Drug Abuse/Nurses/Kristi - page 2

I tried posting a reply directly to your post, but when I typed in my ID, etc., it just flipped me back to your topic, and didn't let me post, so I started a new topic, but on the SAME topic. I can't... Read More

  1. by   traumaRUs
    Whew, what a lot of info and such a heated topic. However, my two cents worth is that I worked with an ER nurse that had me (among others) signing off the wasted narcotics that was really normal saline or water!! So, I too am bitter and not even a little tolerant with this issue. Don't come work with me!! We're just getting a little touchy-feely for me. My sympathy lies with the patients who continued to be in pain after being given normal saline!!
  2. by   bunky
    The reason I am trying to make some sort of a prexisting psych connection is because I am being asked to believe that this is a disease. I don't. You are giving me an eye opener as to the pressure you felt to perform, but not why it got so out of control for you. I have been closely affected by addiction, it destroyed my family. I am trying to decide if maybe addiction is not merely a symptom of a psych problem, a way to cope with a psych issue that was there but hadn't escalated until drugs came into it and masked an underlying problem. I don't understand how a person can let it get that far out of control without having an underlying psych problem. Not being a psychatrist I wouldn't hazzard a guess at a dx, but if things like anorexia, and gambling are treated as a psych problem, then isn't addiction too? Judging by my own experience with it, I'd be tempted to think it was more a personality disorder simply because the cure rate is not that great.
  3. by   Joankim

    Recent research indicates that addictive substances change brain chemistry in ways that persist long after a person stops taking drugs. And, the medical, social and job difficulties that often accompany drug abuse don't necessarily end when drug use stops.

    Despite significant strides in the behavioral sciences and in understanding how the brain works, misunderstandings about drug addiction and treatment remain.

    "At times, it can seem like a simple, straightforward, obvious condition that one gets into by irresponsible behavior and one should be able to change by willpower and 'just saying no,'" says Robert M. Morse, M.D., a psychiatrist at Mayo Clinic, Rochester Minn.

    "On further study, however, it seems increasingly complex, elusive and frustrating with no defining concepts and unclear treatment approaches," says Dr. Morse.

    - Last Updated: Sept. 17, 1998

    PPl go to one of the many sites for alcohol or substance abuse and read what many doctors have to say about this DISEASE.

    I for one am not going to engage in any more time trying to explain to people who do not care about, or think that addicts are the scum of the earth. That is an opinion I cannot change, and I know that this is not true about me. I am a person who made some bad choices, and am now recovering from the results of things that happened due to my addiction. Peace to all!!
  4. by   KIDSRN
    Your outline of a Nursing personality if bang on. I am a recent graduate and lasted three years when I called it quits in January. When I knew I had enough - I could really understand how Nurse's could be drawn to the drugs so readily available to them. If I had a previous Psych condition or didn't have the strong character or support at home - it could have been very tempting.

    Off the subject - I really miss nursing and want to get back into it but I know the conditions at the hospital have not changed and I am not going back into their bad scheduling, overworked floor. Any suggestions on careers where I can still be nursing but am not front line in a hospital and can get decent pay?


    Originally posted by DC:
    Psych related???Interesting, I think many many nurses become interested in a helping profession because they were from some type dysfunctional family/home situation or for whatever reasons, they felt the need to fix/help others with their problems. Many nurses neglect themselves and place everyone elses needs ahead of their own. They have trouble saying no and feel like they can handle a multitude of things before realizing they are overtaxed, not coping well or causing problems for themselves. Nurses tend to be perfectionists and often feel like they have failed if they can't handle these crazy demands or if everyone around them isn't doing well. What is the issue is why certain nurses become addicts and others don't. Perhaps it's coping mechanisms at a given time. Maybe it's a predisposition to addiction much like alcoholism or depression. Maybe it's lack of support systems for themselves. Maybe it's their inability to ask for help. I think this is one of the reasons other react so badly to a nurse's addiction, somehow we should be above this, too strong to succumb , almost beyond being a real human being, vulnerable just like everyone else??So, yes ther'e psych related issues, but they are as different as the nurses who end up abusing drugs. For whatever the reasons, I think the issue is how to help these folks, how to save their careers and how to decrease the horrible, ignorant stigma that follows them for the rest of their lives. Any ideas?

