I think I just ended someone's career

klone, MSN, RN · Nov 12, 2010

I don't think people on this forum would have been as harsh on Asytole RN if she hadn't defended the people who tormented the nurse with the addiction. Saying that they are 'good people' is just mind boggling. They should be disciplined very harshly over this incident. The scenario makes me feel ill thinking about it.

I read it a little differently. I read "These are good people" as though she was experiencing some cognitive dissonance. Kind of like "Holy $&*^, these are good people that I've know a long time! How could they have done this?"

OCNRN63, RN · Nov 12, 2010

I'll bite :-)
my thoughts are that the nurse with the addiction should be treated the same as anyone else who needs help to overcome an addiction. Support should be available to help them overcome their habit so they can move on from it and go back into the workforce. However they should still be held legally accountable for diverting drugs and be held professionally accountable for putting their patients at risk.
With your analogy of the police officer how would you feel in this scenario if the police officers behaved the same as the nurses towards the drunk driver. Threw stuff at the drunk while they lay there helpless? I'll admit that I find it hard to care about it but if you choose to be in a profession like nursing or the police there professional codes of conduct you are expected to follow like treating people with dignity and respect.

Excellent comparison.

moonmaid50 · Nov 12, 2010

Actually, the taunting by staff is more than criminal - it is unethical behavior which should be disciplined by the State Board of Nursing.
ANA Code of Ethics 3.6 Addressing impaired practice specifically states: "Nurses must be vigilant to protect the patient, the public, and the profession from potential harm when a colleague's practice, in any setting, appears to be impaired. The nurse extends compassion and caring to colleagues who are in recovery from illness or when illness interferes with job performance".
Having spent the last 8 years advocating for nurses with substance use disorders, as well as writing and presentingh on the subject nationally, I am outraged by the behavior of the staff who were in attendance. There is excellent resource information on this issue available at www.unbecominganurse.org as well as www.aana.com and many State Board of Nursing sites.
I can unequivocally state that if this nurse enrolls in the nurse monitoring program in her state, follows their requirements and is granted the privilege to be monitored in practice in a stable recovery in the future that I would be absolutely delighted to have her take care of me or my loved ones because in my professional experience nurses in monitoring are not only better nurses than they ever were, they often surpass their colleagues in compassion, reliability, diligence and persistence. Paula Davies Scimeca, RN, MS

Well said my friend.

OttawaRPN · Nov 12, 2010

I'll bite :-)
my thoughts are that the nurse with the addiction should be treated the same as anyone else who needs help to overcome an addiction. Support should be available to help them overcome their habit so they can move on from it and go back into the workforce. However they should still be held legally accountable for diverting drugs and be held professionally accountable for putting their patients at risk.
With your analogy of the police officer how would you feel in this scenario if the police officers behaved the same as the nurses towards the drunk driver. Threw stuff at the drunk while they lay there helpless? I'll admit that I find it hard to care about it but if you choose to be in a profession like nursing or the police there professional codes of conduct you are expected to follow like treating people with dignity and respect.

Okay, but let's take the fact that she was antagonized by her peers out of the equation. I'm looking at her behaviour, and her colleagues' behaviour as two separate entities. I think we can all agree the co-workers acted out of line, but there seems to be a downward shift from the "I support the nurse" camp that the co-workers' behaviour is far worse than the implication that this nurse showed up for work intoxicated. It seems that the discussion has deviated from what I perceive as the real predicament that, irregardless how her peers treated her, she knowingly put her patients at risk. Yes, drug addiction is a disease, we all get that, as is alcoholism. She needs help, no doubt about it.

So all things being equal, would she get as much support, empathy and understanding as the man behind the wheel who chose to drive drunk?

OttawaRPN · Nov 12, 2010

I read it a little differently. I read "These are good people" as though she was experiencing some cognitive dissonance. Kind of like "Holy $&*^, these are good people that I've know a long time! How could they have done this?"

And I read it even more differently. That she feels she knows these coworkers well and under most circumstances they are good people, but were acting out of character during this one particular incident.

GHGoonette, BSN, RN · Nov 12, 2010

Okay, but let's take the fact that she was antagonized by her peers out of the equation. I'm looking at her behaviour, and her colleagues' behaviour as two separate entities. I think we can all agree the co-workers acted out of line, but there seems to be a downward shift from the "I support the nurse" camp that the co-workers' behaviour is far worse than the implication that this nurse showed up for work intoxicated. It seems that the discussion has deviated from what I perceive as the real predicament that, irregardless how her peers treated her, she knowingly put her patients at risk. Yes, drug addiction is a disease, we all get that, as is alcoholism. She needs help, no doubt about it.
So all things being equal, would she get as much support, empathy and understanding as the man behind the wheel who chose to drive drunk?

