Drug Abuse Among Us??

Nurses Safety

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Am I that nieve?? A nurse on my unit was arrested for"drug diversion" Is this rampant among us?? I know we have all taken the occasional tylenol from work, but controlled substances ??

You gotta have a thick skin here sometimes.

Articulation is not everyones strong suit.

Dont let it mess with ya.

Paul

It surprises me that most people think drug abuse only involves narcotics. We had a resident who had a months supply of Ultram come up missing. After getting all the nurses on our unit involved in the search for them, tearing both our Med room and drug carts apart, and calling the pharmacy to re-check if they had been stored there by mistake, 13 people, including the pharmacists and unit manager, were all called in for a drug test. We were not told why, just that a prescription medication had come up missing.

Although i had my suspicions about who had taken the bottle, it was never disclosed who took them. We all had assumed that it was a narc that was taken, but were surprised to find out it was just Ultram.

Re-reading my own posts, I realise that my comments could be misinterpreted as being against the prescribed, common-sense use of narcotics as a pain-management tool. Since I really don't want older nurses "hauled out and shot", let me clarify here.

Personally, I don't take narcotic pain meds or anything else that might impair me within 12 hours of going onto my (non-nursing, hospital support) shift, because narcotics of any kind, unless in low doses with caffeine, knock me on my a--. Drug abuse, though, is not the same as drug use, and if another staffer takes prescribed pain medication AND HAS ADJUSTED TO THE SIDE EFFECTS, I don't see a problem.

As a Canadian, from a country where codeine phosphate is an OTC drug, it baffles me that Americans worry so much about addiction that they refuse appropriate treatment. Nothing cures a headache like 222 tablets (these are aspirin plus codeine plus caffeine, sold OTC in Canada).

So, Duckie, please don't let yourself be "hauled out and shot"...I'd work with you and your bad knees any day.

I have a CNA where I work that very often comes in with a severe hangover to the point where she can't function to the point where she needs to be. She claims that she doesn't even drink to the nurses and turns around and tells all the CNA's that she "got so wasted" last night. It is frustrating, she has been sent home once before for coming to work actually intoxicated, although she denies it, she calls in sick all the time and when she doesn't call she just shows up whenever she wants to. When she does show up its with totally red-shot eyes, smelling faintly of alcohol and walking about very very slowly and complaining of nausea and vomiting.. and always always goes home early. What an aid huh? The funniest part, she has been an employee for 2 1/2 years. She was sent home after only working there 2 months, still in her probationary period. .. and she still works there. hmm..

Point well taken, sorry if I got defensive. Pehaps my response is partly due to the fact I HATE needing pain meds to survive, but anything less than another back surgery and two total knee replacements mean I must continue as I am. I have also learned never to take meds on an empty stomach, that causes un-nesessary side effects, which I suppose could be where the "kick" could come from but for me it just ended up with the meds in the toilet and that did me no good. I do have one thing to say about Ultram. What is the big deal about it. The MD tried it on me and I tried to for two days when I was off work, I never try a new med till I've tested it's affects when off duty and I was in agony the entire time. Since it was in a bottle, I flushed them all, they were useless. How much of this stuff were they taking anyways to achieve this "special" affect because taken under regulated doses it did nothing for me. I guess it has to do with body chemistry. Sorry all if I sounded gruff. Living with pain does that. Today was our tenth anniversary and instead of celebrating, I ended up on the couch all day, snuggled up to the heating pad and my furbabies. Hubby still is my king, he even went to the grocery store and came home with a huge floral arrangment.....I promised him a rain check! hehe

Specializes in CVOR,CNOR,NEURO,TRAUMA,TRANSPLANTS.

Well Im sure I will catch some heat from my opinion but I will stand strong and look whom ever in the eye.

Im sorry I have no compassion what so ever for anyone who diverts the narcs that are intended for the patients. Im sorry I just can bring myself to feel pitty. What I feel pitty for is the patient was exposed to you, and your lack of judgement, and your inability to contain yourself and do what you were trained to do. I was taught " Do No Harm". I have done everything in my power to contiue that creed, I hold my patients care up and above all other needs or desires while the patients are in my care. It is my job as thier Nurse to maintain thier care while they can not maintain it themselves. I Promised as I recited the Nightengale Pledge and I will do all to keep that promise. I can not feel sorry for anyone that can not uphold the same oath that I took.

I have snatched a few Nurses up and walked them myself to the Charge Nurse and reported what I saw and I have demanded that something be done. I will not tollerate the attitude of "but shes a good nurse" Im sure if you have to be f****** up to be at work , then you dont need to be at work.

