I think I just ended someone's career

Nurses General Nursing

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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.

:sniff:

Specializes in Impaired Nurse Advocate, CRNA, ER,.

If the cause of a disease is not treated, treating the symptoms only allows the disease to progress.

Illegal, antisocial behaviors are symptoms of the disease of chemical dependence. Putting someone in jail without also treating the disease is only treating the symptoms. As any recovering individual knows, abstinence is not the same as recovery. Forced abstinence through incarceration not only does nothing to treat the disease, it allows the disease to progress unabated. It's no surprise that someone out of jail returns to drug use within a very short period of time.

Here's the thing I find so frustrating. Despite numerous offers to provide "free" educational presentations to numerous nursing programs within a 100 mile radius of my home, only ONE program has accepted the offer. It's obvious to anyone who deals with nurses struggling with this disease that the profession has not educated the students in their programs adequately. Ignorance is NOT bliss! Intentional ignorance is unethical, unprofessional, and inhumane.

I firmly believe that the nursing profession is the key to changing the nation's attitude about chemical dependence. If nurses "don't get it" when it comes to this disease, how can we expect Joe American to get it?

If not us, who? If not now, when?

This question is for anybody. I understand the resentment people feel when it comes to drugs and alcohol. We are all brought up differently, raised with different beliefs. However, there is no room for that if your a healthcare professional.

I remember during my sophomore year of college we did a clinical on a norm post partum nursery. I was assigned to a border baby. His mom was on drugs when she delivered him. " border babies" as they referred to them were always in need of extra holding so they could bond. I held him all night. We( my clinical group) left the floor for a 15 min break. When we came back to the unit some woman I didn't recognize, was holding him. It was his mother, she was allowed supervised feeding. my instructor saw the anger on my face mixed with several different emotions and said " welcome to the world of objectivity". During our post clinical meeting she used it as a teaching example. She said " if you received a woman who had been physically attacked by her husband and several minutes and he needs medical treatment you have provide the same treatment for him, you can't be a nurse. Of course she was right!!

CAT

Specializes in PACU, OR.
I do see your point and understand the whole premise behind culpability and responsibility, but I suppose the point I was trying to make is that much compassion has been shown to this nurse in her near-miss situation that I doubt would have been shown to another addict in a similar situation but different context ie) drunk driver.

Her situation was fortunately only a near-miss, it could have panned out much worse. By the same analogy the drunk driver's near miss could have been being pulled over before he had the opportunity to run someone over. When we read in the news "drunk driver clocked going 120/km in 60/km zone" nobody is going to feel sympathy for the guy, give him a hug and pat on the shoulder, instead likely public outrage that he dare do such a thing and knowingly get behind the wheel drunk endangering innocent lives, yadda yadda; however this lynch mob mentality is the polar opposite of what has been shown to the addict nurse. That, in a nutshell, was really the point I was trying to make.

I realise what you're asking, and the simplest answer is, she's a nurse, she's one of us. If we can't feel compassion for one of our own, who can we feel compassion for?

As regards drunk drivers, I feel little sympathy for the irresponsible individual who goes out partying and can't be bothered to arrange a taxi home, or for someone to pick him up afterwards. Such behaviour is not only criminal, it is deeply selfish and stupid. If such people are stopped at roadblocks and are jailed they have no-one but themselves to blame. In the case of the alcoholic driver, the nature of his addiction is such that he has passed the point of rational thinking, and deserves pity as much as any other chronic disease sufferer. Sadly, while drug abusers may be recognized as such when they are arrested, and consequently may be sent by the court to a rehab facility, the alcoholic is frequently not identified.

However, any person who is responsible for taking an innocent life while driving under the influence does have my pity and compassion; unless he or she is a heartless, conscienceless monster, the horror and guilt will remain with them for the rest of their lives.

Specializes in addiction nurse.

Right-on, JackStem! Education is definitely the way to go; although many refuse it, some will take it. After the book "Unbecoming A Nurse" was printed, I offered free, complimentary copies to every State Board of Nursing and state monitoring program. About half were happy to receive a copy, which was shipped at my own expense. As I had earmarked several hundred copies for this purpose, it was offered to healthcare systems and schools of nursing, many of whom not only accepted, but embraced the information. Paula Davies Scimeca, RN, MS

Specializes in acute care med/surg, LTC, orthopedics.
Actually it was pretty much the exact mentality which was shown to this nurse.

Not. Go back and read some of the posts, especially near the beginning of the thread. Supportive posts galore.

But I do understand what you are trying to say....though when it comes down to it, what point is there to be made here?

The point is, a double standard does exist which can probably be explained by Goonette's "she's a nurse, she's one of us" comment; it's likely the best reasonable explanation.

The throwing happened while I was being debriefed. The bosses knew, it was used by some to describe the level of impairement to them. I think the bosses were more concerned of what to do with the nurse, couldn't let her drive home yet couldn't restrain her. Eventually she called her husband (numbers dialed for her) as described after refusing a cab.

Not sure why you are including me in this, the bullying occured while I was in another floor of the facility and only (as far as I know) maybe 2 people participated, don't know if anyone else even witnessed since again, I was on another floor at the time.

I took the action that I am legally allowed to and what my facility policy states. In my state it is illegal and considered unprofessional by the BON for me to remove illegal narcotics, restrain her, or give her medical care she does not wish to recieve. I can observe and I can report, thats about it.

I admit I failed her and her patients by not seeing the signs earlier. I failed to jump up and slap the drugs out of her hand. I flinched.

