Ethical Question...

[ConcernedHealthcare3]

Hello all,

I come to allnurses.com with a very heavy subject on my mind. I'm in a very delicate situation and I am looking for advice from you fellow nurses. After reading my post, ANY advice given will be appreciated.

I am currently a fairly new RN. I live at home with my mother, who is also an RN, and has been for many years. Personally, she has gone through some tough stuff lately. I have tried to be there for her as much as I can, but it is just not working. She has been drowning her sorrows in alcohol. Week by week it has gotten worse. She drinks a bottle of hard liquor each day she doesn't work. I know this is sad, but it is not the main problem. I recently discovered vials upon vials of IV pain killers (morphine, hydrocodone, etc.) and anti-anxiety medications (Ativan). She also has other injection paraphernalia such as syringes and IV needles. Also, she track marks up and down her arms. I know deep down she is stealing these drugs from work, from her patients that need these medications, and is taking them at home to try to mask the depression she is going through. I have tried talking to her about this, but she denies denies denies. On her days off she is completely loaded, but on days she works she SEEMS fine...

I feel I am in an ethical dilemma. On one hand, this person is my mom that is going through a hard time. On the other hand, she is a fellow RN who is stealing from her patients and putting them at serious risks.

My question to you nurses, is how should I handle this? Am I putting my license at risk by not bringing this information forward, even though it is my own mother? Should I just let things take its course and sit back and wait for either my mother or one of her own patients to die?

Thanks everyone for taking the time to read my post and I truely appreciate any advice.

[nursejoy1, ASN, RN]

Gosh- so sorry you are going thru this- (((((((hugs)))))))- I know the legally right thing would be to turn her in of course, but I can see how you hesitate, she is your mom after all. But think, too, that would get her the help she so desperately needs. Good luck to you both.

[nygirl1986]

ugghh what a difficult situation, i'm so sorry to hear you have to go through this!! as a new nurse, myself, it's becoming pretty obvious that every single day we're faced with moral dilemmas, and unfortunately i'm not sure if there is ever one clear cut, correct answer. i think it's so amazing that throughout your own stress and struggles, you are still concerned about all of the other patients that are potentially affected by this, which shows your heart is really in the right place and you're obviously a great nurse:yeah:!!

but onto the real question, what to do in your situation......i think that you're priority right now needs to be your mom's health and safety! you mentioned alcohol and drugs....is she also driving when these things are taking place?? she is clearly putting her health at risk...have you confronted her about the syringes and stuff?? i read an article once that said nurses are usually addicted to drugs for about 10 years before they get caught (crazy!!), but you really need to do everything you can possibly do to get her to get help. it's like the show intervention, you have to literally make it impossible for her to keep these activities up. let her know you love her, are very concerned, and you're not afraid to come forward with this information if she decides to not get on board to get professional help! i would definitely give her the opportunity to completely come clean with you and make the decision, together, to help her. this situation absolutely needs to be addressed asap. she is putting her own health at risk, as well as her patients, and yours! you mentioned your a new nurse, which is already a stressful time in itself, you need that support of your mother!! my advice would be to do anything in your power to get her the help she needs now....i think it's awesome you're thinking about her patients also but in my opinion, you're #1 priority needs to be your mother. i hope this helped.....?!

[CuriousMe]

Focus as a daughter first, your Mom needs help. I would do whatever you need to in order to get her that help. Turning her in is a way that she will get help and it will protect her patients.

A hard decision, but the right one I think.

[mamamerlee, LPN]

Are there any other people near you that you can talk to? If you have an EAP at work, make an immediate appointment, ask them for direction. At your first opportunity gather all the injectables and paraphenalia, and move them out of the house. If necessary, contact a lawyer, or put it all in a safe deposit box.

You may need to do an intervention, for which you will have to have a place already contacted to take her. And other people to make it clear to her that her substance abuse cannot be tolerated.

My heart aches for you, in this awful circumstance. Best wishes!

[proudnurseRN]

I think you need to set aside the fact that your both nurses and ask what you would do if you were both accountants, or worked at Walmart for that matter. Personally, I'm not sure. Do you have enough support to do an intervention? Can you talk to her doctor? Maybe even calling a substance abuse center and asking for advice?

I'm sorry to not offer much help, but I can't imagine what you are going through, and what she must be going through to be doing this. Wishing you the best....

[ChristyRN2009]

This situation really sucks and I feel bad for you. My advice, I would address it like a loved one. An intervention and possibly inpatient rehab.

BTW, I have needles and syringes in my house, and have been known to bring a vial home accidently. I have not used anything but I'm just saying, those things alone are not evidence as diverting. The only way you'd ever know for sure is a drug test but like I said, that's not for you to address. This is your mother and while she is a nurse, I would leave that out of your equation. You are only mandated to report if you think patients are in danger, and you have stated that you have no real or even suspected evidence of that. Good luck.