My first travel assignment in a new hospital Nailed this to a head for me, I had been given a passcode for the pixis for the OR, where all the drugs even some anesthesia drugs were kept. I was doing an ENT case and pulled the cocaine out of the box, put the 2 vials in my pocket (upper chest pocket), went on gathering my other drugs and closed the pixis and went on my way. There was another nurse in the pixis room when I was in there, I didnt think anything about it. During the ENT case the cocaine was not used and the Dr, and the CRNA knew that the cocaine was in the pocket and I had not left the room during the case. Another nurse came into my room and stated that the Charge Nurse wanted to see me and for me not to leave the room. Another nurse came in and closed my case. I didnt think anything about it. I waited in the room cleaning and setting up for the next case, when the charge nurse and the Nurse OR Manager and security walked in. I was informed that the pixis was opened with my passcode, and again another dosage of cocaine was removed. Both the Dr and the CRNA stated and confirmed that I had not left during the procedure, and that BOTH vials I had in my person. I was asked who else was in the room with me when I took the original out. I said whom was in the room with me. I remained in my room, both vials in the hands of the Nurse Manager, they went to the room where the other nurse was, she had been out of her room several times, and no drug on her. I submitted a drug test on the spot blood and urine, I had no problems what so ever, the other Nurse refused, then was taken deeper into the depths of the hospital.

Where she proceeded to say that I approached her , gave her my password, and told her to take the cocaine and to hide it because we could sell it. Well that was insane, I wasnt from that area and certainly wouldnt have a clue as to whom to sell it too, then her story changed about 5 more times, each implecating me in each and more wildly then previous. She was removed physically and arrested. I had never been placed in anything like that in my life.

I do not sign for things I have not witnessed even for the anesthesia , I have had a few get mad at me because I wont, and others that know that I wont and respect it, I do not and would not under any circumstances compromise a patient for my own intake. I have worked with nurses that have, and I dont consider them nurses but users with a license. Yes I understand there is an addiction and they dont know what thier doing but Im sorry I know what Im doing and Im responsible for each and every patient that comes through my halls , if they be assigned to me or not.

I have worked with nurses that have had the addiction and over come the addiction and returned to work and I have never had a problem working with them, I do not look at them any differently. I admire them for being able to return.

Just my thoughts

Zoe

Specializes in cardiac, diabetes, OB/GYN.

Here is the thing I have learned in over 20 years of nursing. Just because you are honest doesn't mean everyone else is...And, we have had anesthesia docs who have been "caught"...They do seem to protect the docs over the nurses....big surprise...

Originally posted by Duckie

The attitude I have gotten from many posts here that if anyone routinely takes a narcotic pain relief med, they should not be working. I am speaking for myself and on my own views here. First drug abuse is much different than taking meds scripted by your MD to improve the quality of your life and the ability to maintain having a life. I have a spinal fusion involving 3 disc's in my lower back with radiating nerve damage down my right leg. I also have severe athritic knees from 22 years of walking hard cement floors caring for loved ones of people intrusted into my care. I fought very hard not to start taking pain medications. But when you reach a point, where you are on your knees doing a treatment and your patient has to call a staff member to help you up off the floor because the pain is so great you are frozen, something has to give and this happened to me more than once. My knees are beyond saving . Pain control is the only way to keep me working. I am 46, should I be kicked out of nursing? Should I be expected to work 10-12 hour shifts in so much agony that the tears rolls down my face without my ability to control them. Or should I be taken out and shot like a lame horse, because I am unable to meet the potentil I once did as a younger nurse, and I might add that even on the days of my greatest pain, I can still work circles around many of the whiny new breed intering our facility that calls off because they have a headache. I have finished med passes while passing kidneys stones on 2 occassions. I routinely take pain meds every four hours while working with another narcotic available if that does not make it tolerable. My work performance is not hampered. I think clearly, make vital decisions and have not had a med error in over the seven years at my current facility. So am I empaired. I have ran codes, worked an entire unit alone that was a 2 LN unit, due to call offs, and my average day is 9 - 12 hours. My supervisors know all meds I take. They back me 100% because the old me is back now that my pain is controlled and I can be me again. Please do not" critisize and accuse until you walk a mile in my shoes." My supervisors have even "noticed my pain and asked me to "take a break and give my meds a chance to kick in, to rest a while in the lounge. They do this because they know I never take breaks, I'm there for my patients from start to finish and will work as late as I have to to make sure they have received the very best of care. The discussion at hand is "drug abuse" not medications that are taken as ordered for a good quality of life. If that is the case, then any LN taking an antidepressant or antianxiety medication should also not be allowed to work, because they are also "mind altering". Now instead, let's all go out and get totally drunk the night before, come in hungover and what the dickens and " can I take care of your loved one?" I think not, I'll continue to do it my way and with a very clear peace of mind. Don't judge me till you've felt my pain and walked in my shoes. I would also like to specify that I do not feel "any buzz" from my meds, they have been titrated to minimum dose for maximum effect without those side effects and the principle is keeping the drug level consistant to control pain but not to produce a "High".