I was not there to witness the incident, it is in the realm of the managers to deal with. My authority is fairly limited on issues like and it was after I had been relieved by the oncoming supervisor anyways but I will make sure to investigate it more.

I would not say it is ok or forgivable, I am not up in arms at the moment since it was infact hearsay and the investigation as to what happened by who and when is still going on. I am sure they will get their dues, my facility tends to be very good about that kind of stuff. Don't get away with too many things...come Monday there will be hell to pay I am sure.

A debriefing is a combination of my official statement and answering the questions of my managers. This was being done off the floor in an office as you can imagine.

The specific incident of the staples, which was a single incident amongst a larger event, took place during my debriefing. I heard about the incident third person so it qualifies as hearsay.

Clarify things?

Thanks for your time, Asystole RN.:redbeathe No, it doesn't clarify anything, really. :confused: I may be kind of slow but it sounds like a bunch of official hooey. And yes, I can only imagine the office meeting! You yourself came on the board saying it was cups, tape and staples being thrown at your coworker, and then you downplay it at every opportunity. Are you a nurse? (I'm also curious because of your spelling of the words, 'speach' and 'registery'.) Or an office supervisor of nurses? Or both? I'm just having a hard time believing any nurse feels they have that much power in their hands, to end someone's career, and then cares so much that they start a thread about it in the present and first person tense without regards to privacy issues. Then again supervisors can do what they want without a nurse's union! I mean, really! :twocents:

OP - any update on this situation?

:yawn:

Specializes in addiction nurse.

With all due respect to Wondern, the fact is that the most frequently cited difficulty for nurses in making the decision to report a colleague related to alcohol or another drug is that they will be ending the nurse's career. To quote a nurse interviewed for the book From Unbecoming A Nurse to Overcoming Addiction, "When we had a nurse at work who got caught diverting medication from another floor awhile back, I felt so bad for her; yet I honestly don't know if I would be able to turn someone in." p.284.

Again, it goes back to something Jackstem brought up - the need for more education. Nurses must be educated that the earliest recognition of a problem, followed swiftly by report per protocol, safeguards the life of the nurse as well as the patients AND it is mandated by our code of ethics. Paula Davies Scimeca, RN, MS

No disrespect taken. While it may be difficult you have to do it. I have no argument there, Paula, at all! The way you do it with compassion or assault is an entirely different matter, however.

With all due respect to the OP if you're going to start a controversial thread including assaulting a fellow nurse it's only courteous to follow up on it periodically. :redpinkhe

Specializes in CRNA, Law, Peer Assistance, EMS.
Not. Go back and read some of the posts, especially near the beginning of the thread. Supportive posts galore.

The point is, a double standard does exist which can probably be explained by Goonette's "she's a nurse, she's one of us" comment; it's likely the best reasonable explanation.

I was not aware that you were referring specifically and only to comments made in this thread to the exclusion of the treatment the nurse ACTUALLY received from her coworkers. Her treatment at work, and a healthy number of comments here, reflect that lynch mod mentality.

I WAS very clear on the highlighting of a double standard...but my question still remains...what is the large point to be made? Say we all agree there is a double standard. By definition double standards are inequitable and unfair...but WHO is being treated unfairly and what is the solution? Is placing nurses in jail a constructive answer?

Specializes in Emergency Department, House Supervisor.
I wouldn't worry about her "promising" career. If anything, maybe this will be the impetus she needs to seek and accept help. Maybe you saved her.

On February 11, 2005, I arrived to work severely impaired on my own medications...way too many...way too impaired. In my heart of hearts I will FOREVER be grateful to the charge nurse who had the guts to say, oh so kindly..."Honey, I can't let you work like that." He saved me. He very likely saved some of my patients from God only knows what perils. He saved the people who had been sharing the road with me as a fellow driver.

Finally, I DID have the opportunity to use the time off to get my Master's degree in addiction, and am now half-way through my PhD in same.

Sadly, I can't even remember his name today, so I can't thank him personally.

But please know that whether you ended this nurse's career or spurred her on to greater things...YOU protected other people...the people our code of ethics mandates that we protect...our patients.

SyckRN:redbeathe

Specializes in Impaired Nurse Advocate, CRNA, ER,.
Again, it goes back to something Jackstem brought up - the need for more education. Nurses must be educated that the earliest recognition of a problem, followed swiftly by report per protocol, safeguards the life of the nurse as well as the patients AND it is mandated by our code of ethics. Paula Davies Scimeca, RN, MS

Exactly, Paula. We don't wait until someone has a fever of 104 with no urine output, hypotension and tachycardia before starting antibiotics. Likewise, waiting to intervene on anyone with a chronic, progressive, potentially fatal disease until the signs and symptoms are so obvious even a 3 year old would recognize them would be met with anger, disgust, and charges of incompetence or even malpractice. Yet this is how we approach this disease. In my own case, several of my colleagues told me they thought I might have cancer or HIV due to my dramatic weight loss and other signs. They told me this after an accidental overdose and I had entered treatment. They knew something was seriously wrong yet said or did nothing. If not for my 4 year telling Mommy, "Daddy is a funny color", I wouldn't be here today. Pretty amazing and very disturbing. Of this were an isolated occurrence it would be excusable. But this happens over and over and over...many times with fatal outcomes.

Entirely unacceptable, unprofessional, and unethical. But hey...they're addicts...they deserve whatever happens to them, right?

NOT!!!

Jack

Specializes in Emergency Department, House Supervisor.

Thanks again Jack for a positive contribution!

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