Embarrassing Incident/Klonopin?

lucianne · Dec 19, 2005

I can see how this incident was distressing and embarassing for you (on top of being pretty scary). Even without a psychiatric diagnosis, none of us likes to be in a weakened position in front of our co-workers. We're "supposed" to be the caretakers, not the care receivers. It's a shame your confidentiality was not respected. If you can, try not to worry too much about other people knowing you have a presecription for a benzo. Believe me, you are not the only one in your department taking some sort of psych med.

There are other meds that can be used to treat anxiety, but if you need a benzo and nothing else will work, try taking it one day when you aren't at work and do some tasks that require attention to detail to see if you feel you're impaired by the med.

When you have an anxiety disorder, there doesn't necessarily need to be a clear trigger to set off an attack. It isn't anything to be ashamed of and isn't a sign of weakness on your part. If you feel you can be matter-of-fact and open about your illness, you may be calmer and less likely to have an attack. Sometimes the fear of another anxiety attack can be the trigger for one. I started having them in nursing school during a particular clinical and once I told my instructor and he encouraged me to seek treatment, I felt much better and more in control--even without meds.

I skimmed back through your original post and didn't notice if you said that you had a therapist. If not, maybe you should set up some appointments for cognitive behavioral training to manage your symptoms. If you can't manage that financially and don't want to use your hospital's EAP, you could try one of the anxiety workbooks that are available (although I still think a therapist would be more helpful). Often if you can use relaxation or self-distraction techniques at the first hint of an anxiety attack, you can head one off. Practicing deep breathing, imagery, and muscle relaxation techniques on a regular basis can be really helpful. If you practice them regularly you should be able to get to the point where a couple of deep breaths may be all you need to calm yourself. One of my favorite techniques to teach people who are prone to panic attacks is to count backwards from 100 by 7's. If they get the serial 7's memorized, they can start from a different number or do some other kind of mental math.

One more thing--there's a new med to help with sleep that is not a controlled substance and supposedly has no risk for abuse or dependency and may be taken long-term for insomnia. It's called rozerem and works on the melatonin receptors. This won't address your daytime anxiety but if it works for you, it will be one less situation in which you need a benzo.

Good luck with everything!

HappyJaxRN · Dec 19, 2005

Hi there. I know what you're talking about. I ended up in the ER at the hospital I work at when I was in nursing school because the new MD had MISprescribed a medication that caused HTN and Tachycardia! My blood pressure was sky high! They didn't do anything for hours upon hours! I had a migraine and I was sick as a dog. And unfortunately, it too was a psych med. How embarressing is that! I can across those same co-workers later and they wouldn't even give me the time of day. Wouldn't make eye contact or nothing. I was so embarressed.

Okay so recently, I ended up in the ER again. I was working and I had HTN again and I was tachy...this time, I was SOB. And I had a fever...so I had to leave the floor and go to the ER. I felt horrible. Didn't know I had a fever until I was in triage. Anyway, they did everything on me...chest xray...EKG, 2 IV's....Cardiac enzymes, pee test...My d-dimer came up higher than normal and they also discussed a PE with me....took me to radiology for a CT with contrast. I was so embarressed. Turned out to be nothing...But glad that they checked. I was coming down with a cold or something...And my HTN was worsened because all my CV meds had just been changed. I guess my body was in shock! :rolleyes:

I knew someone that took Ativan long term and he said that when he tried to stop taking it that it caused his HTN. He takes CV meds now.

Anyway, I'm sorry you had to go through all that and it's very embarressing. I hope it's getting better.

Stand tall! Good luck!

10ACGIRL · Dec 19, 2005

I was mortified earlier this week. I work in an ED and during this story, keep in mind that I am a 25 year old healthy-looking female. I have taken lamictal for depression for 4 years and have not had problems with depression. I have been happy as a clam. I also have a prescription for ativan, which I had not taken for 4 months. When I took it, it was because I had obsessive thoughts about things my dad had said to me (he's very heavy handed) and I was up for hours at night regurgitating these thoughts in my head. The ativan helped me to sleep.

