Did I do the right thing?

[Keysnurse2008]

Did I do the right thing? I have a close friend.....and that person has been denying they have a alcohol addiction problem. They made me feel guilty for even asking if they had a problem.Things got worse....they refused to get help.They drank...daily. At times to the point of passing out. They have kids involved, young kids. They wouldnt get help ....got angry when asked to get help. It was just a bad situation. He saw no problem with drinking up until he clocked in to work. he denied it until he was in a position and got caught red handed. It was affecting their health, their kids emotional health and they felt they were in "complete" control of their addiction. They are divorced and their ex lives several states away and is not involved in their kids lives. He said he tried to stop drinking on his own and it didnt work out well.....he had an adverse outcome something like a seizure. So...with him still refusing to get help,...or even admit he had a "REAL" problem....I called his state peer assistance program to try and get someone to intervene. I felt like my hands were tied.....like if I didnt do something he would die and his young kids would have no one. I still....feel horrible. It was .....difficult to make that call. So...did I do the right thing? Could I have done something different...was there another way?

[Keysnurse2008]

wow....how long did it take you to get /gain this much insight into all this? And...after all you have been through.....it is amazing that you can have the patience to try and actually educate someone like me on all this. I have been a nurse for awhile and I see people coming through in DT's all the time,...some tryin to quit on their own...some because they just have no access to get more. I'd like to think I have always treated them in a kind respectful way.....and I think I have. I have never had any of them complain on me......but after this I hope I spend a little extra time making sure that someone knows where they are at.....or just talkin to them.

This cadecus (msp?) meeting....is that available in every state?Is that what they call the peer groups?

Can I ask another question? My friend was angry bc he said that the way the board deals with physicians is way more private. That their professional reputation is left untouched when they tend to be much more punitive of nurses. I didnt know if this was true or not.....but it seems like it would almost be impossible for a MD to get back into practice bc of the availabilty of drugs. Have you heard of nurses complaining that the BON is more punitive towards nurses than physicians?

And also....if you dont mind. What should we look for in collegues? I know in alcohol that missing work,calling in after you were already suppost to be at work, change in appearance, mood swings etc etc. But what about narcotic useage......are there different symptoms you look for with that? That may be a stupid question.....and it probably is. But...it just seems like difference between etoh and drugs you'd maybe see different behavoir. Like in a CRNA what do you see if they have a fentanyl problem? or a nurse with a oxycontin/lortab/percocet problem? That's ....probably a stupid question isnt it? But...I am asking bc this really kinda blindsided me with my buddy's alcohol problem.

I dont know if he was doing more than etoh......he was trashed. What was suppost to be a group of us getting together for a game/dinner and drinks after work...turned into him getting 12 coke and jacks. No one noticed until we had to pay the bill afte rhe got mad at us. One server wouldnt serve him any more so he kept going to the " bathroom" and went directly to the bar and said he was waiting to meet someone. Got like 3 or 4 there....it was bad. You know you have friends when you run out of a resturaunt and they chase you down a busy street trying to convince you the bench is not your bed and youcant "undress" and hop right into bed.

[Magsulfate, BSN, RN]

alcoholic nurse

irritability, mood swings

* elaborate excuses for behavior; unkempt appearance

*blackouts (periods of temporary amnesia)

*impaired motor coordination, slurred speech, flushed face, bloodshot eyes

*numerous injuries, burns, bruises, etc. with vague explanations

*smell of alcohol on breath, or excessive use of mouthwash, mints, etc.

*increased isolation from others

drug addicted nurse

*rapid mood and/or performance changes

*frequent absence from unit; frequent use of restroom

*may work a lot of overtime, usually arriving early and staying late

*increased somatic complaints necessitating more prescriptions of pain

medications

*consistently signs out more or larger amounts of controlled drugs than

anyone else; excessive drug wasting

*often medicates others' patients; may wear long sleeves all of the time

*increased isolation from others

*patients complain that pain medication is not effective or they deny receiving

medication

*excessive discrepancies in signing and documentation procedures of

controlled substances

mentally ill nurse

*depressed, lethargic, unable to focus or concentrate, apathetic

*makes many mistakes at work

*erratic behavior or mood swings

*inappropriate or bizarre behavior or speech

*may also exhibit some of the same or similar characteristics as chemically

dependent nurses

note: it is most important to look for patterns or changes in behavior. not all characteristics need to be present to indicate that a problem exists.

