Impaired Nurses

Nurses Recovery

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I've just recently learned about a program for nurses that may need help with a drug or alcohol problem known as the impaired nurses. I was just wondering what your thoughts were on this subject. Should nurses that have a problem be allowed back into the work place after they have received help? What if they have a relapse?

Specializes in icu, er, transplant, case management, ps.
But what if a nurse was taking something like Percocet or Vicodin (prescribed by a physician) say for example back pain.......and if they couldn't take the meds while working, they might in a sense be 'impaired' because they are in pain....how would that work?

If a nurse takes a narcotic, while working, she/he is violating their NPA. One cannot work under the influence of a narcotic. You can't even drive while taking a narcotic. But there are people who drive, who work, and are not caught. But let's say a nurse takes a perocet at work and then makes a mistake that places her patient in a compromised position. Whose fault is it then? Can the nurse excuse her mistake by saying that the pain would interfere with her ability to function at work? And therefore she had to take the perocet in order to work.

Woody:balloons:

Specializes in icu, er, transplant, case management, ps.
All nurse and doctors should have routine testing done. Im all for it

But I only suggested that nurses be tested. Doctors would never agree. But of course, you know this don't you? Actually there are nurses and doctors who have to undergo routine testing in order to maintain their positions. And none of them are addicts.

Woody:balloons:

Specializes in ob high risk, labor and delivery, postp.
If a nurse takes a narcotic, while working, she/he is violating their NPA. One cannot work under the influence of a narcotic. You can't even drive while taking a narcotic. But there are people who drive, who work, and are not caught. But let's say a nurse takes a perocet at work and then makes a mistake that places her patient in a compromised position. Whose fault is it then? Can the nurse excuse her mistake by saying that the pain would interfere with her ability to function at work? And therefore she had to take the perocet in order to work.

Woody:balloons:

I can appreciate the thought here, however some states don't completely bar narcotics use in their NPA. Then what happens (at least when it is worker's compensation and the insurance companies are completely in charge) is that the doctors clear you to work..and you then have to either work or be fired. Right now they are trying to get me to the point where my back is not hurting but I am able to work. I'm up to 40mg of Kadian given twice a day right now. Its not controlling the pain and it makes me feel nauseated, achy, a little dizzy and extremely fatigued. Part of this could be also that I am unable to sleep through the night. Last night I slept from 12-2, then awake all morning until fell asleep again at 12 until 3, now still awake and gave up on sleeping for a little while. (Its depressing to lie in bed just trying to sleep but in a pain..especially when I feel soooo exhausted). My pain management doc feels that it is just taking a little longer than usual for me to be able to tolerate the medication. When I express my concerns with the idea of driving or working he brushes it off and says he has many pts on narcotics who are docs and nurses. I know that he will shortly clear me to work too. I've checked with my state board and they say it is up to me to decide whether I'm competant. My hospital says that they have no policies against it. My nurse manager says that if my doctor clears me to work she will assign me accordingly. I seem to be the only one who thinks that it is unreasonable...but I really do need the income so what exactly am I supposed to do? Right now I can't even go out of the room to get something and remember what I was looking for!! Anyway, I just keep hoping it will work out. I do think that the pain also made it difficult for me to concentrate and do my job. At this point, my pain has worsened to the point where I simply could not work with it. I have actually broken down and cried in patient rooms and while charting, I've had to call my family to drive me home because I was in so much pain that I could simply not do it on my own. Despite that, my previous doctor wanted to increase my hours and decrease my restrictions. He also couldn't understand why I didn't just take my Vicodin while at work. In fact, he acted like I was just malingering by not doing so since that meant my pain was unbearable after only a few hours of work. It would really help if the whole system was actually fair. If I do end up going back while I still am "impaired", I plan to make sure my argument is clearly on record (when I have read some of my old doctor and treatment records I am appalled at how inaccurate they are). I'll try to be assigned to nonpatient care but I doubt it. I will meet with our Nurse Executive and Human Resource Vice President (hopefully) and finally write to JCAHO and the Health Dept. I really don't want to have to do the final step and even moreso I don't want to have to involve the state board. I've written to them anonymously and their response was that they don't have a rule against it..but that if they have a complaint they will investigate. The thing is..I don't want to lose my license either..then the WC will probably make me work as a clerk or something with less salary. Its so extremely depressing and frustrating!

