Nurses Who Are Drug Addicts

[jill48]

I work with a nurse who I suspect is using drugs, and I think she is stealing them from the facility. Of those of you that have encountered this problem, what were the signs and symptoms? Thanks.

[Magsulfate, BSN, RN]

Wow, this thread is getting pretty long...and a little heated. I'm glad that nobody has resorted to name-calling yet.

I have a question and I hope I can get a couple of opinons (especially from cattitude...RN knows her stuff)

How many chances should a recovering nurse have? Say, for example, I was caught stealing or using drugs at work. I go into rehab, am clean for two years, get rehired and a year after that get caught again. Should I ever work again?

My opinion...second chances are great...everybody screws up at some point and like I said a while ago, anyone can change. BUT, you get caught again, sorry, no go. License: gone. Ability to work in a hospital: gone. Any chance at recovering your nursing career: gone. Fool me once, shame on you, fool me twice: gone.

How does everyone else feel about this?

One second chance. Thats all we should get. Only one. If that first chance doesn't slap you in the face, wake you up and make you realize what you've been doing wrong, then the second chance is not going to either.

[Cattitude]

Wow, this thread is getting pretty long...and a little heated. I'm glad that nobody has resorted to name-calling yet.

I have a question and I hope I can get a couple of opinons (especially from cattitude...RN knows her stuff)

How many chances should a recovering nurse have? Say, for example, I was caught stealing or using drugs at work. I go into rehab, am clean for two years, get rehired and a year after that get caught again. Should I ever work again?

My opinion...second chances are great...everybody screws up at some point and like I said a while ago, anyone can change. BUT, you get caught again, sorry, no go. License: gone. Ability to work in a hospital: gone. Any chance at recovering your nursing career: gone. Fool me once, shame on you, fool me twice: gone.

How does everyone else feel about this?

This is a tough one. See, relapse, unfortunately does happen and can be a part of the recovery process. I have seen several nurses in my group that are there for second offenses. The BON is allowing them second chances as well.

I'm not sure how I feel about this yet. I know for me, I took myself OUT of the hospital setting. I put myself into treatment. I think it's very hard for us to see when we actually are at the point when we do need help. Thus relapse can often sneak in and occur before the addict realizes it.

The 2 examples I am thinking of, the nurses had second offenses that had substances that were NOT the original substance they had problems with. So in reality, an addict or alcoholic must abstain from everything. My drug of choice was opiates. I never had a problem with alcohol but I will not drink. I just won't. I have decided as they say, that alcohol is also a drug and I cannot have any drugs.

So back to the point, I don't think nurses should lose their licenses for second offenses, no. But hard and serious thought maybe about working situations.

I'm hoping that better programs and better support systems will reduce relapse situations in the future. As it stands now, nurses have a better chance of recovery then the general public.

[Magsulfate, BSN, RN]

Very good reply cattitude. I like it. Couldn't have said it better myself.

[lpn2rnstudent, LPN, RN]

I have read through this entire thread. One thing that stuck out to me is the total lack of empathy towards the 12 year old that was left in a vegetative state due to the actions of an impaired physician.

The reality is that relapse can occur at anytime, and due to the nature of the addiction it is highly unlikely you are going to step up to the plate and recognize that you should not be working. The reality is that many of you state all of the characteristics of addiction, but when people like myself say state that many of these characteristics make us uncomfortable working with you we get chastised.

Drug addiction is horrible. I am not writing this to pass judgment on those of you who are fighting addiction. I am writing this so that some of you would understand why some of us feel the way we do.

[Tweety, BSN, RN]

I have read through this entire thread. One thing that stuck out to me is the total lack of empathy towards the 12 year old that was left in a vegetative state due to the actions of an impaired physician.

The reality is that relapse can occur at anytime, and due to the nature of the addiction it is highly unlikely you are going to step up to the plate and recognize that you should not be working. The reality is that many of you state all of the characteristics of addiction, but when people like myself say state that many of these characteristics make us uncomfortable working with you we get chastised.

Drug addiction is horrible. I am not writing this to pass judgment on those of you who are fighting addiction. I am writing this so that some of you would understand why some of us feel the way we do.

I doubt there isn't anyone that isn't horrified by the person left in the vegetative state. While we talk about addiction, etc. you should not presume lack of empathy. But the topic is addiction, not the one left in a vegetative state.

I do understand what you're saying. I'm not 100% comfortable working around addicts who can relapse in a second and cause harm to our patients, but I do know they can and do become productive members of society and the nursing community if they are offered treatment, rather than punishment. Who am I to deny them that.

I also know they pay a heavy price to become active nurses after being caught, or putting themselves in treatment. It's not a slight slap on the wrist. It's treatment, monitoring and accountability, and revocation of license, etc.

