My CRNA friends do illegal drugs

[DrugReptoNurse]

Two of my friends who are CRNA's take recreational ecstasy almost every weekend. They will take it on Saturday night...stay up all night....and then try to sleep it off on Sunday. When Monday morning comes around they go to their contract per diem positions and perform anesthesia mostly in private practice plastic surgery clinics.

I am worried that one day they may provide anestheisa while the ecstasy is still running through their systems.

A couple of questions for those of you who are currently CRNAs.

1. How do you approach a CRNA and tell them you are worried they might harm a patient while under the influence.

2. What else would you do to make sure they don't harm anybody? Should I contact the state board or should I mind my own business? For the record I am just a nursing student.

They have both been practicing for 8 years and have never had any problems in the past. I just know I wouldn't want to be patient under their care.

[kaeri]

i believe you should not report them. it may be that the substance is illegal - but so is under-age drinking/drink-driving/homosexuality/ smoking pot etc.they are not using mdma the night prior to their shift.

dont meddle - the chance of them making a mistake is less than the person who was on an alcohol soaked bender until 1 am monday morning. or smoked pot last evening. marijuana has a much longer half-life and 1 joint/bong can stay in the adipose tissue for 48-72hrs. i've seen +ve results 6 - 8 weeks after last joint.

why do you think they would make a mistake? because they are sleep-deprived? because they have a small amount of stimulant in their blood stream? because they are doing something illegal?

i think your reasoning is specious and you may need to look at why you have the urge to report someone. we seem to have become a society of do-gooders where we need to be recognised for how many negative behaviours we can report to the authorities. perhaps the status of fear which our govts have induced us to live in has heightened our need for reassurance from a paternalistic figure-head. like in grade 1 when your teacher thanks you for reporting britney for chewing gum and later gives you a lollypop when you report kevin for writing on his arm. "miss, i was worried that he might get ink poisoning." "yes, thank you goody, we need to watch those 2 - they will be a bad influence and they will make many mistakes. here's a lollypop for you and you be my eyes and ears."

cheers

kaeri

[kaeri]

There is one thing that I can say for sure, I wouldn't want someone with a drug habbit to anesthitize one of my loved ones.

PS: This use is not a drug habit. It is what is termed recreational.

Would you be saying that a person who takes anti-depressants daily and has formed an addiction, in that sudden cessation would precipitate physical and mental discomfort, should not be in a position of responsibility?

and to the ex fentanyl addict: because they use MDMA it follows they will steal meds??? Perhaps you did, perhaps you have seen others do it, but it doesnt mean everyone who has an illegal weekend activity will undertake illegal activity at work. etc etc.

cheers

kaeri

[MedSurgMale]

The facility where I work has a policy of random urine testing. Therefore, it's not worth the risk to jeopardize my nursing license/employment. I believe people can drink alcohol responsibly and in moderation, and I assume use other substances, legal or illegal, in the same manner and not be under the influence at work at a later time. This implies an understanding of how you are affected by a drug, risk of long-term effects and potential problems. Perhaps you can party all Saturday night, sleep it off on Sunday, and feel fine, alert and focused Monday morning. I would not report or confront anyone unless they appeared to be impaired at work.

[BSNin2007]

PS: This use is not a drug habit. It is what is termed recreational.

Would you be saying that a person who takes anti-depressants daily and has formed an addiction, in that sudden cessation would precipitate physical and mental discomfort, should not be in a position of responsibility?

and to the ex fentanyl addict: because they use MDMA it follows they will steal meds??? Perhaps you did, perhaps you have seen others do it, but it doesnt mean everyone who has an illegal weekend activity will undertake illegal activity at work. etc etc.

cheers

kaeri[/quote

Perhaps you misunderstood me, I did not imply these people have an addiction, but certainly something someone does on a weekly basis can be considered ritualistic and therefore a "habbit.' Semantics aside when your child, mother, husband needs to be anesthetized you can call the people who had used mind altering, unregulated drugs the weekend before, I choose not to.