I'll take you to mean an alcoholic person who gets behind the wheel of a car while under the influence, as opposed to a partygoer who just couldn't be bothered to arrange alternative transport home.

Both have acted with criminal irresponsibility. In both cases innocent people are put at risk. And if this nurse drove herself to work while she was high, it would be just as bad as if she was drunk. Neither are capable of thinking rationally, neither have intact judgment. Substance abuse destroys minds.

This argument can be carried further; how about a crystal meth addict who murders someone to get a few bucks to feed his habit? Or, the old lady dependent on analgesics for her chronic headaches but can't afford them on her pension anymore, so she shoplifts them?

All have committed crimes in varying degrees; none of these crimes can be condoned. Yet in all of these cases, if they seek help, that help should be available! Even for the crystal meth addict. Maybe all he or she really ever wanted in life was a job, a loving SO, a couple of kids, a house in the suburbs and a friendly dog to come home to; taking the wrong turn in life is terrifyingly easy to do....

MaritesaRN · Nov 12, 2010

Long story short, I had to report a registery LPN who was seen crushing, cutting, snorting, and then rubbing the residual powder on her gums by nearly an entire med floor. Most of her narc cards are missing several pills each. She was so intoxicated she could not stand at the cart and nearly fell over several times. She was escorted out and made the statement that she was already being investigated and was about to finish RN school. While waiting for the bosses to arrive some of the staff made it a game to shoot staples at her face and throw cups and tape at her, she was so impaired she didn't notice and just continued to look around the room we had her sit in. Her eyes were half closed and she would constantly fall asleep, while talking in a very slow and slurred speach! She couldn't even dial her phone to call her husband, someone had to dial for her...made we want to cry. I have never seen someone so completely intoxicated.
I feel bad that this nurse's promising career was cut short, I feel worse about her patients.
Sad day for nursing.

Sad day indeed ! But what saddens me even more are those employees throwing staples and cups in her face. These are adults? More shame in their part ....they are sober and picking on an intoxicated , helpless person . this person obviously needs help ........but the ones throwing things at here is very shameful ! :eek: :devil:

OttawaRPN · Nov 12, 2010

I'll take you to mean an alcoholic person who gets behind the wheel of a car while under the influence, as opposed to a partygoer who just couldn't be bothered to arrange alternative transport home.
Both have acted with criminal irresponsibility. In both cases innocent people are put at risk. And if this nurse drove herself to work while she was high, it would be just as bad as if she was drunk. Neither are capable of thinking rationally, neither have intact judgment. Substance abuse destroys minds.
This argument can be carried further; how about a crystal meth addict who murders someone to get a few bucks to feed his habit? Or, the old lady dependent on analgesics for her chronic headaches but can't afford them on her pension anymore, so she shoplifts them?
All have committed crimes in varying degrees; none of these crimes can be condoned. Yet in all of these cases, if they seek help, that help should be available! Even for the crystal meth addict. Maybe all he or she really ever wanted in life was a job, a loving SO, a couple of kids, a house in the suburbs and a friendly dog to come home to; taking the wrong turn in life is terrifyingly easy to do....

But would there be as much forgiveness for the drunk driver as for the nurse? We are quick to ostracize an impaired driver no matter the circumstances involved. You never hear people say "oh poor guy, he clearly needs help, we shouldn't blame him, remember he has a disease" as has been shown to the nurse in the original scenario.

Meanwhile he risks all who happen to cross his path, as did the nurse. But why the double standard?

foraneman · Nov 12, 2010

The comments on the thread run the spectrum of what is expected whenever addiction is discussed amongst the lay public. Unfortunately there is often little difference in the discussion when it takes place amongst health care professionals, despite their having some expectation of understanding the disease concept of addiction to a greater degree. To those who note that the nurse "chose" to work under the influence of a mood altering substance: When an individual has gotten to the point that they divert and abuse medications while at work, they are not trying to get high. They have long passed the point of deriving pleasure from the drugs they abuse. They now use the drug in order to be able to function at the most basic level without becoming debilitatingly ill. They fight to feel 'normal' every minute of the day and to avoid the withdrawal which would leave them unable to fix their own breakfast. They are frightened, hopeless and irrational. They are hanging on by a thread and see NO choices in front of them. This nurse was in such a place and worse. It is obvious from her behavior that she simply did not care whether she was caught, lived, or died. No one can reconcile her snorting a pill she crushed in front of a multitude of witnesses with the ability to make any sort of rational 'choice'.