[Tweety, BSN, RN]

This is a tough one. See, relapse, unfortunately does happen and can be a part of the recovery process. I have seen several nurses in my group that are there for second offenses. The BON is allowing them second chances as well.

I'm not sure how I feel about this yet. I know for me, I took myself OUT of the hospital setting. I put myself into treatment. I think it's very hard for us to see when we actually are at the point when we do need help. Thus relapse can often sneak in and occur before the addict realizes it.

The 2 examples I am thinking of, the nurses had second offenses that had substances that were NOT the original substance they had problems with. So in reality, an addict or alcoholic must abstain from everything. My drug of choice was opiates. I never had a problem with alcohol but I will not drink. I just won't. I have decided as they say, that alcohol is also a drug and I cannot have any drugs.

So back to the point, I don't think nurses should lose their licenses for second offenses, no. But hard and serious thought maybe about working situations.

I'm hoping that better programs and better support systems will reduce relapse situations in the future. As it stands now, nurses have a better chance of recovery then the general public.

Good response. I tend to agree that 2nd chances should be offered, but with a heavy hand. Chronic relapsers should be removed from practice permanently.

[happybunny1970]

The reality is that relapse can occur at anytime, and due to the nature of the addiction it is highly unlikely you are going to step up to the plate and recognize that you should not be working. The reality is that many of you state all of the characteristics of addiction, but when people like myself say state that many of these characteristics make us uncomfortable working with you we get chastised.

Drug addiction is horrible. I am not writing this to pass judgment on those of you who are fighting addiction. I am writing this so that some of you would understand why some of us feel the way we do.

Let me quote myself here:

"I think the major point is being missed here: There is NO WAY to know whether a nurse is 'actively using' or not -- those with stipulations or restrictions on their licenses, or enrolled in a peer assistance program, are also subject to tons of random drug screens (not to mention supervision and restrictions/stipulations regarding narcotics access), so someone in this situation is actually LESS LIKELY to be working under the influence of anything (alcohol or drugs) because they will be caught so easily. Any nurse with a 'clear license' is probably fine (at least, I would always give them the benefit of the doubt until they gave me reason to believe otherwise), but the simple fact is, they just may not have been 'caught' yet."

Should someone actively under the use of drugs and alcohol be working? No. But how are you going to know who those people are? The only way to verify that sort of thing would be to have EVERYONE do a drug screen before each and every shift, and that is just not going to happen. And lets not forget that a person could have a very valid prescription and use it in a non-productive way -- not all of the 'addicts' are diverting meds from their patients. Based on that, does that mean that no nurse should ever be able to have a prescription for narcotics, because they 'might' use it inappropriately? Does that then mean that no nurse should ever be allowed to imbibe alcohol because they 'might' overdo it and show up at work hung over?

This is NOT a black-and-white issue, and there is no one-size-fits-all answer. After my coworker's experience I am quite the wiser, and I pay attention, but I would never accuse unless there was a well-founded basis for the accusation. I think that's the best any of us can do.

[lpn2rnstudent, LPN, RN]

I doubt there isn't anyone that isn't horrified by the person left in the vegetative state. While we talk about addiction, etc. you should not presume lack of empathy. But the topic is addiction, not the one left in a vegetative state.

I would say that a 12 year old left in a vegetative state due to the actions of an impaired physician is absolutely relevant to the discussion of addiction. When discussing the addiction of practicing nurses, patient safety is probably what all of us are concerned about. This unfortunate incident is proof of what can happen when people are working in an impaired condition. Vicky was called a few unpleasant things because she is on the other side of the spectrum from the nurses here who are battling addiction. While some of the nurses here have spoken of how difficult it is to live with addiction, Vicky has spoken of how difficult it is to pick up the pieces from the unsafe practice of the impaired. Both are important sides of the discussion in my opinion.

I do understand what you're saying. I'm not 100% comfortable working around addicts who can relapse in a second and cause harm to our patients, but I do know they can and do become productive members of society and the nursing community if they are offered treatment, rather than punishment. Who am I to deny them that.

I also believe that addicts can become productive members of society. I also believe that addicts can become productive members of the nursing community with some restrictions. I think treatment is key, but taking an addicts license away or restricting it has more to do with providing safe care than punishing the addict.

Treatment of addiction is not fail proof. Relapse can and does occur. I guess it is my opinion that we must take into account the safety of patients before anything else. Being an addict, especially in health care is probably a very difficult thing. I respect all the nurses who have posted here for their honesty and hard work maintaining their sobriety and health.

