nursing alcoholism & codependency

travel50 · Mar 22, 2009

My ADON at work is on a state peer assistance program for a drug addiction. I am the DON. She is one of the best people I have ever met. She was so ashamed that she had given up nursing and was on the verge of giving up her license. A friend of mine knew her and had her come see me...I needed an ADON. I hired her on the spot. She kept telling me that I didn't understand how bad she was. I didn't think she was bad, but could tell she thought it. Short of it is, I could not have a better friend and a better employee. She now goes to the schools here talking to students about what happened to her. She had major surgery a couple of yrs ago, then had terrible complications afterwards. Was in the hosp for 2 wks on IV dilaudid. She had no idea she was addicted...until after she got home and felt like bugs were crawling all over her. It was driving her crazy. At the time she didn't know what it was. She thought she was losing her mind. She'd go to the ER for help, and they'd give her more IV pain meds. She was an ER nurse. One day a patient came in with her same symptoms. She thought OMG!!! I am addicted, that is my problem. She left work then and went straight to rehab for help. Sometimes very, very good people get into trouble. I cannot tell you how good it makes me feel to watch her regain her confidence and her strength. Had she given up it would have been a terrible loss to nursing.

LoveActually · Mar 22, 2009

These are great posts!

I am actually reading "Codependent No More" right now! It's a great read for anyone that has grown up around any kind of dysfunctionality

mama_d, BSN, RN · Mar 22, 2009

Personally, I think that anyone who puts up with the stuff that we do and keep going back for more almost have to have something wrong with them. If someone was in a relationship where they were getting verbally abused, threatened, physically intimidated, ridiculed, and put down on an ongoing basis, everyone in their right mind would ask why stay in that relationship? But there's just something about nursing that keeps us going back over and over again.

All I've been able to figure out for myself is that I enjoy helping others when they'll let me, and being there for people when they need me. Maybe that falls under the co-dependent category. But it means that in general I get a lot of satisfaction from my career, I'm able to keep going back, and it allows me to support my family. So I'm fine with having that particular defect or whatever you want to call it.

There are days when I threaten jokingly to my husband or close friends that as soon as I get home, I'm gonna hit the bottle or smoke a bowl. I never seem to get around to it though...but I think that when you combine the horrible stresses that we're subjected to with a predisposition to certain activities, it can be a recipe for potential disaster.

I'm screwed genetically as far as alcoholism goes...all four of my biological grandparents were alcoholics (my mom's parents would go through a case of beer a day each, they were both dead by 65). But it's rare that I drink, maybe just because I know that there's that history in my family. I do have the occasional glass of wine while I'm taking a bubble bath, but between the kids and work, I just don't have the time to drink. If I was single, without a strong support system of family and friends in place, who knows?

meluhn · Mar 23, 2009

Melody Beattie wrote a book called Codependant No More. there is a chapter that talks about nurses being at risk just because of the nature of codependantcy. I think there are 3 occupations that have such high risk, Cops, firefighters and nurses.
IMHO if the nurse doesn't have a drinking or drug problem then someone close to them does. Caretaking comes from taking care of others from a very early age of taking care of drunks and addicts.

I agree. Nurses are drawn to people that need their help. It makes them feel fulfilled and we are comfortable in this role, however, we can and do learn from our mistakes. I personally could never be in another relationship with an alcoholic/drug addict and I have very little patience/sympathy for them in general. I think they are weak. However, when I was younger it was very much my pattern to get involved with losers that took advantage of my caring/helping nature. I was an enabler/ coedependent, whatever you want to call it. Now I am totally different. I see many of my coworkers in abusive relationships though with or without involving drugs and Etoh. We just have this martyr mentality. Thats why I love that quote by Florence Nightengale, the one about martyrs just making the selfish more selfish and the lazy lazier and the greedy greedier. It is so true.

I have often thought that this might be the result of the values we were brought up with. Many nurses that I work with and have known are Catholic or at least were brought up Catholic. Which, as anyone who is Catholic knows, they are big on the whole serving others idea and self sacrifice, kindness and yada yada. I think this might have something to do with the way we are.

edmurse77 · Mar 25, 2009

Your right edmurse77, but, knowledge about the problem, its causes and its effects, early recognition along with sincere, nonjudgmental, and ongoing advice is one means to try to at least reduce the problem and to help those who can't (initially) help themselves.