But I am not defending the nurse. She joins the ranks of tens of thousands of your colleagues who develop a substance use disorder and require treatment. Her road will be no bed of roses. More so if she desires to ever return to her profession. I dare say that those amongst you advocating the involvement of law enforcement and a trip to prison shirk your responsibilities as a health care professional. I submit that you first must answer the question "Is the disease of addiction present?. Is it acute? Does it require immediate medical treatment?" If the answer is yes all around then the first priority is to ensure the patient gets the immediate medical care they require.

You can then mull over exactly what part of the disease of addiction is treated by being arrested and put in jail. The 'no special treatment' argument FAILS and is not open to you as a health care provider. NO ONE should be jailed for addiction. The fact that they are is a direct indictment of the medical communities failure to develop and implement successful prevention and treatment for the disease...PERIOD. Or else it is NOT a disease. Those are the only choices.

This episode was NOT the first indication the staff had that their colleague was in trouble. For whatever reason, they chose to ignore the signs. The fact that they could treat her so inhumanely in the end leads me to beleive that they either did not work with her often, or they disliked her as a rule. I can't imagine a more pathetic and heart wrenching site than a co-worker seen in her condition. The last thing I would think about doing to a colleague I cared the least about (even one i hated frankly) that was in her condition is the horrendous activities that came to their minds.

The LPN should never have been sent home...much less by the cab they first tried to utilize. She should have been sent to the ER. If she refused, call the police to facilitate her transport. This is a drug overdose...are you MAD?? She is at very high risk for suicide on she leaves the facility. She will be very ill and in withdrawals withing 12 hours and depending on what she has been abusing these can be life threatening.

Her colleagues committed a crime, namely battery. Depending on the jurisdiction, there may be a added condition of battery to an incapacitated person which could be a felony. They can all easily have their license revoked by the state board of nursing for their behavior...in a heart beat. 'The bosses' are equally deserving of disdain. They 'knew' what was going on since they were given a rendition of events which included the battery as a determinant of level of consciousness. Disgusting.

Hang onto your hats. If I were the nurse and I came across this thread I would march down to my friendly plaintiff's attorney and file suit against my former employer and co-workers. This thread would be exhibit A.

Scrubby · Nov 12, 2010

The comments on the thread run the spectrum of what is expected whenever addiction is discussed amongst the lay public. Unfortunately there is often little difference in the discussion when it takes place amongst health care professionals, despite their having some expectation of understanding the disease concept of addiction to a greater degree. To those who note that the nurse "chose" to work under the influence of a mood altering substance: When an individual has gotten to the point that they divert and abuse medications while at work, they are not trying to get high. They have long passed the point of deriving pleasure from the drugs they abuse. They now use the drug in order to be able to function at the most basic level without becoming debilitatingly ill. They fight to feel 'normal' every minute of the day and to avoid the withdrawal which would leave them unable to fix their own breakfast. They are frightened, hopeless and irrational. They are hanging on by a thread and see NO choices in front of them. This nurse was in such a place and worse. It is obvious from her behavior that she simply did not care whether she was caught, lived, or died. No one can reconcile her snorting a pill she crushed in front of a multitude of witnesses with the ability to make any sort of rational 'choice'. But I am not defending the nurse. She joins the ranks of tens of thousands of your colleagues who develop a substance use disorder and require treatment. Her road will be no bed of roses. More so if she desires to ever return to her profession. I dare say that those amongst you advocating the involvement of law enforcement and a trip to prison shirk your responsibilities as a health care professional. I submit that you first must answer the question "Is the disease of addiction present?. Is it acute? Does it require immediate medical treatment?" If the answer is yes all around then the first priority is to ensure the patient gets the immediate medical care they require. You can then mull over exactly what part of the disease of addiction is treated by being arrested and put in jail. The 'no special treatment' argument FAILS and is not open to you as a health care provider. NO ONE should be jailed for addiction. The fact that they are is a direct indictment of the medical communities failure to develop and implement successful prevention and treatment for the disease...PERIOD. Or else it is NOT a disease. those are the only choices. This episode was NOT the first indication the staff had that their colleague was in trouble. For whatever reason, they chose to ignore the signs. The fact that they could treat her so inhumanely in the end leads me to beleive that they either did not work with her often, or they disliked her as a rule. I can't imagine a more pathetic and heart wrenching site than a co-worker seen in her condition. The last thing I would think about doing to a colleague I cared the least about (even one i hated frankly) that was in her condition is the horrendous activities that came to their minds. The LPN should never have been sent home...much less by the cab they first tried to utilize. She should have been sent to the ER. If she refused, call the police to facilitate her transport. This is a drug overdose...are you MAD?? She is at very high risk for suicide on she leaves the facility. She will be very ill and in withdrawals withing 12 hours and depending on what she has been abusing these can be life threatening. Her colleagues committed a crime, namely battery. Depending on the jurisdiction, there may be a added condition of battery to an incapacitated person which could be a felony. They can all easily have their license revoked by the state board of nursing for their behavior...in a heart beat. 'The bosses' are equally deserving of disdain. they 'knew' what was going on since they were given a rendition of events which included the battery as a determinant of level of consciousness. Disgusting. Hang onto your hats. If I were the nurse and I came across this thread I would march down to my friendly plaintiff's attorney and file suit against my former employer and co-workers. This thread would be exhibit A.

