WriteStuff

Hello EarthChild, I've been a member of allnurses.com but haven't posted in a long time for "long" reasons I won't go into......but I'm back and saw your post. All you are doing is seeking to complete an assignment. We have no knowledge of the "do's and don'ts" of this assignment. How you choose to complete it is based on what you do know. To post it in a forum such as this may be perfectly acceptable to your instructors, so go for it. I was going to be one of those leaders of the pack to respond to your interview if you have not already found someone. You can send me a private message (PM) or e-mail me privately through my email in profile, if you choose. As you are learning...it's not so much what people say, as it is "how" they say it in responding. Take courage. If I can be of help, let me know. WriteStuff and an Eaglewings RN

To bclily: If you successfully completed a Diversion Program through your Board of Nursing, including a probation period, your records are then "expunged" = destroyed as if nothing had ever happened. When you apply for a job in the future you are not obligated to divulge your past problem to a prospective employer and today most employers in the health care industry enforce a "drug free work environment" and a urine screen is now part of the hiring process. One other comment, or question....were you convicted of any felony at all? Employers are at liberty to ask this question on applications and you must be truthful in your answer. If your Board of Nursing is satisfied that you are safe to practice once again it doesn't matter what "others" think at that point. You should be proud of the work you have done to address your problem of addiction and the wreckage it has caused in your life. What's important now, if you want to continue practicing your profession, is to go about it realistically, with confidence, and only after taking a thorough inventory of yourself at this stage of recovery. I personally feel it's a grave mistake for a nurse who was impaired to jump back into the trenches of bedside nursing after only one year, two years, or even three years in a diversion program despite the fact that he/she is clean and sober. I am very much aware that diversion programs offer a transition phase in order to accomplish this, however, recovery is not a simple matter of just not using once again. In recovery we have a saying: "you just have to change one thing, and that is EVERYTHING." We have to learn a new way of living, healthy ways for dealing with the stress of not only every day life, but our work environments as well. My advice is to take stock of the quality of your own recovery program. What supports have you put in place for yourself? Are you grounded in recovery in every conceivable way? Are you attending the meetings that apply to a recovering person? Are you actively involved in a Nurse Support Group? Do you continue to seek professional counseling for the mental, emotional, psychological and spiritual damage that has been done? Have you been diagnosed with any primary mental health illness that needs treatment? Is spirituality today an important addition to your lifestyle? What is the quality of your self-esteem? That "difficult time" you just went through is not something that will ever "be over." You have the disease of addiction which can only be put in remission by practicing daily abstinence and learning a new way of living -there is no "cure." My advice is, if you feel you have reached a place of physical, mental, emotional, psychological, and spiritual balance, to look for work within the profession that distances you from handling any and all forms of addictive drugs. There are those who would disagree with me and use the example of falling off the horse and being afraid to ever ride again. There is some truth in that, but we're not talking about having "fallen off a horse." We're talking about a disease that is cunning, baffling, powerful and even while we're clean and sober, is waiting in the "wings" doing pushups...ready to pounce in a vulnerable moment. Because of the work you've done in recovery you have gifted yourself with the freedom to choose once again, something we lost when our disease was active. Only you can know whether you're ready to jump back into the fray. Be kind to yourself. Go slow, put supports in place that keep you propped up. Hang with the winners. Explore the options you see available...clinics, doctor's office, homehealth, teaching, non-patient care opportunities, management positions, longterm care, private duty, etc. Let yourself down gently and all will go well. Best of luck to you, keep it simple, and remember...we only have to live life, one day at a time. And "yes", I'm a recovering nurse who will celebrate eleven years clean and sober, this August the 8th, God-willing. Take care and keep us posted. Bonnie C.,RN

No miracle story is ever "too long" CCURN! Thanks for sharing that - it brought tears to my eyes too - tears of joy and gratitude!

I have always said this about the "caregiver killers" - "What you see on the job (their attitudes, their personalities) - is exactly who and what they are, outside of the job." You cannot change someone's personality for sure - but we DO need to address that kind of negative, destructive and hurtful behavior in our work settings. It is abusive, counter-productive, and in my estimation - self-serving and immature. Frankly, I think it's a topic that deserves a 1 hour course in the Sr. Year of Nursing School, and I'd like to TEACH it, LOL.