I did mention a little something about educating those around you. Not driven just to close contacts and family! I am an ER Nurse and try to educate everyone. I don't mind it or look down on anyone that choses to do it! A few of the factors bother me sure. My family drives on the same road as "this guy". All I was saying that congress changing laws and Blah blah blah. None of it matters. I am not a believer in AA or NA, but I do however like many of their ideas. You can not help the unwilling and you can't help anyone who doesn't have a problem. Do you believe in (informed consent) sure we all do. So are you sure that your patient is informed enough about whatever substance that they can sign your pre-op sheet and smoke, drink, snort, or shoot it! Most of the time they hear it is bad for you. ie: "Cigarettes will kill you" Okay then bye. Not good enough teaching will turn many people away. You just have to do it!

unbecominganurse · Apr 14, 2009

I have read the posts regarding this topic with great interest as a nurse whose practice has been exclusively devoted to nurses who have an issue with chemical dependency, whether or not it impacts their professional license. As duly licensed professionals in our various states, many of our colleagues do not realize the potential for disaster that even a legitimately prescribed substance or alcohol use can have on maintaining and/or renewal of licensure.

As to prevalence, all studies have supported the statistical range that from ten to twenty percent of nurses have an issue of chemical dependency during their lifetime.

One of the important factors that every nurse must consider is that no two states handle the matter of impaired practice exactly the same. While the majority of states offer alternative to discipline programs to encourage early identification of a problem, protect the public and save the nurse's career (which is a valuable resource,) several states do not.

What is crucial is education and that each nurse track trends within their own behavior and circumstances that signal risk of becoming chemically dependent prior to developing a problem in the workplace. As stigma regarding addiction and alcoholism is a deterrent to improved outcomes, I hope as individuals and a collective of professionals that so expertly care for others, we can offer our peers more support going forward than has been apparent to date.

oramar · Apr 14, 2009

Personally, I think that anyone who puts up with the stuff that we do and keep going back for more almost have to have something wrong with them. If someone was in a relationship where they were getting verbally abused, threatened, physically intimidated, ridiculed, and put down on an ongoing basis, everyone in their right mind would ask why stay in that relationship? But there's just something about nursing that keeps us going back over and over again.
All I've been able to figure out for myself is that I enjoy helping others when they'll let me, and being there for people when they need me. Maybe that falls under the co-dependent category. But it means that in general I get a lot of satisfaction from my career, I'm able to keep going back, and it allows me to support my family. So I'm fine with having that particular defect or whatever you want to call it.
There are days when I threaten jokingly to my husband or close friends that as soon as I get home, I'm gonna hit the bottle or smoke a bowl. I never seem to get around to it though...but I think that when you combine the horrible stresses that we're subjected to with a predisposition to certain activities, it can be a recipe for potential disaster.
I'm screwed genetically as far as alcoholism goes...all four of my biological grandparents were alcoholics (my mom's parents would go through a case of beer a day each, they were both dead by 65). But it's rare that I drink, maybe just because I know that there's that history in my family. I do have the occasional glass of wine while I'm taking a bubble bath, but between the kids and work, I just don't have the time to drink. If I was single, without a strong support system of family and friends in place, who knows?

In some professions walking away from positions and staying away for years at a time would be a hallmark of a failure. However, in the nursing profession the truth is it the sign of a powerful person. I know when the crap gets above my ankles it is time to go. I think the people who are run health care management are the typical predatory business types who look down on caregivers as suckers and fools. At least that is a vibe I have frequently gotten from many people in positions of power in this business. Just look at the situation now. Are they using the current over supply of nursing staff as a chance to give better care to patients. NOOOOO, it is an excuse to beat down nurses, reduce cost by adding work load. Oh by the way, after cost go down and profits go up they will give themselves a nice big pay raise and a golden parachute. Nursing will get the same thing it always gets, the shaft.

mustlovepoodles, RN · Apr 14, 2009

Melody Beattie wrote a book called Codependant No More. there is a chapter that talks about nurses being at risk just because of the nature of codependantcy. I think there are 3 occupations that have such high risk, Cops, firefighters and nurses.
IMHO if the nurse doesn't have a drinking or drug problem then someone close to them does. Caretaking comes from taking care of others from a very early age of taking care of drunks and addicts.

This is spot on! Caregiving can easily morph into careTAKING. Caretaking happens when someone lives to help another, to the point that they cannot be happy unless the person they are helping is happy. Sounds like a great thing to be, doesn't it?

Well, psychiatric facilities are full of caretakers. Healthcare providers of all types are especially at risk, because they generally want to help people, care about people, and want to see them get better. We forget that other people *can* make their own decisions, take care of themselves, and that they have a life of their own.