[bonn2424]

drugreptonurse,

by you writting this passage means that you at least wanted to the the right thing, and i believe that you really know what that is. I f you dont report the matter to the bon it should be reported to someone who has some type of influence over them, (maybe their reporting Physician/anesthesiologist, or an office co-worker, or even anonymously) not to get them fired but to get them HELP. THIS IS AN ILLEGAL SUBSTANCE, COCAINE IS STILL COCAINE. If something happens as a result of this then why shouldnt you be held partly responsible. If these people valued the 8 years of struggling to get to the position that they are in they would not jeaprodize their career for an illegal fix. If they would use this judgement outside of work why wouldnt they eventually bring it to the workplace? I mean, I really hate it and would not like to be in your position, but bad judgement is just bad judgement outside the workplace or in. I believe that if one can make a judgement to use illegal substances against nursing policy, that same one would lie to protect themselves or their job. We as students, nurses, friends etc. should not cover for this type of behavior, IT ITS WRONG! and covering it up makes us just as wrong. I will not apologize for telling the truth! GOD still rules!

[pickledpepperRN]

this has been an interesting thread.

my name is jack, and i'm a recovering fentanyl/sufentanil addict. i became addicted in the early 90's when i was dealing with spondylolisthesis and increasinglt severe chronic pain. i eventually had a spinal fusion which significantly relieved the pain.

i am the peer assistance advisor for the ohio state association of nurse anesthetists (osana). my duties include speaking about the risks of addiction in the crna (10-20%), assisting in the development of policies and procedures regarding suspected abuse, investigation, intervention, treatment, re-entry into practice issues, contracts for re-entry, aftercare issues, and to participate in interventions if requested.

i have 11 years clean and voluntarily surrendered my license because i determined it would be dangerous for me to return to practice.

if these 2 crnas are ingesting an illegal designer drug, they are violating the nurse practice act. the decision to use/abuse an illegal substance is very concerning. while they may not be addicted to the substance, their use shows a less than rational thought process. and, if they are willing to use illegal drugs, they are an increased risk to divert meds from the hospital.

for additional information please feel free to contact me by phone or email (go to my website for email address and phone number: http://jackstem.com/ohio-peer-assist.htm)

or go to the aana peers assistance page:

http://aana.com/resources.aspx?ucnavmenu_tsmenutargetid=154&ucnavmenu_tsmenutargettype=4&ucnavmenu_tsmenuid=6&id=191&

another excellent site is called allanesthesia. they have produced a series of dvd's entitled "wearing masks" that deal with substance abuse and addiction in the anesthesia professional (the dvd is free!).

http://allanesthesia.com/

if these crna's practice in california, i can help you get in-touch with the peer assistance advisor in that state. she is more than willing to talk with you about this and may have some advice for you. or, you can follow this link to get the information on california's peer assistance adviro.

http://aana.com/peer/directory.asp?state=ca

here's the link to the alabama peer assistance advisor:

http://aana.com/peer/directory.asp?state=al

finally, here's the hotline number: 800-654-5167

please don't hesitate to contact me. see my profile for email information.

jack

thank you!

i am very concerned that there is even a discussion about whether it is ok for any registered nurse to use illegal drugs.

no it is not acceptable.

[Dakkon76]

Sorry to say, I disagree with you all. While I acknowledge these people have worked extremely hard for their license, and it is possible they have never been "impaired" during a case...it is not certain. The sheer fact that they can use, and rationalize the use, of illegal designer drugs shows poor judgement. It is impossible to know whether they are minimizing the effects of the drug abuse to make others feel as though it has no impact on their performance during anesthesia. I feel as if the right thing to do would be to confront your friend in a firm, yet non judgemental manner and insist that they have a drug problem and should seek immediate help. And the consequences for refusing to help will force you to speak to their employer. I would not take it to the BON. This is my opinion, how I would handle it, and I don't expect anyone to agree with me. Just my two cents.

I agree... and considering the damaging effects of ecstacy... these people have to be completely [suggested edit by mod] ... you get the idea.

[flowechild]

I think if you know for sure that your friends are using illegal drugs it is your responsiblity to tell someone. You can make a complaint to the BON without revealing who you are. This is unacceptable in the nursing profession and you always have to think about patient safety first. It doesnt matter when they are doing drugs the point is that they are taking illegal substances and this is wrong. You have to put yourself in that patients place and you know you would not want them taking care of you. So what if they have been to school for 2 stressful years obviously it doesnt mean that much to them because they are being irresponsible.