I'm posting this thread without knowing whether it has been posted already or not, in some other version or by some other title, but here goes anyway. (And at the outset, if the Moderators feel it's inappropriate I respect that and will abide by the standards set forth.) It has been my observation, and yours too, that within our profession, on the job, we as Nurses (professionals), continue to participate in personal attacks against one another that is not only unprofessional but unbecoming to the reasons we became Nurses in the first place. Why do we insist on this mean-spirited, caustic behavior at all? Are we just immature? Are we so insecure with who we are and what we do that we have to participate in this pointless war mongering? Are we obsessed with the need to be "right" all of the time? Have we forgotten WHO we are and what we do? Is it just a "woman" thing?? We all work in a highly stress-filled environment regardless of the specialty. I've tried to reason it through and make sense of it all by telling myself: "Well, it boils down to venting 'sideways' so to speak." Because of the stressors we feel in just doing the job at hand, we function in high gear for long periods of time keeping volatile emotions at bay and under control and inevitably those emotions have to go "somewhere" - so they come spilling out like lethal verbal bullets! That's the only explanation that makes any sense. We need to stop it. I doubt it is going to "stop" - but maybe we can become more aware, more sensitized to our unprofessional, immature behavior and see our peers and colleagues as the valued human beings they are. In all of my 34 years in nursing I have never verbally insulted, attacked, or intentionally dehumanized another Nurse - especially in front of others. I'm also convinced that there is an element of "competition" involved in our profession, sadly to say. And that's not "good" or "bad", until we use it as a weapon to get our own way. So what are some of the things we can do to stop killing each other in the trenches: 1. Think before we act. 2. Take that "time out" when we know we need it. 3. Ask to speak to a peer or colleage in private, if it's that upsetting. 4. Take our own inventory first - and ask ourselves, "do I need some time off?, do I need to change jobs?, do I need to get out of this field altogether?" 5. Consult with others we trust if there truly is an issue with another colleague. 6. Re-evaluate my own priorities. 7. Remember where I am (on the job), why I'm there, and re-direct powerful negative emotions that threaten to undermine my care giving. 8. Practice giving praise to peers, lifting them up, look for the good in them. 9. Remember there are only three kinds of "business" in life: (a) God's business, (b) MY business, and © none of my business - and practice staying in the category that applies to me.

I just love to read these anecdotal accounts. I simply believe there are "miracles" happening around us all the time and we miss them because we're so distracted by the business of life. So, it's the obvious ones like this that grab our attention. Thx for sharing DG5.

Well John - take my advice - start keeping a journal NOW. I look back and wish I had done that for my entire career because the most rewarding moments come by "surprise" and SHOULD be memorialized in writing - and it makes all the tears you will shed, the hair you will pull out, and the angst you feel, ...worth it. And...you WILL have, not one, but many stories like ours to share as the years fly by! Have a great day. Bonnie in Minnesota

Thank-you Miranda. I just want to add that NO ONE is "immune" from the seduction of addiction. Given the right ingredients, i.e., timing, availability and accessibility, mental, emotional, psychological, and spiritual vulnerability, -ANYONE can succumb to the seducer's "voice" of temptation. All it takes, under those circumstances, is ONCE. I was not, and am not, a "bad" person who needed to "become good." I was then, a VERY VERY sick human being who needed to get well. And I needed a world of health professionals to help me do just that. When they stepped up to the plate, I found the courage and strength to say - "yes, I'm sicker than most, - help me, help me, help me." And they did. I just pray each day that we as health care professionals can reach out to our hurting addicted peers and extend to them the same loving care we give to each of our own patients, every day we go to work. Sadly, the problem of addiction in our profession is widespread and of epidemic proportions across the board.