Hi Duckie,

Well Said!!!! If only others understood that being in severe chronic pain does not mean we are invalids. Because we have finally gotten our pain under control and to the point where we can function again hasn't been an easy road. As you have said, "we do not get "high""from our meds. I can't believe that people in the medical field are so judgemental when it comes to the use of narcotics for chronic pain. There is a difference between addiction vs tolerance and having to take narcotics does not make us junkies. I would never ever put anyone in jeopardy by being "high"......never did drugs(including alcohol), though I suppose nicotine is a drug and yes, I smoke, but that's a whole different topic. I'll stop here, just wanted to let you know that I

understand completely and really hope that others will be less judgemental.

Thanks for your post,

JUDE

Specializes in CVOR,CNOR,NEURO,TRAUMA,TRANSPLANTS.

I certainly hope that you didnt get the impression that I consider Drug abuse as the same as Drug use. There is a clear cut difference I learned that working hospice. Very simple theory... and backed up by science. The pain receptors in the brain are coated with the medications, to relieve pain. If you are in pain or have chronic pain the receptors are just coated enough for pain relief. If you are not in pain and you take pain medications and recieve the"high" then it places the receptors in a addictive /active sense.Increasing the need for more to produce the high. Yet those that abuse the drug thrive from the high itself.Those in chronic pain hardly get relief much less a high.(The lock and key theory)

I have worked with many nurses that had high function of abilities when medicated for chronic pain. The majority that I know have been on meds for years,, some even on pumps and if given half the chance they would be off them immediately. They stay on the boarder line of the pain threshold even when medicated. Its not due to the fact of wanting to risk thier facultys its the fact that they have been in pain for so long its next to impossible for them to be in anything but slight relief.

Im not referring by any means to those Nurses when I speak of Drug abuse amoung us... I speak about those that steal from the patients, take their pain meds, fill the syringes with NS and knowingly allow the patients to needlessly suffer because of their own addictions. Those are the nurses and other Healthcare people I want removed. Those that think of themselves and their needs before the care of the patient.

Just my thoughts

Zoe

When I was in grad school one of the courses I took was about supervision and management in substance abuse rehab programs. We had an expert in the field of impaired professionals come in to meet with us, and she maintained that statistically, healthcare professionals (nurses, doctors, et al) have a 20% probability of being abusers, while the general population has a 10% probability. She also said that many nurses and doctors are ACOA (Adult Children of Alcoholics), and often first-born. Part of our caretaker nature, I guess. I know from listening to many of my coworkers that the ACOA part sure seems to be true!

And years ago, when I was a Unit Clerk in the ER, I kept finding fistsfull of syringes behind the lockers (I had to kick my locker door to get it to open or close, and they would fall down); I always gave them to the charge nurse, who was very offhanded about it, and just put them back in the med room (!) Now I'm wised-up enough that I would report that behavior to the Unit Manager, becasue it sure isn't a normal storage place for needles to be kept!

Savvy

Specializes in cardiac, diabetes, OB/GYN.

It isn't easy to accept that some of us have to take meds just to get through the day and function, and it seems that is something that was brought up here. No one wants to be considered a drug user or abuser, but the fact it, semantics doesn't take away from the fact that if you require meds to function, you are dependent upon them. There is surely a line dividing things, but to those who feel no pity or compassion for those unfortunate people who made choices to go into this type of lifestyle either on purpose or however, I question the ability to "really" care for people. There but for the grace of God go I...I don't have to agree, appreciate or condone someone's bad, unfortunate and sad choices, but I DO respect their humanity, whether I like or agree with what they have or have not chosen to do with their own life and the lives of those it directly affects...I am not perfect, and I don't expect anyone else to be....The big lesson in nursing, as far as I am concerned, is to realize and accept that there are no black and white areas, and to somehow figure out how to negotiate in and around the many shades of gray...

Specializes in Hospice.

Just a reminder, it's not only nurses......but the docs, CRNA's, EMT-P's........we have had several incidents over the past years....even a mother/daugher team that were injecting themselves w/ the pain meds insteads of the patient. Gave them NS.

Nursing is stressful. I honestly think more hospitals should offer stress management classes, maybe this would help.

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