  5. by   Smitty,RN
    From one opinionated and unknowledgeable nurse to another- PPL I agree with you and have the same strong feelings. When I first learned of the Impaired Nurses Program- back in nursing school- I was shocked that you could actually be under the influence caring for patients and basically get a slap on the wrist. For all of you addicts reading this, I am ignorant of your personal situation- I only know what has gone on in my facility- where a nurse was caught stealing ALOT of Demerol. She was out of work about a month or so- now she is back to work as if nothing happened. Oh, I forgot- she can't sign out narcotics. BIG DEAL!
    I don't care what the AMA says about addiction being a disease. I see it as a weakness. As far as taking care of addicts-
    I give them the same care and compassion as I give my other patients- I treat all my patients with the best care no matter what they do in their personal lives- The difference? Theyre not making decisions or administering medications to me or my patients! Thats the problem. If you have a difficulty controlling the urge to be high for whatever reason- YOU SHOULD NOT BE A NURSE! End of story.
  6. by   DC
    Hey guys, it's dc again. For ppl and the nurses who share her feelings, what do you think should be done to impaired nurses? Should there career be over? Should they be arrested? How would ya'll handle us? Every state board is different, I know they are alittle more progressive on the coasts. I live in the mid-west where the board is very out-dated and backwards in their thinking. The punishments here anyway are very harsh. I guess it's too bad I didn't abuse drugs somewhere else hugh?A paramedic and an MD was also caught where I worked. Neither one of them were reported to their respective boards, and the MD is back to work at that facility. I think that everyone should atleast be treated the same.Should nurses who get their licenses restricted for other things alos lose their career? Or should it just be for drug users?? How about alcohol or rx drug abuse??

  7. by   PPL
    Good questions. I addressed this in my original post, as it wasn't clear to me exactly WHAT happens to impaired nurses. Some seemed to get a slap and others just disappeared period. Does it make a difference if they're caught red-handed, then if they seek help themselves? The only case I am familiar with, the person sought help through the state program, and was allowed to work off the floor. They signed a last chance contract with the facility, went through rebab, etc. I believe the state program was a joke. The individual was quite able to work around their "restrictions" including their "random" drug screening, and was using during the program, and that's a fact. This type of thing creates a dilemma for nurses who feel as I do. I received much flack about my use of the word betrayal, but I believe that when you deceive and misrepresent yourselves to your co-workers, your patients, family and friends, etc., plus put others in a situation of conflict, that is certainly a betrayal. I'll turn it back to you. I ask you, what would YOU have us do?
  8. by   km rn
    Yikes - very interesting conversation. I agree that many people from dysfunctional backgrounds enter nursing - we often time are the ones that want to make everything better, and give more of our selves to our jobs, loved ones, etc. than is healthy. In addition, many nurses are also addicted - some to alcohol, drugs, food, smoking, etc.

    During my first job as a nurse, I worked with an addicted nurse - I didn't realize that she was the person responsible for the missing morphine, demerol, etc. until she was fired. Since the night shift was staffed by RNs with less than 6 months nursing experience; this nurse was our "safety net" (or so we thought). She worked primarily on the MICU, but she would come over to the SICU where I worked to "help" (since she knew we were all relatively inexperienced nurses). We thought she was wonderful - as new nurses we had already been "eaten and spit out" by some of the more experienced nurses. However, she used our inexperience as an opportunity to steal drugs from our narcotic cupboard - we felt betrayed by this nurse - she used us to get her drugs!

    My next experiences with addicted nurses happened some 13 years later. I am now in management. One of the addicted nurses worked hard to destroy the professional reputation of her co-worker. Ultimately, a video camera revealed the theft and poor nursing practice of the addicted nurse - however, her co-worker has yet to completely regain her reputation.

    The next addicted nurse was stealing po pain medications. Thankfully, she was not substituting other drugs/substances to cover her theft; so patients did not suffer. However, both of these instances created a hardship for our facility - the financial costs of the investigation were huge - but MOST IMPORTANTLY the damage done to the trust level amongst nurses in our setting was awfull.

    I have been frustrated, angry, etc. about the time it took to investigate the last 2 addicted nurse investigations I have been involved in - it took valuable time away from my primary obligation - our patients. I have more sympathy for those addicted nurses who have not tried covering their substance abuse problems with -
    ruining the reputation of another nurse;
    jeopardizing patient safety and comfort by sustituting normal saline etc. for pain meds.

    However, I feel that as a profession we have not done much to recognize and find treatment for nurses before their addiction causes them to stoop to this level.
    Maybe some of the nurses that "go on and on" about their recovery are trying to reach out and help another nurse that may be struggling with this issue.

    Since we pay licensure fees - can't we band together and mandate that some of that funding goes towards "nurse recovery/advocacy programs", "education regarding early recognition of addiction". One of my nursing professors cautioned our class that nurses always want to help - as such many of them marry addicted persons. We also freqeuntly want to make everything better - often impossible which leads to feelings of guilt, worthlessness, etc.