[jeroboam]

i believe you should not report them. it may be that the substance is illegal - but so is under-age drinking/drink-driving/homosexuality/ smoking pot etc.they are not using mdma the night prior to their shift.

dont meddle - the chance of them making a mistake is less than the person who was on an alcohol soaked bender until 1 am monday morning. or smoked pot last evening. marijuana has a much longer half-life and 1 joint/bong can stay in the adipose tissue for 48-72hrs. i've seen +ve results 6 - 8 weeks after last joint.

why do you think they would make a mistake? because they are sleep-deprived? because they have a small amount of stimulant in their blood stream? because they are doing something illegal?

i think your reasoning is specious and you may need to look at why you have the urge to report someone. we seem to have become a society of do-gooders where we need to be recognised for how many negative behaviours we can report to the authorities. perhaps the status of fear which our govts have induced us to live in has heightened our need for reassurance from a paternalistic figure-head. like in grade 1 when your teacher thanks you for reporting britney for chewing gum and later gives you a lollypop when you report kevin for writing on his arm. "miss, i was worried that he might get ink poisoning." "yes, thank you goody, we need to watch those 2 - they will be a bad influence and they will make many mistakes. here's a lollypop for you and you be my eyes and ears."

cheers

kaeri

well, perhaps you, being from australia, are unaware, but consensual homosexual conduct between adults is not illegal anywhere in the united states. and sexual conduct doesn't impair one's mental status, but drug use certainly does, both during and after use.

further, certain conduct (namely, that conduct which endangers others) should be, and is, within the purview of government. perhaps you're an anarchist, perhaps not, but most people that i know want the government to protect them from people who are dangerous, and ecstasy users whose day job is anesthesia are just that: dangerous.

and by the way, as someone who is slightly to the left of ted kennedy, i'm all for personal freedom and civil liberties... except when it comes to issues like this. if you want to live in the outback and take ecstasy, god bless you. when you do so, and then expect to be putting me under for my surgery in alice springs the next day... no, i don't think so. in that case, you should lose your license.

and that brings me to this: a license from the government to engage in a specialized occupation is a privilege, not a right. when you violate the requirements for maintaining that privilege, you lose your license. we don't care if the kid at mcdonalds used ecstasy last night, because his cash register is preprogrammed to give the correct change. at the worst, i may get someone else's order in my bag. but we do care about airline pilots, and doctors, and nurses, and bus drivers, and child care workers, etc.

i'll repeat my advice: report these women.

[Doog]

i believe you should not report them. it may be that the substance is illegal - but so is under-age drinking/drink-driving/homosexuality/ smoking pot etc.they are not using mdma the night prior to their shift.

dont meddle - the chance of them making a mistake is less than the person who was on an alcohol soaked bender until 1 am monday morning. or smoked pot last evening. marijuana has a much longer half-life and 1 joint/bong can stay in the adipose tissue for 48-72hrs. i've seen +ve results 6 - 8 weeks after last joint.

why do you think they would make a mistake? because they are sleep-deprived? because they have a small amount of stimulant in their blood stream? because they are doing something illegal?

i think your reasoning is specious and you may need to look at why you have the urge to report someone. we seem to have become a society of do-gooders where we need to be recognised for how many negative behaviours we can report to the authorities. perhaps the status of fear which our govts have induced us to live in has heightened our need for reassurance from a paternalistic figure-head. like in grade 1 when your teacher thanks you for reporting britney for chewing gum and later gives you a lollypop when you report kevin for writing on his arm. "miss, i was worried that he might get ink poisoning." "yes, thank you goody, we need to watch those 2 - they will be a bad influence and they will make many mistakes. here's a lollypop for you and you be my eyes and ears."

cheers

kaeri

being a professional means being held to a higher standard, whether we liked or not. the public expects us to take the high road, and our patients lives depend on it. whether this drug use is recreational or not, it is still not the appropriate behavior of a professional. another phrase that comes to mind is if your willing to do the crime, then be prepared to do the time. these individuals should be reported.

[BSNin2007]

RN/BSN/JD/ESQ

Thank goodness for your conviction. I am seriously worried that I may receive medical care from some of the respondents to this thread. Some of these people are defending the actions of the alleged users so voraciously one may begin to question their motives.

[jeroboam]

BSNin2007: I hear ya. I think the only solution is to have periodic randomized drug testing, on the spot.

My thinking about this has evolved over the years. Without getting into a much larger debate, I'll say that I don't believe such testing is necessary for college athletes, or government bean counters, or auto mechanics. But I'll gladly pee in a cup for my employer anytime it asks me to. They pay me well, and treat me well, and the least I can do is to show up unimpaired so that I won't kill or injure their patients.

As for fearing treatment by a drugged-up medical provider, all I can say is: I'm VERY careful about who takes care of me. You should be as well.