Let me explain a few things to you about patient education (this is not directly related to this thread but it is). How much a patient retains, how much their family and others want to help or impede them, it varies from person to person. A person may want to follow their diet, while a diabetic, and take their medications but for some reason, their spouse does not want to help them. One of the major problems I have with my peers is that they love to believe that everyone should learn everything when they teach them. And with this imparted wisdom, they should never blacken their doorway again. Tell me, did you learn everything that was taught to you the very first time? Or did it take several attempts before you grasp the principle? Some things I learned the very first time I was taught. But there were other things that took some more education. And I know my own I.Q. And it is above normal range. But if you based your assesment on spelling, I would be rated a dummie. I can't spell worth a darn.

Woody:balloons:

You don't need to explain anything about pt education to me. I think you have seen the Dx of diabetes in my post and took it personally. It was just an example. And once again , you have restated my point of why adicts are like any other pt. Not saying they don't need to take responsibility for the addiction and I'm not saying they are easy to care for,,, , just saying their may be reasons that they have become addicted in the first place. It doesn't mean they are week or stupid, just means for some reason they feel to get through life they need to hide the pain. Same as with any other pt I care for be it diabetes, crf, copd etc.....there by the grace of God go I. And another saying , never say never: for any disease. You mention your problems with diabetes and your family. Imagine living with an abusive spouse that uses meth in front of you when your trying to remain clean, or a teen that have mom and dad that drink in front of them when they just go a dui. It's the same thing. You say with what appears to be some frustration, that do I think pt's learn everything when we teach them, no....I don't and this goes for any disease entitiy including addiction. Of course I didn't learn everthing the first time... Which once again backs up my original post.

Specializes in icu, er, transplant, case management, ps.
I can appreciate the thought here, however some states don't completely bar narcotics use in their NPA. Then what happens (at least when it is worker's compensation and the insurance companies are completely in charge) is that the doctors clear you to work..and you then have to either work or be fired. Right now they are trying to get me to the point where my back is not hurting but I am able to work. I'm up to 40mg of Kadian given twice a day right now. Its not controlling the pain and it makes me feel nauseated, achy, a little dizzy and extremely fatigued. Part of this could be also that I am unable to sleep through the night. Last night I slept from 12-2, then awake all morning until fell asleep again at 12 until 3, now still awake and gave up on sleeping for a little while. (Its depressing to lie in bed just trying to sleep but in a pain..especially when I feel soooo exhausted). My pain management doc feels that it is just taking a little longer than usual for me to be able to tolerate the medication. When I express my concerns with the idea of driving or working he brushes it off and says he has many pts on narcotics who are docs and nurses. I know that he will shortly clear me to work too. I've checked with my state board and they say it is up to me to decide whether I'm competant. My hospital says that they have no policies against it. My nurse manager says that if my doctor clears me to work she will assign me accordingly. I seem to be the only one who thinks that it is unreasonable...but I really do need the income so what exactly am I supposed to do? Right now I can't even go out of the room to get something and remember what I was looking for!! Anyway, I just keep hoping it will work out. I do think that the pain also made it difficult for me to concentrate and do my job. At this point, my pain has worsened to the point where I simply could not work with it. I have actually broken down and cried in patient rooms and while charting, I've had to call my family to drive me home because I was in so much pain that I could simply not do it on my own. Despite that, my previous doctor wanted to increase my hours and decrease my restrictions. He also couldn't understand why I didn't just take my Vicodin while at work. In fact, he acted like I was just malingering by not doing so since that meant my pain was unbearable after only a few hours of work. It would really help if the whole system was actually fair. If I do end up going back while I still am "impaired", I plan to make sure my argument is clearly on record (when I have read some of my old doctor and treatment records I am appalled at how inaccurate they are). I'll try to be assigned to nonpatient care but I doubt it. I will meet with our Nurse Executive and Human Resource Vice President (hopefully) and finally write to JCAHO and the Health Dept. I really don't want to have to do the final step and even moreso I don't want to have to involve the state board. I've written to them anonymously and their response was that they don't have a rule against it..but that if they have a complaint they will investigate. The thing is..I don't want to lose my license either..then the WC will probably make me work as a clerk or something with less salary. Its so extremely depressing and frustrating!