[sethmctenn]

Find a counselor for yourself who is equipped to deal with addiction issues. In the meantime, get to an Al-Anon group. They can give you some immediate support and may be able to refer you to an appropriate counselor.

Most states have an organization that has a relationship with the state BON and supports addicted health care professionals through the process of recovery from addiction and then recovering their license. My state requires 90 days in patient treatment most of the time in order to retain your license.

You have to get the unsafe behavior stopped right now. Otherwise, you could come home and find your mom not breathing at anytime. Remember that if you throw away her stash, she will likely be in immediate withdrawal. I would want my plans in place before I precipitated withdrawal in her. That process is really best handled in a detox center.

Take care of yourself. You're on a rough road but it'll smooth out. I've supported three of my family members through the process of starting recovery. Two have achieved long lasting sobriety and are productive. One is still finding his way. Really prioritize living YOUR life and not letting this situation take it over completely.

Anyway, those are my 2 cents. May you be blessed in this endeavor!

Seth

[worldnurse2000]

Oh, my heart goes out to you. From your description ("vials upon vials of IV pain killers (morphine,...)" and "track marks up and down her arms") it sounds like an awful situation to find yoruself in but one that needs some kind of action. I agree with previous posts that suggest accessing supports for yourself and then taking steps to help your mother (and her patients, her co-workers). Hoping you are able to find what you need to help you work through this challenge.

Kam

[rn/writer, RN]

Please, contact Al-Anon or Nar-Anon, the groups for people who care about family members or friends who have addiction problems. This is not something you deal with alone.

http://www.alanon.org.za/is_alanon_for_me.html

Al-Anon Family Groups have been in existence for over 50 years as a community resource providing support to those affected by someone else's drinking.

Is there a problem with alcohol?

Do you need some answers?

Are you a family in Crisis?

If the answer is Yes then the following page link may help:

Is Al-Anon for you?

http://www.nar-anon.org/Nar-Anon/About_Nar-Anon.html

What is a Nar-Anon Family Group?

The Nar-Anon Family Group is for those who know or have known a feeling of desperation due to the addiction problem of someone close to them. Nar-Anon members share their experiences, strength, and hope at weekly meetings. The meetings are usually held at locations such as treatment centers, hospitals, churches, community centers, or local twelve-step clubs.

Regarding your post--

I recently discovered vials upon vials of IV pain killers (morphine, hydrocodone, etc.) and anti-anxiety medications (Ativan). She also has other injection paraphernalia such as syringes and IV needles. Also, she track marks up and down her arms. I know deep down she is stealing these drugs from work, from her patients that need these medications,

The sentence in bold type may be a reasonable supposition, but you don't know this for sure. I say this, not to protect your mother, but to point out that this is a side issue as far as you are concerned. Yes, it needs to be dealt with, but because you are not involved with her job, your first priority is to deal with her.

Please, contact counselors with one or both of the groups mentioned above. The websites should tell you how to find someone in your area. You need help in formulating an intervention. This is NOT something you can do alone, no matter how much you care about your mom.

I encourage you to also contact your own Employee Assistance Program for support for YOU. This is not an easy situation to deal with. Even if your mother is grateful down the road, she may despise you in the short term for forcing her to face reality. It may be necessary, but it isn't pretty.

She is fortunate to have someone who cares about her enough to step in and say, "Enough!"

Please, get help for both of you. This is too intense and too dangerous to handle by yourself. You also want it on record that you have been seeking assistance so that if things get really ugly, she won't be able to say the drugs are yours.

I wish you the best. Please, keep us posted on how you--and your mother--are doing.

[nursel56]

[ConcernedHealthcare3;4011984]My question to you nurses, is how should I handle this? Am I putting my license at risk by not bringing this information forward, even though it is my own mother? Should I just let things take its course and sit back and wait for either my mother or one of her own patients to die?

My heart goes out to you! You do know what the right thing to do is. You're like on the end of the diving board. It is so hard to do this, I know. But you've got to do it. It sounds like she is already consuming near-lethal amounts of alcohol and drugs. You don't want your mom to stop breathing when you aren't there to watch over her. And just as you wouldn't want an intoxicated person driving a bus full of schoolkids, an impaired nurse is risking the lives of her patients. Even if she "seems fine" on her work days, she isn't fine.

You don't have to do this alone, as has been mentioned Al-Anon groups will help, and intervention plus inpatient stay.

I've got a question-- what is her hospital's drug screen policy? No random checks? That would certainly get her into a recovery prog. for nurses right away. It would be better if she does this voluntarily, though. Hoping for the very best outcome for you and your mother. :)

[SkiingCait, BSN, RN]

I don't really have any advice for you that hasn't already been mentioned, but I just wanted to let you know that I am thinking of you and your mom and hope you are able to get her the help she needs. Best of luck...