I read all 8 pages of posts on this topic. My name is Bonnie. I'm a recovering, alcoholic, addict who will celebrate 10 years of continuous sobriety this August 8th, God willing. I am a Registered Nurse with 34 years of experience. I am responding to this post because I think it's important to hear about the problem of addiction from one who has been there. In particular, one who has been there and survived to date. Everyone who has posted has offered excellent suggestions for the most part. As I read them, I thought of myself of course, 10 years ago and where I was - so far down that road and journey into hell! This is what I would say. An impaired Nurse is an impaired Nurse. The substance being abused isn't really the issue at all. I was a high-functionning addict as well. I diverted and injected Demerol, Morphine, Dilaudid, every single night ON DUTY, and functioned quite well. This friend you are talking about "uses coke" - but that's all you know about. Generally speaking, addicts are poly-addicted. This is a person who, if she isn't diverting in her work setting yet, she will be. I diverted drugs on my unit for THREE SOLID YEARS before my employer intervened. And let me just say this - we were a close knit unit and like a family -as peers and colleagues. I was absolutely terrified to "confess" to my friends this dirty little secret that was killing me. I silently prayed that one of them was "seeing" what I was doing and would report me. I knew I was on a course, that if not interrupted, would kill me, or one of my patients. The hold that addiction has on you is so powerful, so seductive, so unrelenting, that all judgement is altered. It's a "no holds barred" situation because an addict first lives to use, and ultimately uses to live. As health professionals we are considered mandated reporters by law. I'm pretty certain this is true in every state today, although I have not researched it for the purpose of this post. What has to happen in your situation is that the nurse in question has to be brought to the attention of her employer by whatever means it takes. I say this because addicts NEVER NEVER "get well" on their own. And I wouldn't worry about the "friendship" part that has you so baffled because although your exposing of this impaired Nurse might make her extremely angry , (along with your friend), they will thank you later that you saved her life, and probably somebody else's too. It's always a risk to pull an intervention in any situation. I was suicidal when my employer intervened. And I personally have known of cases where the Nurse DID in fact go out and commit suicide after an intervention. So employers are NOT "stupid" and "ignorant" as it might seem - it is a very delicate situation that demands to be handled carefully, with great discretion, and at all cost, with the health needs of the impaired nurse in mind. So don't wait. GO, and tell SOMEONE what you know. I will thank God to my dying day that one of my colleagues TOLD SOMEONE! (and to this day I do not know who it was) I not only got into recovery, but I got my life back and a NEW life at that!! Over the past 10 years I have shared my story openly and unashamedly. If there is anyone, nurse or otherwise, who is reading this and needs to talk to someone about this subject, please contact me privately at: [email protected], or [email protected]

Yes, TriageRn 34, I can totally relate. I am also convinced that the way in which our lives unfold has everything to do with "design" and "forethought" by a Higher Power - rather than chaotic randomization, which would be meaningless. Thanks for sharing your story, I loved it too. It is very inspiring to share such stories!

Hi Stitchie, Unfortunately we did not stay in touch, but I got to meet "Elijah" one time, and it was another "basket-case" moment for me, LOL. I moved from Phoenix not long after that.

