Depression and Naltrexone

[Eris Discordia BSN, RN]

I'm going to try to keep this brief. I'm in my second year of monitoring and getting ready to finish my first year working at my present job. I have a massive commute, but I only work 2 days a week. And frankly, with my history, I was lucky to find a job. I work in a psych hospital in the medical detox unit.

The thing is...I hate it. Hate it so bad. I mean, since I'm an addict, you would think I would have more patience for the population, but I have never worked with a more difficult patient population in my life. Foul language, abusive behaviors, bad attitudes, and behavioral codes for throwing crap all over, for say, getting the wrong meal tray. Fist fights, body checks, you name it. I'm very sensitive in general to conflict, so I feel like I shake internally the entire shift.

And to make matters worse, 2 of the most senior nurses on my shift are hell bent, out to throw me under the bus. I get nit picked and turned in to management for EVERYTHING. I brought a patient his pills in bed because he was withdrawing hard and I got reamed for "hindering his recovery" by not forcing him to be independant and come to the med station. See, I've been thru withdrawals and when you are pouring lava out your bum hole and vomiting while you are pooping, it's nice if someone brings you your pills. Silly crap like that.

I told my director about it, and she says it's jealousy based because several months ago I won an award from the CEO for excellence in patient care, complete with a ceremony on the unit. She and the clinical coordinator say they are very aware of the problem and are working on it. Honestly, that is nice to hear. But between the coworker issue and the patient population, I fantasize about transferring back to medical.

The problem is that I really need some solid time in one job for my employment record. And, I don't even know if medical would hire a monitored nurse. I'm passed my narc restriction, but I still am not allowed nights or intensive care, which is what I did before.

And on top of it all, my program requires me to take witnessed naltrexone...and it doesn't have a ton of side effects, but it has killed my sex life and I have lost all motivation to do even basic self care like showering and brushing my teeth. I'm on vacation this week and I only get out of bed to pee and eat. And they won't let me stop it...I've asked. I see a shrink and I'm on meds, but this pill just sucks every ounce of joy from your life. Pills and therapy can't touch it, and if I want to work as I nurse, I have to take it for my entire 5 year contract.

Okay, so this wasn't short. And I guess I'm not really looking for a solution. I just needed to throw it out into the void that I hate my job, I'm depressed, and life isn't much worth living...and I've got until March 2022 to live this way. I'm going to keep living, no worries there. I'm not suicidal. I'm just hating it right now.

[Recovering_RN]

Sorry to hear this, I've been in a position to hate my job too, as well as a particular coworker who enjoyed making my life hell. So I get it.

Is there a way you could drop down to PRN? If you only had to deal with this job for one or two shifts a week, or even less, you could choose which shifts you pick up, maybe avoid the toxic coworkers by picking up shifts where they won't be there. And generally just work fewer hours with them. It keeps the job on your resume, without subjecting you to the emotional and psychological poison on a regular basis. I don't think a prospective employer would ask how many hours a week you work, when they check your references, would they? You get to list it as a job reference, without saying that you only work a few hours a week.

I'm doing something similar myself. I wanted to get my resume to the 2 year mark for my current job. I left my previous job at 8 months (home health) so I knew I needed to keep this one throughout the rest of my monitoring contract, no matter what. So the last month or so, I've start using my PTO to take one day off every week, which just happens to be the day that the one coworker who I can't stand working with works. So I haven't seen her in 4 weeks now! It's totally worth it to me to use up my PTO this way. Soon I'll be out of PTO, and I will continue to take that same day off work, and I'll take it unpaid. I don't care that my paychecks are going to be smaller, I just know I don't have to work with her, and my whole outlook improves! I'm fortunate that we have several other nurses who work PRN and can pick up my shifts, I know that's not a situation for everyone, but it's working for me.

Or is there another position with your employer you could transition to? Same employer, so it doesn't look like you're job hopping, but gets you away from the toxic coworkers. On your resume you'd list it as one line item, the employer, then below that you'd have two different job titles...to avoid the appearance of job hopping.

I'm sorry about the naltrexone, maybe you need to develop an allergy to it :). A rash can't be faked of course, but who's to say that some itching that doesn't have a rash couldn't start developing...

[Clean&SereneRN]

I take Naltrexone every day too. My administration isn't monitored, I just have to provide pharmacy records every so often to prove I am getting it filled. When I first started taking it, it really did make me feel terrible. I was tired, spaced out, and just felt generally gross. But after a couple of weeks, the symptoms subsided. Now, I don't even notice it, but I am also on some decent antidepressants. I am very happy day to day. I also have zero libido, but I attribute that to the antidepressants. But it is a worthy trade off for me personally. It beats the hell out of the crippling depression I had.

I also get you with your job. I got a job about three months after my license was reinstated to probation, and it took using people I knew in positions of power to get that job. But I am happy to have it. I had only a few restrictions - no high acuity or critical care areas, constant supervision, etc. But my job is also non-medical, and I do not find it nearly as fulfilling as my previous nursing jobs. I also find myself daydreaming about returning to my previous positions in nursing. One day I may, but certainly not until after monitoring for sure. I'll just stay in the moment for now.

All of this to say, I feel you, and support you in what you're going through! Keep your chin up and show them how it is done! :)