[Magsulfate, BSN, RN]

can i ask another question? my friend was angry bc he said that the way the board deals with physicians is way more private. that their professional reputation is left untouched when they tend to be much more punitive of nurses. i didnt know if this was true or not.....but it seems like it would almost be impossible for a md to get back into practice bc of the availabilty of drugs. have you heard of nurses complaining that the bon is more punitive towards nurses than physicians?

one thing i want you to understand is, tpapn is not punitive. it is not punishment, and this is very important for him to understand. the punishment will come if/when he does not follow tpapn's rules and does not complete tpapn. the peer assistance programs were formed as a non punitive,, alternative to punishment and a way for nurses to recover and return to work as a nurse.

[jackstem]

one thing i want you to understand is, tpapn is not punitive. it is not punishment, and this is very important for him to understand. the punishment will come if/when he does not follow tpapn's rules and does not complete tpapn. the peer assistance programs were formed as a non punitive,, alternative to punishment and a way for nurses to recover and return to work as a nurse.

amen mag...amen!

jack

[Keysnurse2008]

amen mag...amen!

jack

i guess i know that it isnt punitive. i got to read a copy of his contract...and it is rough. i mean it looks like every waking moment is spent either working or going to a meeting of one or another thing. i mean he has a family...so when will he really get to spend time with his kids? i mean....it is so rigorous it does appear punitive..but i guess holding his hand and singing kumbahya isnt getting it huh?

but also...i mean i keep getting told that physicians are treated so differently. like their peers have no idea that they are in a program...whereas nurses...well their coworkers do know. so does that seem fair?bc their social reputation is preserved whereas the nurses is not. so...shouldnt all the boards be under one monitoring agreement?

[Magsulfate, BSN, RN]

i guess i know that it isnt punitive. i got to read a copy of his contract...and it is rough. i mean it looks like every waking moment is spent either working or going to a meeting of one or another thing. i mean he has a family...so when will he really get to spend time with his kids? i mean....it is so rigorous it does appear punitive..but i guess holding his hand and singing kumbahya isnt getting it huh?

but also...i mean i keep getting told that physicians are treated so differently. like their peers have no idea that they are in a program...whereas nurses...well their coworkers do know. so does that seem fair?bc their social reputation is preserved whereas the nurses is not. so...shouldnt all the boards be under one monitoring agreement?

physicians have money/power, attorneys and prescriptive authority. it is a whole other ball game with them. you can't even compare the two.

as far as him spending time with his family.. he will have more time with them now than he's had in a long time. there's one hour a day in aa/na.. that is to keep him from relapsing and helping him to take it one day at a time. then there's work.. of course he worked before. but,, here's the kicker... the one hour he's spending in meetings is probably less time than the time he spent drunk at home with his kids,, or at a bar ,, or going to the liquor store..etc.

so, i really don't think the time issue is a problem. the way you said that it sounds like you've been listening to him.. maybe he said that? it sounds like it.. another excuse. i know you're trying to help him ,, i am just saying.. it really sounds like it came out of his mouth. :)

[jackstem]

i guess i know that it isnt punitive. i got to read a copy of his contract...and it is rough. i mean it looks like every waking moment is spent either working or going to a meeting of one or another thing. i mean he has a family...so when will he really get to spend time with his kids? i mean....it is so rigorous it does appear punitive..but i guess holding his hand and singing kumbahya isnt getting it huh?

but also...i mean i keep getting told that physicians are treated so differently. like their peers have no idea that they are in a program...whereas nurses...well their coworkers do know. so does that seem fair?bc their social reputation is preserved whereas the nurses is not. so...shouldnt all the boards be under one monitoring agreement?

he (and everyone else involved) need to stop comparing his contract with what a doc gets. he's not a doc. it wouldn't matter if he was. his contract is his contract, and that's the one he needs to focus on.

now he can be ticked off and feel like people are defecating on him, or he can wake up and smell the coffee (which may take a few weeks, because his brain is messed up as a result of the disease and his substance misuse). if he continues down the path that the disease has taken him, he won't have a family. he won't have time to spend with his kids...especially if he's in jail or dead. this disease kills people. it's as deadly as cancer, heart disease, or any other chronic, progressive illness. look at michael jackson. lot's of money and talent. a personal doctor with him when he collapses...and he's still dead. john belushi....dead. elvis presley...dead. river phoenix...dead.

if this disease was purely physical, do you think a contract would be required to return to work? no. this disease alters a person's personality, their ability to make rational decisions, their ability to "just say no" (if any catch phrase was based on sheer ignorance of this disease, that's one of them). this is not a punitive contract. it's exactly what's needed to get him over the denial which keeps the addict in their own little lala land that allows them to keep using. it puts teeth into the consequences of relapse. it creates the toughness that friends and family can rarely create, at least initially. the consequences of relapse are many...divorce, loss of job, maybe even some jail time. but for addicts who have access to some of the most powerful substances on the face of the earth...the first sign of a relapse is too frequently death.