:balloons: :Melody: :balloons: :Melody: :balloons: :Melody: After 34 years in nursing I've witnessed lots of "miraculous" outcomes. There's one in particular that has stood out, and remains vivid to this day. I'm defining a "miracle" as that unexpected good outcome after all else has been attempted, and failed. Your "miracle" can be something you witnessed as a student, or within your own family, or even yourself for that matter. But what medical miracle stays with you today? (And thanks in advance, for sharing it.) My story took place in 1971. I was a Senior Nursing Student and we were only a few short months away from graduation. Our last clinical rotation was Pediatrics which we took at Good Samaritan Hospital, in Phoenix, AZ. I was assigned to care for a seven month old baby in the intensive care unit. For confidentiality reasons I'll refer to the baby as "Elijah", and his mother as "Sharon" - not their real names. When my instructor informed me of my assignment my heart fell into my feet. A baby in intensive care!! Even as a student, I had known that Pediatrics would NOT be my speciality after graduation. Don't get me wrong, I love children, but I knew I did not have what it takes to be a Peds Nurse! I would be too much of a wreck all the time to be effective. Peds Nurses are a separated breed as far as I'm concerned. God has anointed them with gifts and talents beyond my comprehension. And that was not who I was. My first day of caring for Elijah was filled with apprehension. It was only after meeting his mother that I was able to calm my jangled nerves. She was a quiet, unassuming woman, whose faith in God was gargantuous compared to mine. Elijah was not only her only son, but her only child as well. His father was no longer in the picture. Sharon was of Latino extraction so she and Elijah were well supported by extended family during this crucible time. Elijah's medical history, in his short life so far, had been relatively un- eventful with the exception of multiple, stubborn, "upper respiratory" infections that grew increasingly "resistant to treatment" with each successive episode. This time, when he developed the all too common symptoms of URI, he had gone into a respiratory arrest at home and thank God Sharon was there to call an ambulance! Elijah had been hospitalized for one week when I came upon the scene. To see him lying supine in that hospital bed attached to mechanical devices that were bigger than he was seemed sci-fi to me. He was on a ventilator, he had three IV pumps, a feeding pump, and of course the leads to a cardiac monitor. Infrequently he opened his eyes. He had these huge, dark brown, doe-like eyes that pleaded for "help" whenever he made eye contact. I had all I could do to give his care each day, just because of those pleading eyes! And he had a head full of thick, angel soft, brown hair as well. The worst moments of all were when I had to suction secretions and Elijah would cough and fret, - then the baby tears would trickle down from the corners of each eye. And of course he couldn't howl with rage to protest these uncomfortable procedures, so the tears sufficed for him. And I wanted to hold him and comfort him desperately but could not under the circumstances. He had been poked and prodded by specialists galore. Tests of every kind had been done. Finally the doctors had informed Sharon that: "We don't know why, but Elijah has lost the rigid quality of his bronchial cartilege so that whenever he would take a breath, and exhale, his bronchial tree collapses." They called it a "bronchial atresia", for which there was no known "cure" or treatment and the prognosis was grim. That was the "why" of his respiratory arrest. Elijah would die without the vent now. Our rotation was only a two week period of time. My heart was attached to Sharon and Elijah and it was HER faith in God that kept ME coming back! She did not know that, I never shared that with her. When the final day came and our rotation ended, I was an emotional basket case. I knew I was leaving and it would be the last time I would ever see little Elijah and his mother, -and that Elijah's short life would end soon. After I hugged Sharon and we cried together, I kissed Elijah on his baby cheek, stroked his thick brown hair one more time and walked out of the unit. I barely got outside the door when I just lost it. I knew I was going to be a heaping, sobbing, mess so I ran for the nearest solitude which I found behind a supply cart in the corner of a hallway. I sat on the floor and cried, and cried, and cried, for Elijah and his mother. After the fact, I checked the "Obituary" column of the newspaper every day for months. I never did see Elijah's name and picture. But I never forgot about the two of them. Life went on for me. I graduated from nursing school, and my career was in gear. It was seven years later that I had decided to give Psychiatric Nursing a try and accepted a position at Maricopa Co. Hospital in Phoenix, AZ. I was in my orientation period of that new job when one day I showed up on the unit and we had hired a new Nursing Technician. Her name was Sharon. Name tags did not have last names on them. I introduced myself to Sharon and felt a strange "familiarity" about her but just passed it off in the moment. Later that day we took our lunchbreak together in the Nurse's Lounge on the unit. We started chatting and swapping the usual..."where are you from", "how long have you lived here", etc. etc. stories. Then Sharon began sharing "why" she took a job in the nursing field. The longer I was with her the more convinced I became that I "knew her from somewhere" - I just couldn't put my finger on it yet. Then the floodgates opened. She said: "I have a son, named Elijah, who the doctors gave up on when he was a baby. He had a respiratory condition for which there was no cure at the time. But I never gave up. I trusted God would heal him somehow and HE DID!! To the amazement of everyone, including the doctors, the problem Elijah had reversed itself, and he is seven years old today!" (as she reached in her pocket and pulled out a picture of the most beautiful, smiling, big-brown-eyed , seven year old boy I had ever seen in my life!!) By this time I was screaming at her....."Sharon, Sharon, Sharon...it's ME, Bonnie, the student nurse who took care of Elijah back then!!" Well, it was quite a scene in that Nurse's Lounge! We hugged and cried and hugged and cried together for what seemed like an eternity. But sure enough....Elijah never did die. Sharon said that "the doctors had no explanation for why Elijah improved. They weaned him off the vent...and IT WORKED. He's my MIRACLE BOY today!" What a day that was. And what were the odds that I would just "run into" Sharon like that........SEVEN years later??? I could have done my own detective work, if I had wanted to - at ANY time during those seven years, but I didn't. I'm not only convinced it was a total "miracle"...I'm convinced that God had several lessons in all of it - designed just for me, as that student nurse. My faith grew by leaps and bounds on that wonderful day of our "reunion." Bonnie Creighton,RN, in Minnesota