Believe it or not, I understand where you are coming from. I spent ten years as a major case manager, for a private company, managing W.C. clients. And the last year, I worked in severe pain while battling with a W.C. insurance company, first trying to get authorization to be evaluated by a neurosurgeon, then trying to get authorization for surgery. I drove, in pain, over a thousand miles a week, seeing clients. I had pain medication available to me but I did not take it. I was driving. I was afraid that it might affect my reaction time. And my W.C. insurance company wasn't the least bit concerned.

If one works or drives and takes pain medication, regardless of who has told you you can, don't have a traffic accident. Don't hurt or harm a patient. You will find that the very people who told you it was all right, with suddenly not support you. And if you have a car accident, the cop who responses, will ask if you have taken anything. And if he suspects you have, either you submit to a blood test or you lose your drivers license.

I know that employers and insurance companies tend to speak out of both sides of their mouths. But it was my license. It was my livelihood. I could have taken the medication and driven but I chose not to. And, over the months, it became evident about how much pain I was in. I lost weight, I developed deep purple circles under my eyes. I had trouble walking and sitting. But since one doctor had released me, I had no choice. And the doctor's offices that I visited and even some of my clients, called my boss concerned.

We are caught between a rock and a hard place. But if we make the wrong decision, we cannot fall back on the excuse that we were told it was all right because we know it was not. The impaired nurses that I have worked with have accepted their responsibility for their own actions. None of them has ever blamed anyone but themselves. They have all worked hard to get their lives back. And I would trust anyone of them to take care of me or a family member.

Woody:balloons:

Specializes in ER, ICU, L&D, OR.
Yes, there are professions that do drug testing in the interest of public safety.

A very large number of professions actually

and it should be so

wont even mention world class athletes or other homerun hitting megastars

Specializes in ER, ICU, L&D, OR.
But I only suggested that nurses be tested. Doctors would never agree. But of course, you know this don't you? Actually there are nurses and doctors who have to undergo routine testing in order to maintain their positions. And none of them are addicts.

Woody:balloons:

Actually I believe doctors would agree nowadays

I believe all nurse should

Shuckins, even the PGA is going to and supporting Random Drug testing

Go Go PGA

Hello everyone... I loved this posting. I am an alcoholic nurse. I have a history of drug abuse, but alcohol is my drug of choice. I also participate in a peer assistance program. I have been sober for almost 6 months and my life is changing tremendously.

I wish that all nurses active in their addictions would step away from the profession until they embrace a program of recovery. Unfortunately, people that are addicted put their addictions before everything else - their careers, their families, and of course - their patient's safety. So people usually have to screw everything up pretty good to realize just how unmanageable their lives are.

It's sad that it took "hitting bottom" to realize just how bad I needed help. The denial process is so magical and attractive. It really is what kept me drinking for so long.

My bottom came when I found myself planning my own death. I was going to hang myself from the balcony with a sheet. As an addict, this is how I think. I would rather off myself than find a new way of life. Getting sober was the easy part, it's the "staying" sober that is so difficult. I am essentially charged with the task of changing everything I know, coming to terms with the fact that I'm not in control of everything, and allowing myself to "feel." For the normies, this might come a little easier - but for this addict - I spent my life trying to forget and erase certain feelings, now I get sodomized by them on a daily basis. And I only knew to reach for one thing to make me comfortable.

I am better nurse today than I have ever been. I think of others before I think of myself. I have more compassion in my big toe than I ever had when I was drinking or using. And I believe with all of my heart and soul that as a nurse in recovery, I can touch lives on a level I never dreamed possible.

To stay sober, I have to work with other addicts and alcoholics. Talking to them and working with them helps me keep my perspective on what I am. By not incorporating certain principles and actions into my daily routine, falling back into that magical denial becomes ominous.

It's hard. But it's a lot easier and requires a lot less time than what I put into my drinking. It's just not as comfortable.

