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.

[Cattitude]

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 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.

So many thing to comment on . First, I really don't think there was an intended lack of empathy for the 12 yr old. Rather as was stated, it's not the MAIN focus of this discussion. Are we addicts , especially those that have hurt patients full of remorse? Yes, I would say so.

We could have an entire thread discussing patients that have been hurt at the hands of addicted nurses. We could discuss how awful the nurses feel and then the non-addicts could flame the addicts. But we addicts have beaten ourselves up enough for years to come, believe me! We DO have empathy for patients, why do you think we fight to stay in nursing?

But again, it's not the focus of the discussion. Certainly there are probably TEN times as many patients that have been hurt by NON addicted health care professionals, nurses included. Just take a look at the thread in the general forum now re: worst mistakes or whatever it's called.

And to address the issue of "us" understanding how all of "you" feel when you have to work with "us". Of course we understand! I think at least I have made it clear that we do get it. We just want a chance to try and prove ourselves. You don't have to like us or smile, be nice to or even supportive. Just asking that you don't go out of your way to be cruel or disrespectful (you meaning general you).

I know that some feel we should be stripped of our licenses and never work in health care again. I don't agree with that but I respect that they have an opinion. I only feel that maybe a part of that opinion does come from lack of knowledge about addiction. I too was ignorant until it happened to me.

I think for the most part the dialogue here has been mature and respectful. Vickinurse speaks from hurt and those reacting do so as well. I understand both sides. Not every recovering nurse is the one that hurt Vicki however. We're strong, happy, and continually working on ourselves.

I know I feel emotionally healthier than I've ever felt in my entire life.

Okay, enough rambling....

[leslie :-D]

i think our intellects and emotions are at odds w/ea other.

our intellects understand that all of us are infallible, vulnerable and imperfect.

while acknowledging that addiction is a disease and deserves treatment, we want everyone (including our pts) to take responsibility for ourselves in order to heal.

that's what the intellect states.

our emotions are much grayer.

we 'feel' the consequences and repercussions of an unresolved disease process.

even knowing that the addict is a pt in the healthcare system, bystanders are human and so, still feel disappointment, distrust, anger and judgement on those who wronged their pts.

i am very familiar with the addiction process.

i have seen the journey these people take in trying to rise above their disease.

it is never just a matter of stopping drugs/etoh.

it takes alot of reflection, insight, confrontation, strength and determination to rise above the need to use.

and it doesn't happen overnight.

again, it's a journey.

i applaud anyone who takes the necessary steps to lead a more productive life.

i don't have as much patience for those who remain in denial and that don't understand the necessity of walking the walk.

my philosophy does not pertain to only addicts, but to all in mankind.

honestly, i remain ambivalent about whether 2nd chances are merited.

but admittedly, i do feel harsher towards those that actually inflicted harm on their pts than those who didn't.

i realize that if i want to welcome my addicted sisters/brothers back into the workplace, that i need to take my own journey.

it's a growing process for all involved.

leslie

[subee, MSN, CRNA]

i think our intellects and emotions are at odds w/ea other.

our intellects understand that all of us are infallible, vulnerable and imperfect.

while acknowledging that addiction is a disease and deserves treatment, we want everyone (including our pts) to take responsibility for ourselves in order to heal.

that's what the intellect states.

our emotions are much grayer.

we 'feel' the consequences and repercussions of an unresolved disease process.

even knowing that the addict is a pt in the healthcare system, bystanders are human and so, still feel disappointment, distrust, anger and judgement on those who wronged their pts.

i am very familiar with the addiction process.

i have seen the journey these people take in trying to rise above their disease.

it is never just a matter of stopping drugs/etoh.

it takes alot of reflection, insight, confrontation, strength and determination to rise above the need to use.

and it doesn't happen overnight.

again, it's a journey.

i applaud anyone who takes the necessary steps to lead a more productive life.

i don't have as much patience for those who remain in denial and that don't understand the necessity of walking the walk.

my philosophy does not pertain to only addicts, but to all in mankind.

honestly, i remain ambivalent about whether 2nd chances are merited.

but admittedly, i do feel harsher towards those that actually inflicted harm on their pts than those who didn't.

i realize that if i want to welcome my addicted sisters/brothers back into the workplace, that i need to take my own journey.

it's a growing process for all involved.

leslie

Nurses who cause harm to a patient secondary to their addition do not quality for

diversion programs per the state boards. That is an immediate disqualifier for non-punitive treatment by the state. Nurses who do relapse are picked up quickly since their behavior is being scrutinized; unlike nurses who use and have no record who tend to work much longer before being picked up. People who relapse (who have caused no harm!) should be allowed to work but with newer, stricter provisions on their license - no agency, no access to narcotics, day shifts, frequent urines, etc. These are generally jobs that pay much less and they have to pay for all their own urines - recovery is never cheap.

