Nurses Who Are Drug Addicts

Cattitude · Jan 13, 2007

i do not agree with this advice.
it is your professional responsibility to report an impaired nurse. typical signs and symptoms of an impaired nurse include but are not limited to: obvious changes in mood or behavoir, pinpoint or dilated pupils and slurred speech or uncoordinated movement, excessive sluggishnish or bursts in energy, patients of said nurse who complain of pain or state that the pain med was not given to them although it was charted, narcotic counts always coming up short when said nurse is on shift, etc. sometimes an addict can become so proficient at hiding the signs that the problem will go unnoticed for long periods of time. they may be in denial that they have a problem or may be so dependent upon their job for their supply that they accuse others. their addiction is beyond their control and beyond hoping that a little guilt will kick in an convince them to clean up their act!
they need an intervention. they need to be directly confronted with the problem. a good co-worker would go immediately to their supervisor and report their suspicions. state the facts. a good manager will call the co-worker in and have a very well-thought out confrontation, one that is not meant to scare the employee but confront the problem and allow them to own up to their actions. drug testing at that moment must be mandantory if they deny the accusations. if it were me, i believe the employee deserves the chance to report themselves immediately to the bon and enter an impaired nurse program. if they refuse, then it is the manager's professional obligation to dismiss the employee immediately and report the incident to the bon.
you can not make a suspicion known haphazardly in hopes that an impaired nurse will feel guilty and clean up his/her act. if you do so, you are just as guilty as putting patients in harms way as the nurse who is practicing under the influence. shame.

great advice in all aspects. i'm very curious and hope you can answer my question. i notice that you are a student or maybe just graduated so i don't believe you could have possibly yet worked with an impaired nurse. how did you come up with such accurate information? is it possible that they are actually addressing this issue in nursing school now? i would be thrilled if they are because they were not 13 years ago when i went and they should be. when i was impaired i, like many impaired rn's, thought i was the only one ever to be in this situation. information and education can help fight this horrible disease and if i can be a part in helping just one nurse not succumbing, i will... i am in recovery and will be doing my best to educate (speaking at seminars and such).

thank you if you do answer and if its personal and you choose not to answer, i understand completely...

nurse4theplanet, RN · Jan 13, 2007

great advice in all aspects. i'm very curious and hope you can answer my question. i notice that you are a student or maybe just graduated so i don't believe you could have possibly yet worked with an impaired nurse. how did you come up with such accurate information? is it possible that they are actually addressing this issue in nursing school now? i would be thrilled if they are because they were not 13 years ago when i went and they should be. when i was impaired i, like many impaired rn's, thought i was the only one ever to be in this situation. information and education can help fight this horrible disease and if i can be a part in helping just one nurse not succumbing, i will... i am in recovery and will be doing my best to educate (speaking at seminars and such).
thank you if you do answer and if its personal and you choose not to answer, i understand completely...

yes, i just graduated in december and no i have not yet had personal experience with an impaired nurse.

i was given a very good education in school about the subject. we examined nursing trends, the psychological components of addicition, why nurses are susceptable secondary to high stress and immediate availability, legal ramifications and rehab programs, signs to recognize a possibly impaired nurse, and the professional obligation to report it. it was covered in theory lecture, in psychology, and in our leadership classes.

i am no expert but the professional obligations were made very clear to me in my education. it must be reported. there are some excellent rehab programs for nurses who suffer from addiction available today. it is not only our duty to protect our patients and help them with their disease process, but to also protect our co-workers and extend them help in such extreme circumstances. turning your head and hoping they work it out on their own only enables the addiction, put's patient's in harm's way, and does nothing to help your co-worker who is suffering from self-destructive behavoir.

Trauma Columnist · Jan 13, 2007

I think you owe it to the nurse, her patients and co-workers to report it.

Cattitude · Jan 14, 2007

yes, i just graduated in december and no i have not yet had personal experience with an impaired nurse.
i was given a very good education in school about the subject. we examined nursing trends, the psychological components of addicition, why nurses are susceptable secondary to high stress and immediate availability, legal ramifications and rehab programs, signs to recognize a possibly impaired nurse, and the professional obligation to report it. it was covered in theory lecture, in psychology, and in our leadership classes.
i am no expert but the professional obligations were made very clear to me in my education. it must be reported. there are some excellent rehab programs for nurses who suffer from addiction available today. it is not only our duty to protect our patients and help them with their disease process, but to also protect our co-workers and extend them help in such extreme circumstances. turning your head and hoping they work it out on their own only enables the addiction, put's patient's in harm's way, and does nothing to help your co-worker who is suffering from self-destructive behavoir.

that's great to hear. we were taught nothing about it in my adn or bsn program. i'm glad that's changing. i didn't know how big the issue was until i got into recovery. i probably worked with several addicts in my career and didn't know it.

there's a ton of help now for nurses that need it, it wasn't always like that. year ago, they just fired nurses. now the nurse is given a chance for recovery/sobriety (usually, some places are still punitive). but always report to your supervisor if you are 110% sure that said nurse is using substances. please be sure first.