[lpn2rnstudent, LPN, RN]

Let me quote myself here:

"I think the major point is being missed here: There is NO WAY to know whether a nurse is 'actively using' or not -- those with stipulations or restrictions on their licenses, or enrolled in a peer assistance program, are also subject to tons of random drug screens (not to mention supervision and restrictions/stipulations regarding narcotics access), so someone in this situation is actually LESS LIKELY to be working under the influence of anything (alcohol or drugs) because they will be caught so easily. Any nurse with a 'clear license' is probably fine (at least, I would always give them the benefit of the doubt until they gave me reason to believe otherwise), but the simple fact is, they just may not have been 'caught' yet."

Should someone actively under the use of drugs and alcohol be working? No. But how are you going to know who those people are? The only way to verify that sort of thing would be to have EVERYONE do a drug screen before each and every shift, and that is just not going to happen. And lets not forget that a person could have a very valid prescription and use it in a non-productive way -- not all of the 'addicts' are diverting meds from their patients. Based on that, does that mean that no nurse should ever be able to have a prescription for narcotics, because they 'might' use it inappropriately? Does that then mean that no nurse should ever be allowed to imbibe alcohol because they 'might' overdo it and show up at work hung over?

This is NOT a black-and-white issue, and there is no one-size-fits-all answer. After my coworker's experience I am quite the wiser, and I pay attention, but I would never accuse unless there was a well-founded basis for the accusation. I think that's the best any of us can do.

You are absolutely right. This is not a black and white issue. I spoke up because I felt it was important for some of you to understand why I would feel uncomfortable working around an addict. Of course everyone is different and just because some nurses are battling addiction does not mean that they are the same as every other addict out there.

I suppose a honest, open, and respectful dialogue is a good thing when trying to deal with the not so easy issues.

[Magsulfate, BSN, RN]

Let me quote myself here:

"I think the major point is being missed here: There is NO WAY to know whether a nurse is 'actively using' or not -- those with stipulations or restrictions on their licenses, or enrolled in a peer assistance program, are also subject to tons of random drug screens (not to mention supervision and restrictions/stipulations regarding narcotics access), so someone in this situation is actually LESS LIKELY to be working under the influence of anything (alcohol or drugs) because they will be caught so easily. Any nurse with a 'clear license' is probably fine (at least, I would always give them the benefit of the doubt until they gave me reason to believe otherwise), but the simple fact is, they just may not have been 'caught' yet."

.

Very very well said, and I have tried to make this point myself in a post or two. Nurses who are in recovery will be the FIRST ones to get caught because of the possible daily random UA's.

[rn/writer, RN]

I would much rather work with a recovering nurse who has intense supervision and accountability than someone who has a substance abuse problem of lesser intensity who still thinks she can control her situation. The former has many checks and balances to give her a fairly constant reality check. The latter is just about compelled to rationalize and play head games with herself and others.

Besides the addiction itself, there is the addictive thinking that led to it in the first place. Actual substance withdrawal is small potatoes compared to the struggle to root out the toxic and twisted thinking. Some manage to do one without doing the other. They are prime candidates for relapse.

[Tweety, BSN, RN]

I would say that a 12 year old left in a vegetative state due to the actions of an impaired physician is absolutely relevant to the discussion of addiction. When discussing the addiction of practicing nurses, patient safety is probably what all of us are concerned about. This unfortunate incident is proof of what can happen when people are working in an impaired condition. Vicky was called a few unpleasant things because she is on the other side of the spectrum from the nurses here who are battling addiction. While some of the nurses here have spoken of how difficult it is to live with addiction, Vicky has spoken of how difficult it is to pick up the pieces from the unsafe practice of the impaired. Both are important sides of the discussion in my opinion..

I was taking issue with the accusation of lack of empathy by the posters on this thread. I agree that it's important to talk about all sides of the issue. But because many of us on this thread are focusing on the nurses doesn't mean we lack empathy to our patients.

I also believe that addicts can become productive members of society. I also believe that addicts can become productive members of the nursing community with some restrictions. I think treatment is key, but taking an addicts license away or restricting it has more to do with providing safe care than punishing the addict.

Treatment of addiction is not fail proof. Relapse can and does occur. I guess it is my opinion that we must take into account the safety of patients before anything else. Being an addict, especially in health care is probably a very difficult thing. I respect all the nurses who have posted here for their honesty and hard work maintaining their sobriety and health.

I agree with you here.

I favor a heavy handed approach and this is because of my concerns for patient safety. Just because I favor treatment for the nurse, doesn't mean there is no concern for patient safety.

I am 100% for removing an addict from practice, revoking their license immeidately. However, I am 100%for offering them treatment and an opportunity to become productive nurses again..........under strict guidelines (treamtment, urine testing for drugs and ETOH for several years, limited narcotic priviledges, etc.)