[Magsulfate, BSN, RN]

I just wanted to share with you all a quote from a newsletter from TPAPN (Texas Peer Assistance Program for Nurses), that is Texas' program for recovering nurses. There are some suprising statistics, and I quote:

"At press time 679 nurses were either enrolled or pending enrollment in TPAPN. Each of our five case managers received on average 3 new cases daialy. Monday through Friday. During the Board of Nurses Examiner's 2006 fiscal year, a total of 133 RNs and LVNs successfully completed TPAPN. We congratulate every nurse participating, and those who have already graduated, for it takes tremendous sacrifice and discipline to maintain recovery and to succeed in TPAPN."

Now, if you do the math... that means that wayyyy more nurses are being referred and in the program than are graduating. So, it is a VERY strict program to follow. These nurses are not given the easy way out, by far.

I would just like to hear everyone's comments on this.

[sissiesmama, ASN, RN]

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.

Hey, Tweety! As usual, you offered some great insight and responses! And you are right, that we don't need to lose sight of the fact that something horrible did happen to that young person and the family. My husband and I are both nurses, but also in recovery. We are also parents of two children, 15 years old and 9 years old.

As recovering addicts, it is a line that must be diligently watched at all times. What may trigger for 1 addict may do nothing for another. One of the girls that was in our aftercare meeting was an MD, well she was a resident in our city teaching facility and we exited rehab at the same time. Later, she told us that this was her 3rd offence, that she had been removed from work right after passing boards from Pharmacy school, and charged with medicaid fraud, the whole nine yards. I wasn't sure how she didn't end up in jail. Anyway, I heard she had gotten married, and we hadn't seen her in a while. We had heard that she had moved out of town with new hubbie.

About 1 week or so, I was reading the newspaper and her obit was the first one I saw! Horrible for her husbanbd, her 2 young children and everyone else in her life. And please dont think I am the pot calling the kettle anything because I have NO reason to talk being an addict in the first place, but she was one we are talking about that should not have gotten a third chance, or fourth, ect. When she started using bad the last time not long before getting married (to an ICU nurse)that the dean at school maybe she should take care of animals and try vet school. (And this is horrible but she wouldn't have taken care of my sweet baby "Sam", my 15 year old cocker spaniel/g. retriever mix. He ended up paralyzed from the waist back almost overnight.

Anyway, thanks Tweety for the support of the addicts who are clean and trying to earn back some of the trust we have lost, and also helping us keep in mind of the poor young adult that will never have the life she or her family had planned.

Best wishes! Anne, RNC

[Cattitude]

honestly, i remain ambivalent about whether 2nd chances are merited.

but admittedly, i do feel harsher towards those that actually inflicted harm on their pts than those who didn't.

i realize that if i want to welcome my addicted sisters/brothers back into the workplace, that i need to take my own journey.

it's a growing process for all involved.

leslie

Ok you remain ambivalent but at least your mind seems open to the idea. You know what addiction and recovery are all about and knowledge is key. Thank you for that knowledge and understanding.

It's when people respond JUST based purely on emotion that's tough to deal with.

[teeituptom, BSN, RN]

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.

If you think she is abusing drugs she needs to be turned in immediately.

If she is stealing the Police need to be called, as theft of drugs is still a crime. Thus what that nurse is doing is a criminal act. No matter how you paint it. Its against the law.

[zoo4uRN]

Hi-

This is a really important topic, and I'm happy to see the open discussion! This is what ANA has to say:

"Addiction in the nursing profession has been identified as an Occupational Hazard by the American Nurses' Association and The National Council of State Boards of Nursing."

Here's the link for the reference

http://www.recoveringnurses.org/aware_project.html

If you know a nurse that needs help, or you're a nurse in recovery, or work with nurse's in recovery, this is a great resource-just follow the links at the top of the page.

http://www.recoveringnurses.org/home/

Debbie

[sinagbayan]

i have known nurses who steal drugs from the hospital. if you suspect a nurse is stealing and taking drugs, you have to be very careful that this is really the case. otherwise, the RN concerned will basically lose his career. besides, we don't want to be debarred because of a mistaken suspicion.