Well, the other day I was at work and kind of felt odd, and I purposefully did not drink the one mountain dew that I normally drink at work. Later during the shift, I felt a little odder. When I got home, my heart was beating rather fast, but I did not take my pulse, and I fell asleep. When I woke up in the morning, I took my pulse and it was 100-110. I decided to push fluids, wondering if I might be dehydrated. I went to work. My chest started hurting that morning before I headed to work at 2 pm, when my shift starts, but I didn't tell anyone. Then, I was just standing there at work a couple hours into my shift and I could feel in the snap of a finger, that my heart had kicked up its ticking by 100 notches. Then I took my pulse and it was 145. The charge nurse was nearby and took my vitals. My blood pressure was 140/85, when it's normally 100/60 and pulse was 137 (pulse is normally 88). So charge nurse said that I needed to be admitted and get a stat ekg. So there I was admitted in my own ED where I work (can we say mortifying--esp. with a psych hx?). I told them that I take the lamictal for depression and that I have ativan, but haven't taken it for four months. They put me on the monitor, did a portable chest x-ray. Did an ekg (which looked like sinus tach, but they didn't rule out stable svt [with a foci really close to the sinus node]). They gave me 3 bags of NS, even though I had no reason to be dehydrated. They gave me an aspirin and nitro paste. Then they did blood work and found a positive d-dimer, which means you might have a PE. So then they took me for a spiral chest CT with contrast. I got quite anxious about the idea of a PE and waited to be offered ativan [felt weird asking for it....didn't want to be thought of as a psych pt by the nurses I work with]. The nurse came over and ask me nicely "how much do you usually take." I was so embarrassed because I hadn't been taking ativan for four months and had told her that previously. The CT came back negative for PE. They finally gave me metoprolol or labetol, which slowed down my heart and I left the ED after 8.5 hours with a heart rate of about 100-105.

I didn't go to work the next day and my chest still kind of hurt.

I went to work the next day and my chest still kind of hurt. But I was working. Well, at one point I had been standing for a while near the nurses station and suddenly my chest felt stabbing pain and I started sweating a little and put my hand on my chest. Well, the nurse nearby looked at me and sweetly said in her normal tone of voice (i.e. not a whisper) "do you have any ativan?" I said "no... IT'S not anxiety." However, I was just mortified that she'd say that at the nurses station (how could she say it out loud like that?). She told me she was sorry later and that she thought that the thing she had asked me to do immediately prior to my chest pain had made me anxious [which it had nothing to do with it]. So she said she had felt like she caused it. So...I'm thinking....she thinks I have an anxiety disorder.

So I go find myself a family practice doctor the next day to see, who happens to be a resident and she does what I perceive to be a very unthorough exam. [i mean...I would at least get a follow up EKG or set of cardiac enzymes if I had a pt with chest pain]. She left for a while, probably talking with her attending and came back and said she thought it was anxiety. She said that I should probably get on klonopin. So I said, why don't you prescribe that? And she said she didn't feel comfortable prescribing it. Well, later I wondered if she was just nervous about prescribing a psych drug if the problem wasn't a psych one. She also suggested an antacid, which was probably a good idea. I've never had a problem with acid reflux before, but it's a good idea to try. It didn't help. I took 4 mylanta yesterday and it didn't help. I took two this morning while we were hiking, and it still didn't help. Today I went hiking with some friends and felt more chest pain 2/10. It was a fast paced 7 mile hike. In terms of anxiety, an example of anxiety more typical for me would have been an incident that happened last night. I was at a party and someone showed me that someone else was crumpled on the floor. My heart rate increased. I took some deep breaths. Walked over. Checked responsiveness. The woman was reponsive and there was a nurse at her side talking to her (and several other people). Once it was okay, I walked away and my heart slowed right down in 3-4 minutes. And during that whold incident, my heart did not increase near 140 beats a minute.

So...my question is.....fine.....I suppose I *should* trust the doc and treat this as a psych problem. Obviously starting a job in an ER is anxiety provoking, as is being away from my family for the holidays for the first time. Given that I'm so young, it would be odd to have something else major going on with my heart.

