Nurses Who Are Drug Addicts

Cattitude · Jun 5, 2007

I agree with everytjing you wrote. Well said.
When it happened on my unit (years ago), management "knew" but she had not been caught in the act. So when they confronted her, she was able to deny it, and our union (GRRR) supported her in her fight to return to work. It was a big "open secret" that we had am impaired nurse on the unit. We were ALL sick and frightened every time we worked with her. I would go all day with no break sometimes, just so I wouldn't risk her near my patients. We all kept an eye on her patients. One day a pt with PCA morphine lost all pain control, and had to be aneasthetized and have an epidural put in to get his pain back under control - she mixed his PCA with only saline.
I can never forgive these events. I cannot forgive the nurse in question, and I cannot forgive my management for not dealing with it more effectively.
And yes, I do know that "addiction is an illness". This nurse was pressured so much that she eventually quit and became someone else's problem. Then she killed herslf by overdose (left a note) IN her new workplace supply room. Maybe if managers had better dealt with it in the first place, that could have been prevented. We'll never know.
Knowing that these impaired and addicted nurses are in their own struggle does nothing to lessen the upset that happened in my own workplace when patients were in jeopardy, and staff were unfairly placed in a position of protecting our own and someone else's patients from harm.

Hearing that a nurse killed herself fills me with complete sadness.

I ask you Pebbles and KM also and anyone else that has been hurt or affected on the job and does not trust or ever want to work with another nurse in recovery. What do you do with a recovering nurse? Just tell them to give up their career? I am asking seriously. I know the systems in place now are not perfect but they are getting better each and every day.

The systems we have now are still fairly new. Some states still don't even have programs for recovering nurses. Hopefully in time it will be even better than it is now.

If a nurse has an excellent chance at making it especially with support than why not? Many nurses that are not addicts already work ON narcs or taking psych meds to function. Many nurses get support for having every other single illness. Even nurses that did NOT divert get frowned upon.

And just what if it ever happened to you? Or someone close to you(family) Would you want their/your career taken away?

I do understand the patient safety aspect and that is why it is so important for strict monitoring guidelines to be in place during early recovery. I am thankful for those that do support though I do understand those that don't.

pebbles, BSN, RN · Jun 6, 2007

Hearing that a nurse killed herself fills me with complete sadness.
I ask you Pebbles and KM also and anyone else that has been hurt or affected on the job and does not trust or ever want to work with another nurse in recovery. What do you do with a recovering nurse? Just tell them to give up their career? I am asking seriously. I know the systems in place now are not perfect but they are getting better each and every day.
The systems we have now are still fairly new. Some states still don't even have programs for recovering nurses. Hopefully in time it will be even better than it is now.
If a nurse has an excellent chance at making it especially with support than why not? Many nurses that are not addicts already work ON narcs or taking psych meds to function. Many nurses get support for having every other single illness. Even nurses that did NOT divert get frowned upon.
And just what if it ever happened to you? Or someone close to you(family) Would you want their/your career taken away?
I do understand the patient safety aspect and that is why it is so important for strict monitoring guidelines to be in place during early recovery. I am thankful for those that do support though I do understand those that don't.

I have never seen a situation where a nurse was actually supported (and SUPERVISED) after admitting there is a problem. I would not support it in the (very acute and critical care) areas I have worked in, there is too much going on, too much pressure and too much chance to slip. But I am open to nurses who have admitted their problem and gotten treatment coming back to work in a supported way, and as long as there is adequate supervision.

You see, the nurses I have seen who came to work impaired or stole and used drugs that were meant for patients - to me, by doing that, they violated trust. They proved that they would not admit the problem, that they would hide it, sweep it under the rug and try to act like nothing was amiss. I know that's part of the nature of addiction. But it also makes me less likely to trust that this person can be safe in the workplace on a permanent basis. When I have not had enough sleep or feel sick and do not think I can be safe to practice, I call in sick. These nurses do not. They come to work anyway.

To me, this is not a "you're an addict - boo!" type of judgment. It's a "you were unsafe and did not admit it and protect your patients, how can I trust you to be safe in the future" thing.

Frankly, some nurses who have problems should definitely consider getting out of patient care areas if their problems create such difficulties. Addicted or other problems. Patient safety has to come first. Having said that, I don't know what the support systems are like. Where I work, I would not trust my management to enact such a support system safely. But every facility is different.

I've seen a member of my family slip off the addiction wagon numerous times. And knowing that an addicted person will almost always try to hide it if they do develop the problem again. Sorry, but I would always not trust someone if I knew they'd had a problem in the past.