so yes, it appears punitive...to the naive and the uninitiated. however, it can actually be the one thing that keeps him alive. it is definitely the only thing that will keep his career alive. if he chooses to play games, his license and career are gone. believe me when i say, losing that career can make finding another job very difficult. i'm speaking from experience, an experience i don't want others to have to go through. unfortunately, many are destined to repeat the experience. it's the nature of the disease.

please read the book "staying sober". it will give you a better handle on this disease than we can give you in this forum. if you really want to get a better understanding of addiction you must read, read, read. i know most of us here don't mind answering questions, but i think your best bet for getting a strong basis of understanding will require more information than we can supply in this forum.

if you'd like, pm me for more in-depth discussion.

jack

[Keysnurse2008]

he (and everyone else involved) need to stop comparing his contract with what a doc gets. he's not a doc. it wouldn't matter if he was. his contract is his contract, and that's the one he needs to focus on.

now he can be ticked off and feel like people are defecating on him, or he can wake up and smell the coffee (which may take a few weeks, because his brain is messed up as a result of the disease and his substance misuse). if he continues down the path that the disease has taken him, he won't have a family. he won't have time to spend with his kids...especially if he's in jail or dead. this disease kills people. it's as deadly as cancer, heart disease, or any other chronic, progressive illness. look at michael jackson. lot's of money and talent. a personal doctor with him when he collapses...and he's still dead. john belushi....dead. elvis presley...dead. river phoenix...dead.

if this disease was purely physical, do you think a contract would be required to return to work? no. this disease alters a person's personality, their ability to make rational decisions, their ability to "just say no" (if any catch phrase was based on sheer ignorance of this disease, that's one of them). this is not a punitive contract. it's exactly what's needed to get him over the denial which keeps the addict in their own little lala land that allows them to keep using. it puts teeth into the consequences of relapse. it creates the toughness that friends and family can rarely create, at least initially. the consequences of relapse are many...divorce, loss of job, maybe even some jail time. but for addicts who have access to some of the most powerful substances on the face of the earth...the first sign of a relapse is too frequently death.

so yes, it appears punitive...to the naive and the uninitiated. however, it can actually be the one thing that keeps him alive. it is definitely the only thing that will keep his career alive. if he chooses to play games, his license and career are gone. believe me when i say, losing that career can make finding another job very difficult. i'm speaking from experience, an experience i don't want others to have to go through. unfortunately, many are destined to repeat the experience. it's the nature of the disease.

please read the book "staying sober". it will give you a better handle on this disease than we can give you in this forum. if you really want to get a better understanding of addiction you must read, read, read. i know most of us here don't mind answering questions, but i think your best bet for getting a strong basis of understanding will require more information than we can supply in this forum.

if you'd like, pm me for more in-depth discussion.

jack

i guess i am still looking at this as if it is something easily controllable....and it isnt...i get that. it is hard to understand...but....i guess i am lucky i dont understand. i have actually ordered 2 of the books you talked about. i love to read...and as i still dont understand alot about this it might help. i do have one question though.....with the tpapn contract being so rigorious....is there any data available on the success rates? i mean....like...exactly how many can complete the program from begining to end without a violation? and also how do you guys handle it when you go on vacation....if you are oit of state as his family is?you call the number each morning...and there has to be a lab nearby? i know he is trying to wiggle out of signing the contract...which is sounds like is par the course. and i was suprised when he showed me the things he has to do. but....it looks like nothing else has worked. he acts like his case manager is going to be a real hard a**, but...i cant help but think that they will work with him if he wants to travel to see his family out of state. that was the big issue.

[Magsulfate, BSN, RN]

i guess i am still looking at this as if it is something easily controllable....and it isnt...i get that. it is hard to understand...but....i guess i am lucky i dont understand. i have actually ordered 2 of the books you talked about. i love to read...and as i still dont understand alot about this it might help. i do have one question though.....with the tpapn contract being so rigorious....is there any data available on the success rates? i mean....like...exactly how many can complete the program from begining to end without a violation? and also how do you guys handle it when you go on vacation....if you are oit of state as his family is?you call the number each morning...and there has to be a lab nearby? i know he is trying to wiggle out of signing the contract...which is sounds like is par the course. and i was suprised when he showed me the things he has to do. but....it looks like nothing else has worked. he acts like his case manager is going to be a real hard a**, but...i cant help but think that they will work with him if he wants to travel to see his family out of state. that was the big issue.