But klonopin during the day? Can people work on klonopin? The doctor said that lots of people work on klonopin. I'm not an expert, so I thought maybe some of you would have thoughts on this. If klonopin will prevent another incident of 140 bpm heart rate and quell the recent chest pain....fine....but I've never made a medication error before or done anything unfortunate, and I'm worred that taking a benzo at work might make it easier to make a mistake?

As for the ativan that I hadn't touched in four months, well, I am so mortified that all the nurses know I have ativan and how they might think of me that I have been taking it to help me fall asleep at night the last two nights or else I keep thinking about the nurses' station for hours (I hadn't taken it for 4 months).

As for the job. I love the job. I love working in the ED. I know I have what it takes to work there. one piece of advice someone gave me yesterday is that I absolutely must not mind-read what other nurses are thinking about me now that they know what is supposed to be confidential information about me [which was shared at report and through word of mouth all around the ED]. My supervisor was even at the nursing station when the nurse asked me if I had any ativan (mortifying, I say).

Any constructive feedback would be greatly appreciated.

Sweetie, Email me ok? We need to talk hun, I know EXACTLY what you're going through. PM me ( I can share my email address with you this way if you need it) :uhoh21:

CyndieRN2007 · Dec 20, 2005

I think the bias on nurses with mental health illnesses is horrible. I myself don't have a mental illness, but my sister does, and I have been by her side through her illness. She tells me just imagine the most anxious moments you have ever had and multiply that a million times. I'm so sorry for what you are going through and I hope everything works out for the best

CowsRGreat · Dec 24, 2005

I'm so glad someone finally brought attention to the issue of nurses with anxiety/depression:rotfl: . I too suffer from anxiety and panick attacks:uhoh21: . They are under control now thanks to Lexapro and the occasional Klonapin when my sypmtoms are severe. At one point I was almost unable to leave my house:scrying: . Yes, there were even a few occasions where I started to have a panick attack at work. During those times I would slip into the bathroom and try some deap breathing or take .25mg of Klonopin. I always carry the Klonopin with me (as a safety blanket), but I haven't needed to take it in about three months. I did talk to my nurse manager and simply told her that I was going through a rough period and was experiencing some anxiety. I told her this in confidence and she was extremely supportive. My advice if you are suffering from anxiety or depression would be to talk to one person on your team that you can completely trust. You may find that they are more supportive than you thought they would be. As nurses we deal with daily stresses just like anyone else in the world and we are not immune to emotional problems. It is important though that we recognize them and get the help we need! Forget about the stigma, focus on your own healing. I now have helped out several nurses that I knew were facing emotional problems and they were very thankful for my help. so, for all that are reading this...let's not kill our own, but help our own..because you never know when you may be that nurse in need:wink2:

Good Luck

Thunderwolf, MSN, RN · Dec 25, 2005

I'm so glad someone finally brought attention to the issue of nurses with anxiety/depression:rotfl: . I too suffer from anxiety and panick attacks:uhoh21: . They are under control now thanks to Lexapro and the occasional Klonapin when my sypmtoms are severe. At one point I was almost unable to leave my house:scrying: . Yes, there were even a few occasions where I started to have a panick attack at work. During those times I would slip into the bathroom and try some deap breathing or take .25mg of Klonopin. I always carry the Klonopin with me (as a safety blanket), but I haven't needed to take it in about three months. I did talk to my nurse manager and simply told her that I was going through a rough period and was experiencing some anxiety. I told her this in confidence and she was extremely supportive. My advice if you are suffering from anxiety or depression would be to talk to one person on your team that you can completely trust. You may find that they are more supportive than you thought they would be. As nurses we deal with daily stresses just like anyone else in the world and we are not immune to emotional problems. It is important though that we recognize them and get the help we need! Forget about the stigma, focus on your own healing. I now have helped out several nurses that I knew were facing emotional problems and they were very thankful for my help. so, for all that are reading this...let's not kill our own, but help our own..because you never know when you may be that nurse in need:wink2:
Good Luck

Excellent post. Thank you!