Cattitude · Jun 6, 2007

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You see, the nurses I have seen who came to work impaired or stole and used drugs that were meant for patients - to me, by doing that, they violated trust. They proved that they would not admit the problem, that they would hide it, sweep it under the rug and try to act like nothing was amiss. I know that's part of the nature of addiction. But it also makes me less likely to trust that this person can be safe in the workplace on a permanent basis. When I have not had enough sleep or feel sick and do not think I can be safe to practice, I call in sick. These nurses do not. They come to work anyway.
To me, this is not a "you're an addict - boo!" type of judgment. It's a "you were unsafe and did not admit it and protect your patients, how can I trust you to be safe in the future" thing.
.

I thank you for your honesty. Yes the above is part of the addiction. You don't really KNOW unless you are experiencing that unrelenting compulsion. No nurse WANTS to steal or shortchange her patients, the disease overwhelms and whispers "it's ok".

Oh I know there are plenty that will scoff and say "yea right, they could have stopped". It's very easy to quarterback, very simple to judge.

Another major factor of why addicted nurses don't get help earlier is that they don't know how. I didn't know what help was available. I thought I was the only one, an outcast. I would have gotten help MUCH sooner had I known where the help was. In every single med room there should be a number for EAP and any other relevant help number.

Nurses that are addicted to opiates also face another huge battle. Withdrawal. Sometimes the fear of withdrawal is so great that even when the desire to stop and get help is there, you can't. Withdrawal can be worse than death. You feel like you've been run over and then thrown into a blender. Many, many times, I tried to stop and got so sick, I used just NOT to be so sick.

An addicted nurse is a sick nurse, there's no comparison to a nurse that hasn't had sleep or has the flu. There, you have somone who is still thinking rationally. Addiction robs you of rational thought.

Your workplace sounds like IT needs work when it comes to supporting recovering nurses. Many others do as well and this is one area that needs a lot of change. Hopefully it will get much better.

gitterbug · Jun 6, 2007

Years and years ago, on my first real job as a nurse, I was working nights and was working with a nurse who had a drug problem. It was an open secret to all of the staff even the supervisor. I was not advised of this, and freaked out when a whole pack of Demerol 50 mg IM vials came up missing at 0400am. My patient needed a shot, I went to the drug cabinet and no meds, I called the super and she calmly came to the floor and asked this nurse to return the meds to the drug cabinet, which she did. NOTHING

was said or done to this nurse, the next AM I was asked to keep an eye on her when we were working together! Who were they kidding? I was new, green, and scared to death of being blamed for stealing drugs. I walked out and never went back. Now I realize I should have reported this to the boards, but at the time, I was so green I did not know where to turn. Today I would do things differently but that incident left a hugh scar on me and I am still paranoid if drugs come up missing. The nurse retired about a year later but I will always wonder how many patients suffered because no one confronted this problem.

sissiesmama, ASN, RN · Jun 7, 2007

I have been reading this thread since its beginning, and just wanted to bring up just a few points. I am an RN and in recovery. I have over 6 years clean time. My husband is also an RN with only a few months longer clean time.

To kmblue and pebbles - I understand you have valid comments, but the feelings you describe regarding working on a busy unit with a nurse either suspected or one in "the program", I wish you could walk just a couple of feet in their shoes and feel the anxiety and apprehension that we all feel not just starting a new job or even going back to work at the facility where they were "popped". Because some of us come in and see the looks on the faces of nurses that think like you and we know most of what you are thinking, even though nothing may be said. Every time we come to one of the nurses to give narcs for us, surely you know how degrading it is to have to do this. Now I am not saying that it may not be warranted, and I am not trying to deny the fact that I stole drugs and was under the influence at work, and driving home still under the influence. But if you could realize how hard it is for us, not to mention the fact that a lot of places when there is a question or the possibility of a missing drug, even if it is just the fact that someone just miscounted, we know that almost all eyes are on us, and we know what the others are thinking. It is not a good feeling, and yes, we know we did something very wrong to be in that situation.

Secondly, to Cattitude (sp?) come work with me any time! You are great and your postings regarding this are more eloquent than mine.

We are just trying to repair our professional reputation and gain back some of the trust we lost.

Anne, RNC

Cattitude · Jun 7, 2007

Secondly, to Cattitude (sp?) come work with me any time! You are great and your postings regarding this are more eloquent than mine.
Anne, RNC

Thank you! I am just writing from my heart and it took a long time to get where I am. I would love to one day be an integral part of the change in dealing with addicted nurses and also educationg others.

I think a big part of the problem is truly accepting this as a disease. Even I didn't, early in my illness. I thought I "misused drugs". That addiction was something you "chose" to do. Even while I was doing it!!! It took a long time before I could accept that I was sick, had an obsession and compulsion that I couldn't control.

My addiction is my tumor and my support groups, therapy etc are my radiation. Without my treatment, the tumor grows and becomes unmanageable.

And also, I really don't think that people believe it can happen to anyone. I think that they somehow feel that maybe we were meant to turn bad or had tendencies or something. If anyone here could see my support group you would just see a bunch of normal looking nurses. No ones background sounds harsh or predetermined to a life of drugs/alcohol. It really can happen to anyone.

pickledpepperRN · Jun 10, 2007

I was asked to orient a nurse who had been terminated from another hospital for taking Vicodin.