Glad you saw the humor in it. Metal bedpans and bedside commodes with a Spring-loaded platform went out of "fashion" right after that. LOL

Hi 50cal, Every Nurse has made med errors - some of them serious. We are human. If a Nurse ever tells you she has "never, ever, made a med error", she/he is lying. Whether you are a student nurse or a seasoned nurse with 50 years under your belt...the bottom line will always be: zero tolerance for medication errors. That will never change, for obvious reasons. You are asking for advice. 1. Own it, without being patronizing and whining. Just own it. "I made a terrible error. This is why I made the error. When I realized I made an error, this is what I did immediately. This is what I could have done to prevent this particular error. This is what I can do in the future to prevent medication errors." 2. Put it all in writing. 3. Put in writing all of the negative outcomes you can think of -or find by researching....regarding your failure to inspect that dressing. Some might be this: I failed to look for - (a) abnormal swelling and/or bleeding at the site, even hemorrhaging into the spinal column, (b) abnormal presence of large amount of "clear" fluid on the dressing - which could be leaking spinal fluid, © green yellow or brown drainage with a fetid odor, indicating infection, (d) the wound has eviscerated - the staple sutures have not held, and the wound is gaping, - these are some of things a Nurse pays attention to with wounds and dressings. Every one of these requires IMMEDIATE intervention. To not inspect a dressing, especially a post-op dressing, immediately, and at regular intervals can lead to disasterous consequences. It is NOT the patient's responsibility to keep us informed. Treating medications errors lightly, or failing to follow-thru with assessments and treatments is inexcusable. Your instructors are not looking for "excuses" from you. They are looking to see if you are taking this as serious as it is, and have the ability to do the critical thinking required around all of it. They will "size-up" your attitude toward it. Does she SEE the seriousness of this or not? Is she indifferent about it all? Is she more worried about herself than the patients involved? Then they will "size-up" your plan of action regarding both incidents. Did she take IMMEDIATE action to protect the patient, once the error was discovered? The reason we are "licensed" in the first place is to give evidence to the general public and those we serve, that we have met the minimum standards required by our board of licensure to ensure the safety of the public. Your instructors will put you on the "hot seat" to test your marketability in terms of the public's safety. Because this is what a Board of Nursing would do as well. Do keep us informed. Good luck with your future in nursing.

nursewendy.....I don't know how old you are, how much experience you've had in nursing so far, but I'll be 61 next month (God willing!), am a Registered Nurse, and have 34 years of experience under my stethescope. Twenty-eight years in acute care, and the last seven in LTC. At the outset let me say this: what you have experienced is NOT the "exception", it is the rule. It is NOT "you", it is the current "mind set" of the healthcare industry at large. In particular, the LTC setting. I have been in the profession long enough to see the health care industry transform from "patients before profits", to today's disastrous "profits before patients" mindset. What you experienced is part of the consequences of this shift. Once health care became "big business", instead of a caring industry, the numbers crunchers (administration and management) also saw you and me in a whole new light. Patients became "clients", and you and I became worker bees. We are no longer valued for what we bring to the table (our education, our experience, our desire to care for others) - we are now devalued in the sense that when push comes to shove (to keep from hemorrhaging dollars), we're kicked to the curb, figuratively and literally. Management and administration does not, did not "listen" to you for the simple reason they would have had to "do" something about it and that costs time, money, and energy. These same management/administrative folks WANT the "deadwood" to remain on the job so they have scapegoat resources when the time comes. They are threatened by the good employee who sees the shortcomings and wants something done about it! None of what you went through was an exaggeration of your emotions. It is a sad reality. The best thing you can do is pick your drooping feelings up off the floor, dust them off, do some objective thinking, cut your losses and move on. The one huge perk of nursing is you have so much to choose from. So, go for it!! And best of luck...