there are many prescribed meds that cause weird side effects or personal situations that can cause mood changes. just be sure...as i have said in a previous post, if you do report it and the nurse gets help, the majority of the time, they will be grateful you did report them...

beez

ladytraviler · Jan 14, 2007

There are others out there who are going through the same thing. I am a recovering alcholic and addict. I will always be recovering. I started when was a medic, got caught, did inpt therapy, attend AA & NA meetings. Was clean for 5 years before nursing. Yes the temptation is there, but when I think about it I aknowledge that this time around I would loose my life as well as everything that makes life worth living. I go to events where people around me drink and I think just one wont hurt, Then I remember what it was like when I was actively drinking. I let my doctors know that I am an addict so that they will not prescribe large amounts of narcotics if I need them. I am so careful to comply with the drug testing my company requires. I have many friends who ask me how do you do it? I can only say that I have someone who takes the temptation and shows me the reality of addiction.

I am sorry this is so long. I think the issue of addiction needs to come out of the closet and be realize as a two part problem. It is not just the active addiction that causes problem, but the self loathing and denial that contribute to it. How can recovery start when there are many nurses who don't understand the process of addiction. If you take a close look at your life, you will see that all of us have an addiction. It may be to coffee, coke, cigaretts, or chocalate. The drug addiction cause problems for not just the nurse but for co-workers who unknowingly help them, the patients who think that they did get the med but no relief, and the family of the addicted. It is not just a lack of will power, nor the need to feel the high. I am very close to this subject so I will shut up before I really get on my soap box.

The best piece of advice I got from my sponser was "What is reality for you? Can it come from a bottle or a pill? Or is it in the feelings that life evokes that you are trying to avoid? Answer those when you feel you must have a drink/drug. Then if the answer is yes you still need, call me." And I did call alot in that first year. I still call 10 years later. Sad to say she died of a drug overdose this year. But I will make it. I have to for me.

Nursing On The Run · Jan 26, 2007

Hi!

Add me to the list of recovering alcoholics/addicts who successfully works as a nurse in the hospital. I was sober a long time before becoming a nurse, btw. For my recovering friends out there: When you choose a password for withdrawing drugs, why not use your sobriety date? Or the famous page number from Doctor/Alcoholic/Addict aka Acceptance Was The Answer? I feel like that's a good reminder for me, everytime I'm grabbing a bunch of narcs :smilecoffeecup:

Anyway, I once worked alongside a nurse who later turned out to be stealing drugs from the hospital. (Sad to say, I was not quick to pick up on this at all). Two things come to my mind when I remember working with her, in terms of signs and symptoms. One is, she was prone to flying into temper tantrums. She happened to be very humorous, which may be why this was tolerated. But she was noticeably volatile.

The other thing I distinctly remember is once, when I was entering my password into the pyxis/omnicell, she seemed to be looking at the keyboard trying to see what my password was. Most people make a point of looking elsewhere.

Anyway, I agree with the advice to tell your nursing supervisor, and follow up to make sure more is happening than just offering the nurse the chance to resign. My kids want on the 'puter....

Hugs, and I love knowing there are people out there who put sobriety first, with their families, patients, and colleagues all benefiting....

Cattitude · Jan 29, 2007

Hi!
Hugs, and I love knowing there are people out there who put sobriety first, with their families, patients, and colleagues all benefiting....

Back at ya! Thanks for the idea of using the sobriety date for passwords. I like that even though I don't work in a hospital right now, I will keep that tip in mind.

I too love knowing and living sobriety first. For putting that first then means I can be a better wife, daughter, friend, and nurse to my pt's. There's nothing better than waking up each morning clean. :smilecoffeecup: Ok. ok except for the caffeine...

bluesquare · Mar 15, 2007

im not a nurse, nor am i a student...however, my mother was. she got her degree as an RN while raising 3 children, graduating with a 3.9! i swear, she was born to be an RN. she had all the qualities an ideal nurse should possess, and she has also been featured in a reknown medical journal, although i cant remember the name of it. point is, she was great at what she did, and as young as i was and as infrequent as i saw her because of all the hours she was working, i still could sense her compassion. not only did she love the job, but the job loved her. the relationship she had with nursing was like an exciting, passionate love affair that gradually turned into a self destructive relationship of push and pull.

the hours wore her down, and being a sufferer of depression and adult add with a history of drug abuse, she began taking medication from the hospital she worked at. now i dont know specifics; i dont like to ask much because i know how ashamed of herself she is and i dont want to remind her. but the pattern went like this - shed steal meds, get caught, and because she was so good at her job and such a valued asset of the hospital, theyd send her to rehab without pressing charges. eventually she ended up getting transferred or resigned (once again, who knows) and went from hospital to hospital to hospital, the last of which being a small detox center downtown. whatever happened, one of the hospitals she worked at decided to press charges after she got out of rehab and had already moved on. from what i remember, they waited out their 2 year grace period and at the last minute decided to press charges.

my mother was 40 when she was sentenced to jail. she was locked up for about a year - i was just 13 years old. when she came back, her condition was worse, her addictions more severe. i didnt know who she was anymore, and what i thought was a reaction from some traumatic experience while serving time turned out to be the result of a severe addiction to a different narcotic. anyways, she has since cleaned up but her destructive behavior from her addiction was a catalyst to the end of a 20 some year marriage between my parents.