Her union representative had encouraged her to participate in the BRN diversion program.http://www.rn.ca.gov/div/div.htm

She never told me details but it was more than two years of treatment before she got her license back. Then she had taken a refresher course. She had been a critica care nurse before.

She was still not allowed to give controlled substances.

Many of my fellow nurses were sceptical but after more than a decade she is our friend and valued colleague.

Any time one of us needs help with a bath, pulling up a patient in bed, entering orders, or bringing supplies to a room she can be counted on.

In exchange we give controlled substances to her patients.

Although she is now allowed to we are happy to do so.

It is so sad that a nurse who wasn't forced into treatment killed herself.

Statistically licensed nurses who admit their addiction and seek treatment have the highest rate of success of any other group. Much better than physicians.

Success does not only mean staying clean. It is considered a failure if the person leaves the program or stops going to meetings.

kate76 · Jun 10, 2007

A word from down under. In Australia, nurses who use drugs carry a heavy penalty. Not only loosing their registration, but also facing criminal charges.

I am an RN with over 10 years experience and I have seen a couple of addicts thru my time.

Repeating on what has been suggested already. Tell your Unit Manager/Nurse in-charge immediately. However, ensure you have concrete evidence such as physical characteristics like drowsiness, stuppor, weight loss, dialated pupils, or tremor. It may also be worthwile to keep a journal of your interactions with her in the work place as this will provide you with the amunition to support your claims as well as providing evidence should she go to court of law.

My experiences have involved marajuana use before work and fortunately the impact of the drug use prior to work was sufficient enough for my nurse UM to identify, so my intervention was not required. I wish you good luck.

VivaRN · Jun 15, 2007

This is an interesting thread with a lot of angles on this issue. I thank all of you for being so honest about your experiences and feelings as you deal with this illness.

I have a question, though: to move forward, I agree that we need better support for nurses who have a problem. But looking at it from the other end: how does this happen to begin with? Of course it wasn't your choice to continue abusing, but was it your choice to begin in the first place? How did it start, and why? Was it that you didn't realize how far it would go and what could happen?

As someone who has never had this experience, I'm trying to understand. Maybe we should talk more about this in nursing school - how would you do prevention?

Thanks,

VivaRN

pebbles, BSN, RN · Jun 15, 2007

Your workplace sounds like IT needs work when it comes to supporting recovering nurses. Many others do as well and this is one area that needs a lot of change. Hopefully it will get much better.

THAT, I very much agree with. Mentally and rationally, I would love to be supportive to nurses coming back to work. But honestly, I can say I never encountered any. So it's hard to say. Maybe I would feel differently.

The experience I recounted above - where we all knew and it was an "open secret" that we had an impaired nurse at work... I think it was truly a Critical Incident for me. I know at the time we asked our manager when she left if we could have a debriefing with our Critical Incident stress Management team. She said no (of course) because of the nurse's privacy needing to be respected.

the next time I encountered an impaired nurse, I went home shaking and crying, and could not stop for hours. Having flashbacks to the first one.

I truly think that management did not effectively deal with a serious problem, and it affected me and frightened me so badly that it's part of my reactions now. I wish things had been different. All the ones I hear about who came back as nurses are not in acute care areas any more.

vickynurse · Jun 17, 2007

Addiction is a horrible disease an rampant in our profession. I wish that more of us would be supportive when you find out that "Jim" or "Sarah" has a problem. It really can happen to anyone...
Beez

It cannot happen to you if you do not take drugs for recreation. This is a choice. This is NOT a rampant problem in our profession.

Because of a drug addicted dr., I saw a peds pt end up in a veg state. Myself and 3 other nurses ended up in court. I have no use for impaired colleagues.

Dalzac, LPN, LVN, RN · Jun 18, 2007

It cannot happen to you if you do not take drugs for recreation. This is a choice. This is NOT a rampant problem in our profession.
Because of a drug addicted dr., I saw a peds pt end up in a veg state. Myself and 3 other nurses ended up in court. I have no use for impaired colleagues.

How sad you feel this way. I am retired now but also I have 18 years of recovery and haven't used any drugs or alcohol in that 18 yrs either. I have been working clean longer than not. If you just met me you would have no idea I used. You would have thought I was some nice little old granny nurse. I worked in Critical care and ER the whole time, and yes I even diverted in the first part of my career. People change their lives every day. And the ones I know did it with 12 step programs. I even volunteer with the board of nursing to help other addicted nurses. If I can change then others can too. And since I see hundreds of nurses a year that have addictions It is a far bigger problem than you think. I didn't start out with drugs I started with a huge amount of alcohol but drugs were faster.

At peer we tell our nurses to watch out for folks with your mind set. I have seen nurses like that They will do anything to get rid of a recovering nurse that includes setting them up.