techs that have the key codes and nurse assesors do not have access or responsibilities, telenursing for insurance carriers, physician proteges (accompany physicians on rounds and make case notes), school nurses, public health nurses, (give vacines and well baby care). Basically any facility or job where med techs or staff nurses give all meds is OK. Large businesses hire nurses to do employee drug testing and emergency care and flu shots. I saw that a large retailer was looking for that type of nurses just recently. The pay is a little less but its a cushy job without any narcotics present. Hope this gives you some ideas.
    shopgirl44 likes this.
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    I entered Dialysis as an option after getting caugh diverting from a trauma center....I so often miss the fast pace and turn over, but to this day, 4yrs clean I can not hold a tb syringe without wondering what it would be like to shoot up "just one more time".....I hate my job setting, but through NA, and recovery I have learned that my job doesn't define me...no matter how bad it gets, I don't have to use today.
    So...to answer your question, Dialysis is a very safe, narcotic free workplace. You can even go to acutes and dialyze in the hospital setting.
    One thing to remember....you have an addictive personality...that means you don't have a eating disorder, or a drug problem...you have a thinking problem (I do as well).....no matter what I do, where I work, or anything...If I want to use, I am going to use! I hope you have a solid recovery program and can surround yourself with people who care about you and support you. Good luck!
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    There are no "safe" nursing positions. I was working with the US Post Office as an RN. I worked on a computer, there were no meds around and no direct patient care. I left work and went to a seedy side of town and asked some disabled person in a wheelchair if he could find me some heroin. I even gave him $20 so he would have the $ to pay for this opiate. He never came back. He probably was a secret angel and went home to his family to buy food. I didn't use that day but nonetheless, it doesn't matter whether I am collecting blood at a Red Cross donor site or working at Loma Linda Childrens Hospital Trauma Center, I will always have addiction as an issue. Recovery is like walking up an escalator that is going down-you always have to be moving foward to keep from hitting the bottom.
    Rascal1 likes this.
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    I wouldn't recommend psych. I give narcs and benzos all day long. Half my job of med nurse is differentiating the people who would benefit from the meds and those who are addicted.

    the best to you =)
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    Quote from rninmi
    through NA, and recovery I have learned that my job doesn't define me...no matter how bad it gets, I don't have to use today.

    One thing to remember....you have an addictive personality...that means you don't have a eating disorder, or a drug problem...you have a thinking problem (I do as well).....no matter what I do, where I work, or anything...If I want to use, I am going to use!
    I love the way you put this and I am so glad to read things like this. It's like a mini-meeting, a mid-day refresser. So thank you. Learning that my job doesn't define me was a really hard thing and still is. I was a proud Er Rn and now I am sitting at a desk doing medical chart audits until I find something else in nursing that I would enjoy yet it wouldn't test my recovery. I have to remind myself that my job does not define me. Along with that I have to find who I actually am because for a long time I was an er nurse, an anorexic, a depressed soul, a drug abuser. Now I feel a little empty but I know it takes time.

    And yes, it's not x or y or z....it's me.
    So thanks again for the wisdom!
    JJONES_RN_BS likes this.


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