I know addicts are frustrating - and nurses who can't take care of their recovery should not attempt to care for vulnerable patients. Don't hold them to a higher standard than the rest of the population, but KEEP THEM ACCOUNTABLE for what they do. If your managers are enabling addicted nurses, they are acting on their own set of problems.

The best thing that anyone could have ever done for me was let me go. To let me follow my addiction into the despair and grief that I was meant to experience, so that when I finally become enlightened I have that gift to share with another hopeless alcoholic/ addict.

Thank you all for sharing. I loved reading what you all had to say!

What's the difference between an alcoholic and an addict?

An alcoholic will steal your wallet but an addict will steal your wallet and help you look for it.

Specializes in L&D, High Risk OB, OR, Med-Surg, PHN.

nurseboudin, thanks for the wonderful discloser about your addiction. i am also a recovering addict and it is always a wonderful thing when someone is in recovery and realize their life is getting better c each new day. hopefully your story will help another nurse in active addiction guide them to get help or make them start thinking about what is going on. let us also hope that this will help other nurses that don't understand the disease of addiction that it is not just a choice you make, that is a disease that progresses from a maybe a choice of just having a drink or drug to a full blown addiction. :nono::nono: to other nurses don't condemn another nurse, you have not walked in his/her shoes and remember that i didn't wake up one day and say "i think that i will became a addict today". i could go on but tis the season to be kind to fellow man and to forgive.

merry christmas everyone.

:reindeer::xmas_smilies_daz:

lisa

Boudin and Presla, thank you for sharing your stories. One day at a time, my friends!

Tazzi

13 years 8 months 25 days

Specializes in geriatrics.

When I was younger, I had a run in with the law. I was 17 years old and just graduated High School. I hung out with the "cool crowd" and yes, marijuana was one of our past times. No, Not an every day thing.. I was by no means addicted. The days that me and my friends did it it was usually a weekend, and it was something that we thought was fun to do. When I didn't have it, I didn't go on a search, however there were weekends that my friends and I would get together and look for it as that is what we wanted to do. Well, weekend of HS graduation.. I was moving to another state in 2 weeks.. my friends took me to bush gardens and we were caught smoking it.. (yes very stupid, but happened nonetheless).

So, I was ordered to do some community service, had a substance abuse evaluation, and my drivers license was suspended for 6 months. After all that was done, they stated "your record will be expunged and sealed as a minor record". Fast forward 4 years and I just graduate nursing school, go on an interview and turn in my consent to a background check. The background check comes back and the DON who was interviewing said "It shows here that you had a posession of marijuana charge". I explained everything, exactly as above.. and this is what the DON said "I understand that you probably feel like I'm going to let that effect my decision, but I want you to know that this is something I know was a mistake. I can see that you have learned from it and Its not my place to do that. You have done the things necessary to come this far, the BON did not set any restrictions on your license.. you will be a damn good nurse" So, I am so thankful that this lady and the BON for that matter, didn't judge me. They could have easily realized that if it happens once it could happen again.. however Anyone can make a mistake at anytime. Never judge. Regardless, we're not talking heroine or crack or prescription drugs that are relentlessly addicting.. but the point was made.

I just turned 21 and so sure i drink on the weekends.. not all of them but when I go out with friends I drink. Some people think that nurses shouldn't drink at all, smoke at all, or even say obsceneties. We are not saints, however. I am human too. I wouldn't drink on a night before I have to work the next day, thats just me.. but im sure some do. Its when it starts to intefere with patient care that it becomes my business... and I would expect the same from anyone else.

Specializes in Operating Room Nursing.

[i've just recently learned about a program for nurses that may need help with a drug or alcohol problem known as the impaired nurses. I was just wondering what your thoughts were on this subject. Should nurses that have a problem be allowed back into the work place after they have received help? What if they have a relapse?]

Yes i do believe nurses who have done the right thing by taking responsibility for their addiction should be allowed back into the workplace.

And i do believe in monitoring nurses who have had an addiction. IMHO the HCF would be irresponsible by not monitoring nurses with a known addiction as it may compromise patient safety.

For nurses who have stolen narcotics from the HCF etc i agree with teeituptom that they should always be monitored.

As for other drug and alcohol addictions where the nurse hasn't stolen drugs from the HCF i don't believe they should be monitored for the rest of their careers.

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