[rn/writer, RN]

i have known nurses who steal drugs from the hospital. if you suspect a nurse is stealing and taking drugs, you have to be very careful that this is really the case. otherwise, the RN concerned will basically lose his career. besides, we don't want to be debarred because of a mistaken suspicion.

Actually, it is not the responsibility of the reporting nurse to be certain. That is for the administration folks to handle and even they defer to law enforcement when necessary.

Any nurse who has a reasonable suspicion should be able to report her concerns to a manager. Concerns are not the same as accusations. They are the starting process in what should be a thorough investigation. And this investigation needs to be done by someone who has the authority to pull the nurse's usage records and look at her charting, etc.

You're probably saying that we need to be careful about making accusations, and this is true. We should have objective data to report along with good reasons for having suspicions in the first place. One example would be that the questionable nurse's patients consistently complain that they are in pain when you follow her, even though the ADU shows they were given appropriate narcs.

BUT, it is not the job of any floor nurse to either prove or disprove allegations.

Be prudent in expressing suspicions. Keep your information objective--stick to what you see and hear directly, not what others report second-hand. (If others have things to report, they should do it themselves.) Keep emotions out of your information. Write down what patients say (and when) so that ADU records can be matched to the statement times. In other words, supply information, not supposition. Then let the higher-ups sort out what it all means.

If a nurse loses her job over diversion, it is her own fault, not that of the reporting nurse. If she is falsely suspected, a proper investigation should bear that out. Either way, it is the responsibility of the reporting nurse to come up with the questions, not the answers.

[burn out]

So if you don't think it's a disease then what do you think it is? A choice? Do you think anyone chooses to be an addict? .

Note: I refer to " you" figuratively not in refereence to cattitude or any one person in particular.

Yes it is all about choices. You may not have chosen to become an addict but you choose the drugs to make you an addict , don't try splitting hairs. I am so sick of the poor woe me addicts look what I did to myself. If you can't make wise decisions for yourself you certainly can't make wise ones for your patients. Yes you got caught like you deserved to and need to pay the price like you deserve too. Personally, it is too much for society to bear your burdens of stupid decisions and shouldn't have to worry about what to do with you when you burn you bridges to a decent livelihood. You don't belong bedside nursing with your hand in the narcotics box, you have already proven your weakness . I firmly believe in the old addage, trick me once shame on you, trick me twice shame on me...if it were up to me I wouldn't hire any nurse with a drug problem to pass narcotics, and I wouldn't hire an alcoholic as a bartender.

[Cattitude]

Note: I refer to " you" figuratively not in refereence to cattitude or any one person in particular.

Yes it is all about choices. You may not have chosen to become an addict but you choose the drugs to make you an addict , don't try splitting hairs. I am so sick of the poor woe me addicts look what I did to myself. If you can't make wise decisions for yourself you certainly can't make wise ones for your patients. Yes you got caught like you deserved to and need to pay the price like you deserve too. Personally, it is too much for society to bear your burdens of stupid decisions and shouldn't have to worry about what to do with you when you burn you bridges to a decent livelihood. You don't belong bedside nursing with your hand in the narcotics box, you have already proven your weakness . I firmly believe in the old addage, trick me once shame on you, trick me twice shame on me...if it were up to me I wouldn't hire any nurse with a drug problem to pass narcotics, and I wouldn't hire an alcoholic as a bartender.

Many addicted nurses start out by taking medication for pain. So I don't understand how that's "choosing" to be an addict. You use pain meds, unfortunately sometimes an addiction develops.

Or sometimes there are other things going on in the nurse's life and then yes the nurse is self medicating, so to speak. Whether it's street drugs, prescription meds, alcohol. If someone is using a substance, initially if it makes YOU feel better to say it's a choice, go for it.

Not every nurse steals from patients. Not every nurse gets "caught". Some actually get treatment on their own! And not every recovered nurse works aroun narcs either.

There will always be opinions like yours. Always be one or two people completely on the negative side but that's FINE. It doesn't make me feel bad for me. It makes me feel bad for patients. For if you can think of your fellow nurses like this and have not one ounce of compassion, what must you think of the addicted patient who crosses your path? Or any patient who you dissaprove of? Are you telling me you're able to put aside your prejudices about addiction then? I think not.