yes, they will work with him if he needs to travel out of state for a bit. but like the contract says (and i am very familiar with this contract) he cannot move out of the state, and you better believe they will be testing him as soon as he returns. vacation is the ultimate kicker for alcoholics/drug addicted.

i don't know the statistics of tpapn completion vs failure rates. but i do know many people that have completed it, and i don't personally know any that have failed. i have read several court orders of nurses that did not complete tpapn and have had their license revoked. i also know nurses that are in the program right now. they are happy, they are grateful for life and grateful for a second chance at their career. i think i read in the last newsletter that there were about 700 tpapn participants (this is texas only of course) right now.

if he can get over this hump ,, he will finally see the light and understand what is going on. he doesn't see it right now. just like jack says,, his brain is fried. (well, maybe jack didn't say it like that. ) but it is fried. and it will take time to heal. once it does, he will be a different person. he will be grateful, he will be sorry.. he will have a new lease on life.

[jackstem]

If he can get over this hump ,, he will finally see the light and understand what is going on. He doesn't see it right now. Just like Jack says,, his brain is fried. (well, maybe jack didn't say it like that. ) But it is fried. And it will take time to heal. Once it does, he will be a different person. He will be grateful, he will be sorry.. he will have a new lease on life.

AMEN again Mag!!! Preachin' to the choir!

Jack

[Magsulfate, BSN, RN]

ohh jack,, you forgot the wonderful anna nicole (and her son), the iconic marilyn monroe........ judy garland.

heath ledger..

elvis presley...

bruce lee..

one of my favorite actors of all time chris farley..... that broke my heart. john belushi.

sid viscious... janis joplin .. jim morrison.... andy gibb...jim hendrix... rick james...ike turner...keith whitley...very different musicians, but they awesome in their own way.

kimberly from different strokes...

howard hughes...

i could go on... but you get the point right??

he (and everyone else involved) need to stop comparing his contract with what a doc gets. he's not a doc. it wouldn't matter if he was. his contract is his contract, and that's the one he needs to focus on.

now he can be ticked off and feel like people are defecating on him, or he can wake up and smell the coffee (which may take a few weeks, because his brain is messed up as a result of the disease and his substance misuse). if he continues down the path that the disease has taken him, he won't have a family. he won't have time to spend with his kids...especially if he's in jail or dead. this disease kills people. it's as deadly as cancer, heart disease, or any other chronic, progressive illness. look at michael jackson. lot's of money and talent. a personal doctor with him when he collapses...and he's still dead. john belushi....dead. elvis presley...dead. river phoenix...dead.

if this disease was purely physical, do you think a contract would be required to return to work? no. this disease alters a person's personality, their ability to make rational decisions, their ability to "just say no" (if any catch phrase was based on sheer ignorance of this disease, that's one of them). this is not a punitive contract. it's exactly what's needed to get him over the denial which keeps the addict in their own little lala land that allows them to keep using. it puts teeth into the consequences of relapse. it creates the toughness that friends and family can rarely create, at least initially. the consequences of relapse are many...divorce, loss of job, maybe even some jail time. but for addicts who have access to some of the most powerful substances on the face of the earth...the first sign of a relapse is too frequently death.

so yes, it appears punitive...to the naive and the uninitiated. however, it can actually be the one thing that keeps him alive. it is definitely the only thing that will keep his career alive. if he chooses to play games, his license and career are gone. believe me when i say, losing that career can make finding another job very difficult. i'm speaking from experience, an experience i don't want others to have to go through. unfortunately, many are destined to repeat the experience. it's the nature of the disease.

please read the book "staying sober". it will give you a better handle on this disease than we can give you in this forum. if you really want to get a better understanding of addiction you must read, read, read. i know most of us here don't mind answering questions, but i think your best bet for getting a strong basis of understanding will require more information than we can supply in this forum.

if you'd like, pm me for more in-depth discussion.

jack

[jackstem]

ohh jack,, you forgot the wonderful anna nicole (and her son), the iconic marilyn monroe........ judy garland.

heath ledger..

elvis presley...

bruce lee..

one of my favorite actors of all time chris farley..... that broke my heart. john belushi.

sid viscious... janis joplin .. jim morrison.... andy gibb...jim hendrix... rick james...ike turner...keith whitley...very different musicians, but they awesome in their own way.

kimberly from different strokes...

howard hughes...

i could go on... but you get the point right??

yep...that is the list of the victims of the "drug war". the only people dyin' are the addicts.

and it's gonna continue until we change the way we approach the whole thing. the popous politicians, the righteous police and boards of nursing, medicine, pharmacy, etc. have to change what they're doing since it ain't workin' the way they're doing things now.

jack