  9. by   PPL
    Hi. Thanks for your post. We have a system in place now, where the controlled substances are in a machine and every nurse has a secret code to enter the machine, and it spits out the requested amt of the drug. Some drugs still have to be wasted, with back-up of 2nd nurse, but it is a much more controlled way to dispense meds. Of course, I am aware of the ways addicts find to get around even this system, and so they will always be able to deceive trusting individuals. Is it true that facilities are charged huge fines when there are drug incidents? This is just another cost to us all in monies that can't be spent on staff and patient care. So disheartening.
  10. by   ltm
    wow, this is a really interesting and heated topic. i can see both points of view. i am not intolerant of a nurse that has a substance abuse problem, but as it was said earlier the use of drugs or any other substance is a choice, no matter who you are. it is betrayal of everyone's trust in you as a competant and honest healthcare provider. if you use on the job you are compromising everyone's safety no matter what effect the substance has on you. you would not want a healthcare provider to take care of you while under the influence. and it is hard to be readily accepted back into an environment where you will constantly be around drugs. its the same rationale as a recovering alcoholic staying away from bars. i am not saying the solution is to stay out of nursing, but its going to be hard to be around drugs after you have been addicted to them. it is also hard for people to trust you again. so maybe there should be a special program for nurses with this problem, but i don't think that they should be totally banned from nursing. i truly commend the nurses that have openly talked about their substance abuse experience and i feel like you guys are owning up to your mistakes. best of luck.
  11. by   ikelly
    Originally posted by Joankim:
    I cannot help but respond to your post. I am one of those recovering nurses and take offense at some of your ignorant comments.

    Yes, it is a disease, one I would rather not have!! I fail to see where "betrayal" plays any part in this dieases, or maybe I am just ignorant. Did I betray my former employer? My coworkers? Yes I used in the job, but I do not think I bertayed them. I misrepresented myself and lied about my using initially. I was hesitant to admit I had a problem, because of people with attitudes similar to yours! There are so many people who lack knowledge regarding addiction. I am in recovery, I do not spout recovery talk to anyone I work with, and am grateful that I have been given a new chance in life! My liscence is on probation, has been for the past 34 months and I choose , today to not work around narcotics. Instead I work in an office setting with insurance.

    I really take umbrage with your comments about the "loaded weapon".
    Where is there money to be made, and by whom? Yes it is a disease, but at least in my state, it is NOT a disability. I did not collect 1 dime of money from any one when I was in treatment and out of work for over 4 months. Maynr there are people out there like that , but the majority of people who do such things are not addicts!!

    I suggest you become a little more open minded and get off whatever throne you think you are sitting on. I would not like you to care for any of my family or friends with the attitude you display.If your attitude is loke this , how are you with patients eho are alcoholics, or addicts? What about HIV patients? You must live in an awfully enclosed world!! Unfortunately, you are not alone in your thinking. There are many others in the medical field who are just as opinionated and unknowledgable as you!!
    There is a really good article in this months AJN (June 2000). The Effects On Professional Discipline on Nurses. It covers drug abuse and also other offenses.
    It might shed some light on the subject..
  12. by   PPL
    iKelly, hi and thanks for posting. I read the article word for word, and found it interesting and informative. An interesting aside, is that none of the nurses who had been disciplined for narcotics issues responded to the survey. Did you catch that?
  13. by   Joankim
    What is it that you are really looking for? It seems to me you have formed your opinions and are not very open-minded to what people who are pro recovery have to say. Would it make you happy to say all nurses who have substance abuse(including alcohol) problems be banned from nursing?

    I for one did not know there was any other way then what I was doing, I started drinking in high school and it took me away from who I was when I was sober. My disease progressed until I was finally confronted. I was then given a choice, go into treatment, or surrender your license. Recovery IS POSSIBLE !! I also know of nurses who refuse to admit they really have a problem, or who cannot recover for maby different reasons. In that case, they should have their licenses revoked. When I was in treatment 4 years ago, there were 5 nurses in treatment with me, I still keep intouch with 4 of them and they are all clean today. I have also seen many nurses come and go... they just cannot get clean because they do not want to. Recovery is hard work for me. I remind myself every day that I am an addict. I am thankful I no longer feel I have to use over anything today. In my active addiction I was not aware that I had the coice. Today I do know about the choices and I choose not to use. So yes there are choices involved, but in active addiction I could not see them. Treatment broke the cycle, and helped to to take a look at myself. At times it was very painful, but something necessary in order to stay clean! I still am getting consequences regarding my addiction, hard to get employment in a hospital, financial problems, cannot get self insurance because I am considered high risk.... But life is good today.

    Please tell me,and other addicts what you think should be done. I for one did not see the article in AJN, and I would definitely have responded. Your statement implies that addicts do not take an active part in the process.