How do I know this? Besides the fact that I read the book(Codependent No More), I just graduated from 7 weeks in a Recovering Professionals program, one of the best in the country. Everyone in my group was some kind of professional, someone who gave advice or treated others and had reached a point of no return, either through severe depression or substance abuse. Every one of us exhibited codependent behaviors to the extreme. I was so far gone, I was just about to "help" myself to suicide. That's how serious codependency can get.

I thank God for the program I am in(oh yes, I'm on a 1 year contract for aftercare.) I thank God that so far my license has not been affected. However, it could be and I want to make sure I do everything I can to prove that I'm taking my mental health seriously.

CrunchRN, ADN, RN · Apr 14, 2009

So, is there any proof that it is higher in nurses than the general public? It seems hard to have a serious discussion about this unless you know that fact.

unbecominganurse · Apr 15, 2009

My congrats to mustlovepoodles for the long term commitment to self-care and embracing recovery.

As to the question crunchRN posed regarding the facts related to the incidence of chemical dependency in nurses, several studies support the position that the rate in the nursing profession is higher than the general public. But what is most germane is the unequivocal fact that nurses frequently lose their license to practice due to chemical dependency whereas non-licensed personnel do not have that issue; many have difficulty seeking another position, particularly if professional misconduct charges are filed and made public on internet databases; many die of inadvertent overdoses or outright suicide due to a combination of alcohol and/or other drug use, stigma, shame, loss of income, license, identity; and this is just a preliminary list of the loss, grief and tragedy of chemical dependency among our ranks. I must emphasize - among our ranks.

I would like to make this very provocative analogy, if I may: If the mantra of realtors is "location, location, location" certainly nurses' chant "prevention, prevention, prevention." We prevent patients from falling out of bed, getting bedsores, infections and educate them regarding optimal mangement of diseases, both acute and chronic. Yet, we are WAY behind the curve of other industries regarding protecting ourselves. Electrical workers are mandated a certain amount of hours annually for education regarding their own safety. They work with a potentially lethal substance - electricity. If electricity directly touches their path in the line of duty, they are helplessly "attached" to the electrical circuit without any volitional ability to free themselves.

As nurses, many have directly "touched", so to speak, the circuit of mood-altering substances which they have inadvertently become tangled up with. Once the connection is made, particularly with Oxycontin, Fentanyl, Vicodin, etc., the ability to stop use is lost.

My point is that if 10-20% of utility workers were harmed by electrical current to such an extent that they lost the ability to work for 3 months to a year after exposure, there would be such an outcry for measures to improve their safety that we'd be deaf from the uproar. Yet, we have nurses EVERY DAY in our fifty states alone that are being confronted at work for alcohol and drug use and many of them are losing their jobs, license to practice and insurance coverage for treatment. These nurses are usually out of work for a minimum of three months if they have had to surrender their license to practice. and that is IF they are lucky enough to live in a state that offers an alternative to discipline program and if they qualify for enrollment into it.

For those who think they are immune to the possibility of developing a problem, I suggest you check out the Wellness DVD at the American Association of Nurse Anesthetist site, www.aana.com; select the Wellness page and scroll down to Wellness DVD which is viewable on-line. Then, if you really want "statistics" about the toll nurses' chemical dependency causes, multiply each nurse affected by alcohol and/or drug use by a minimum of 4 - one parent, one child, one friend and one colleague who is left bereft, bewildered, wondering if they could have or should have done something, anything different.

These nurses are our kin and God help us if we don't help them because we need all the expert, compassionate nurses we can get. We ALL need nurses at some point. We as individual nurses and as a collective group need to step up to the plate; get educated about the fastest track to unbecoming a nurse, because this is it; DEMAND mandatory education about this risk to each of us on an annual basis and in our basic and advanced education and training to become nurses; and be immensely grateful, as I am, that I became a nurse and have not had addiction force my hand to unbecome a nurse.

CrunchRN, ADN, RN · Apr 15, 2009

Thanks so much for your thoughtful response unbecominganurse. I guess since I am not involved in acute or long term care I just do not see it that much. What a rough issue to deal with especially in view of how much more punitive the system is towards medical professionals.

unbecominganurse · Apr 16, 2009

Unfortunately, a problem with alcohol or other drugs is not at all limited to acute and longterm care settings. In fact, because of the insidious nature of the disease, the stigma, genetic predisposition of some and the increasing exposure everyone in present-day society has to even legitimately prescribed prescriptions for things as commonplace as dental procedures, no nursing position offers a barrier reef of safety.

Having worked solely with chemically dependent nurses for roughly six years, and to date they have numbered in the hundreds, I can tell you that every specialty was represented - from nurse educators to administrators; school nurses to office and outpatient clinic-based nurses; psychiatric to detox nurses; and of course, every type of hospital and long term care setting imaginable.