I agree with pretty much everything you said. I don't believe anyone should be jailed for having an addiction in itself but they should still be held legally accountable for any crimes they commit while under the influence.

MaritesaRN · Nov 12, 2010

The comments on the thread run the spectrum of what is expected whenever addiction is discussed amongst the lay public. Unfortunately there is often little difference in the discussion when it takes place amongst health care professionals, despite their having some expectation of understanding the disease concept of addiction to a greater degree. To those who note that the nurse "chose" to work under the influence of a mood altering substance: When an individual has gotten to the point that they divert and abuse medications while at work, they are not trying to get high. They have long passed the point of deriving pleasure from the drugs they abuse. They now use the drug in order to be able to function at the most basic level without becoming debilitatingly ill. They fight to feel 'normal' every minute of the day and to avoid the withdrawal which would leave them unable to fix their own breakfast. They are frightened, hopeless and irrational. They are hanging on by a thread and see NO choices in front of them. This nurse was in such a place and worse. It is obvious from her behavior that she simply did not care whether she was caught, lived, or died. No one can reconcile her snorting a pill she crushed in front of a multitude of witnesses with the ability to make any sort of rational 'choice'.
But I am not defending the nurse. She joins the ranks of tens of thousands of your colleagues who develop a substance use disorder and require treatment. Her road will be no bed of roses. More so if she desires to ever return to her profession. I dare say that those amongst you advocating the involvement of law enforcement and a trip to prison shirk your responsibilities as a health care professional. I submit that you first must answer the question "Is the disease of addiction present?. Is it acute? Does it require immediate medical treatment?" If the answer is yes all around then the first priority is to ensure the patient gets the immediate medical care they require.
You can then mull over exactly what part of the disease of addiction is treated by being arrested and put in jail. The 'no special treatment' argument FAILS and is not open to you as a health care provider. NO ONE should be jailed for addiction. The fact that they are is a direct indictment of the medical communities failure to develop and implement successful prevention and treatment for the disease...PERIOD. Or else it is NOT a disease. Those are the only choices.
This episode was NOT the first indication the staff had that their colleague was in trouble. For whatever reason, they chose to ignore the signs. The fact that they could treat her so inhumanely in the end leads me to beleive that they either did not work with her often, or they disliked her as a rule. I can't imagine a more pathetic and heart wrenching site than a co-worker seen in her condition. The last thing I would think about doing to a colleague I cared the least about (even one i hated frankly) that was in her condition is the horrendous activities that came to their minds.
The LPN should never have been sent home...much less by the cab they first tried to utilize. She should have been sent to the ER. If she refused, call the police to facilitate her transport. This is a drug overdose...are you MAD?? She is at very high risk for suicide on she leaves the facility. She will be very ill and in withdrawals withing 12 hours and depending on what she has been abusing these can be life threatening.
Her colleagues committed a crime, namely battery. Depending on the jurisdiction, there may be a added condition of battery to an incapacitated person which could be a felony. They can all easily have their license revoked by the state board of nursing for their behavior...in a heart beat. 'The bosses' are equally deserving of disdain. They 'knew' what was going on since they were given a rendition of events which included the battery as a determinant of level of consciousness. Disgusting.
Hang onto your hats. If I were the nurse and I came across this thread I would march down to my friendly plaintiff's attorney and file suit against my former employer and co-workers. This thread would be exhibit A.

Wow , well said !!!!! It covered a lot of areas that are extremel;y important . The legality , the principle, the intervention process , etc. It looks to me that this place of work is poorly trained in a lot of things.....sadly, they work in a place of which is mainly involved in the intervention process, and they could not even do a proper intervention of their own nurse that needed help . What place is this? Possibly will not stay open for long , considering their ignorance of the issues involved above. :confused:

Altra, BSN, RN · Nov 12, 2010

OP - any update on this situation?