she now lives by herself in a tiny apartment - her oldest son is 26 and in prison, her other son, whos 21 and lives at home with my dad, has yet to successfully complete a semester at community college with an IQ of 160, and finally her youngest child of 19 years, myself, is her only source of encouragement and companionship and the only person she trusts, but goes to college two hours away. to top off her loneliness, her struggle with drugs has resulted in the revocation of her nursing license - a piece of paper that defined what was both the greatest love of her life and the most destructive.

the lost license limited her ability to practice ever again, but it's the felony and drug charges that have proven to be the most inhibiting as far as jobs are concerned. she is prohibited from working in schools, any branch of gvt, hospitals, etc, because apparently DRUG FELONY isn't enough to scare employers off. shes been working as a medical transcriptionist in her home, but the pay amounts to little after factoring out bills, rent, food, and lawyer and court fees with the divorce, my half brothers indictment, and with an old lawsuit both my parents fought against the builders of our home. not to mention trying to give anything she can to help out her kids. she has fallen into a serious depression - divorced, not much family, ashamed of her mistakes, guilty and self-loathing for the damage shes done to all of us, and unable to practice nursing after working so hard to get that piece of paper.

has anyone been in or know of anyone in this situation? she feels that her options are so limited because of her past; shes lost a couple jobs without warning due to their random backround checks. the government provides programs to help those who have been released from serious crimes, but there doesn't seem to be much that deals with my mom's situation, a situation which i tell her time and time again is so common. any suggestions?

TraumaICURN · Mar 15, 2007

In TN, we have a program called TNPAP...Tennessee Professional Assistance Program. If you suspect your colleague may be addicted, you can contact TNPAP anonymoulsy, requesting help from them. Then TNPAP will contact that nurse and request an evaluation. If they feel that treatment is needed, then the nurse can either consent or deny. If the nurse successfully completes the program (I think it's 3-5 yrs) then the BON won't hear anything about the addiction.

I don't know if these same rules apply in all states or not though.

Nursing On The Run · Mar 15, 2007

i'm replying to bluesquare's post above....

you sound like a very devoted daughter, and like someone who is determined to keep to the good path despite the self-destruction around you. keep it up!

i feel for your mom. there is a lot going on-- money pressure, self-image and self-esteem issues, regret over the past, feelings of responsibility for her sons going astray. but, as a fellow addict/alcoholic, i can tell you that the only important issue is whether or not your mom picks up today. and for that, most of us need help. i would encourage her to go to aa and to na (aa has the rep of having better/longer sobriety). and i would really encourage you to go to al-anon (same deal-- better rep than nar-anon). go to at least 6 meetings before you decide if it's for you.

believe it or not, yes, i have heard stories in aa of people, including in the medical professions, who have been in your mom's straits and regained their standing and in one case, a professional license. it takes a lot of time and change. if your mom goes to enough different meetings and actually talks to people and tries to do as they suggest, she will surely meet someone who has been where she has been and can show her the way out.

sometimes i feel like i sound like i am over-simplifying. but i think that's the result of knowing that:

sobriety is the most important thing in my life today. the most important decision i ever made was the decision to give up drinking. i am convinced my entire life depends on not picking up the first drink (or drug).

(that's part of what i pray every morning....from the literature-- hazelden not aa approved--and very true. but counter-intuitive to someone still feeling the heat).

so in short: go to al-anon (at least 6 meetings). encourage your mom to go to aa and to na. and that's all you can do-- but it's enough.

hugs

Cattitude · Mar 15, 2007

has anyone been in or know of anyone in this situation? she feels that her options are so limited because of her past; shes lost a couple jobs without warning due to their random backround checks. the government provides programs to help those who have been released from serious crimes, but there doesn't seem to be much that deals with my mom's situation, a situation which i tell her time and time again is so common. any suggestions?

hi, there are a couple of nurses in my support groups with felonies, one who just got her license back. she did have to work very hard and it took a while.

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[color=#483d8b]so yes it's possible to rise up from this situation. each state is different and then each employer looks at it differently as well.

[color=#483d8b]again as the poster before me stated, the most important thing is she not pick up today. as long as that happens, she can then make it all happen.

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[color=#483d8b]mom sounds like she's on the right path and believe me, sometimes getting caught and even jail has saved lives, kind of a blessing in disguise. i know she feels like she's lost herself but she did not! being a nurse is only a part of who we are.

[color=#483d8b]staying clean is top priority.

jill48, ASN, RN · Mar 28, 2007

I know that many of you think I am some kind of monster because I am so strong-willed and assertive (as evidenced in other threads), but when I started this thread I really was just wanting to know what signs and symptoms you all had encountered. I have no ill feelings toward anyone with addiction problems. Far from it, actually. I really want to help this person; I'm not out to bust her. To all of you who are in recovery, thank you for being so brave as to tell your story. Your strength is unbelievable and I applaud you. Thank you all for your advice. :kiss