I see that the orginal poster is a "registered user" and does not identify as a licensed health professional. That being the case, the poster may very well not know that licensure is required. My apologies to the poster for my oversight there. As long as I"m here.........maybe I haven't come out from under my rock yet, but it seems you don't read or hear in the news media about persons fraudulently impersonating a Nurse, like you do a Doctor. Doctors are independent practioners, we are, for the most part, employed by someone else. Because of that we're subject to the background check, the license verification, etc. etc. So at least in the acute care and LTC settings it's probably much more difficult to be an imposter.

Now I'm curious why the question was posed in the first place, go figure. Isn't the answer fairly obvious? It would be in complete violation of the Nurse Practice Act in every state and prosecutable. Every Nurse who meets the standards for licensure is demonstrating that she has met the "minimum" standards required by her/his state board. The bottom line is public safety.

Fortunately Adam, he was NOT "bobbitted" that day, not even seriously injured, thank God for that! And you know...not only my story, but others of our stories we're sharing were not all that "funny" at the time. I think the comic relief is in the fact that he was not hurt and I can look back and see it as a humorous story. If I had done him true damage, I would not have shared this of course. But it is a true story. I did "giggle" a little when you you signed your post as "Adam", LOL.

I was in my last year of Nursing School. We were doing our geriatric rotation in a small community hospital. My patient that day was a 91 year old gentleman who had all of his "faculties" intact, - mental and physical alike. He was to be discharged home that day. I entered his room to assist him in morning cares and dressing to go home. He was a spry one for 91 years. He insisted on getting up immediately to "go to the bathroom first." Although he was on the spry side, I didn't trust him standing alone with me so I called one of my classmates to come and help. We decided the best method would be to use his bedside commode. Now, for you nurses who entered the profession after the fact............back in the "cro-magnon" days of nursing, when I was a student, the hospitals used metal bedside commodes that had a seat, but also had a spring-loaded "platform" under the metal seat. The idea was for the nurse to push the metal bedpan onto this platform, which would then be held in place by the "springs" (flexible springs) as the bedpan rested on the platform. Got the picture there?? Ok. I'll call him Mr. Jones......91 yr. old Mr. Jones was in a great hurry that morning and urged us to "hurry with that contraption or you're going to have to shovel manure all morning you two!!!" My classmate stood in front of Mr. Jones to steady him as he positioned himself to sit on the commode. Suddenly, he began yelling: "Hurry it up, hurry it up......." I grabbed his metal bedpan from his bedside table and he leaned over at the waste, positioning his derriere over the "target" (metal seat of commode). The closer he got to sitting, the louder he yelled at me: "HURRY UP WITH THAT THING WILL YOU?" Who was I to pay attention to "what" was also dangling into the open seat of the commode when I gave that bedpan a shove only Daddy would be proud of?? Suddenly , Mr. Jones gave out a blood curdling scream that was heard all over the hospital and people came flying into the room from every direction! I was in shock. What happened? Yep, it happened alright. Mr. Jones, more than adequately "endowed" in the "family jewels" department, in his rush to sit, -combined with my youthful reflexes and lightening speed.....caught his member between the metal rim of the seat, and the bedpan! I got an "F" in Clincal that day. Bonnie Creighton, RN

The long and the short of it is: the "dreamkillers" made me do it! :angryfire We're talking the early 60's here, right out of high school of course. I grew up in a family where you NEVER dared "question" the wisdom and counsel of dear old dad. I knew I harbored this passion for writing ,but I was also smart enough to figure out that "dear ole dad" would never support me in terms of it becoming a "career" of any description. It was only after I had worked as a "candy striper" in the local hospital, and began hearing from significant adults around me that "you would make such a wonderful nurse"....it became a possibility in my own mind. Such feedback was not lost on my parents' ears either. It even filtered through to my high school guidance counselor's ears and he beat me over the head with the idea for two solid years. Frankly, to shut everybody up (the dreamkillers) - I became a nurse. Have I loved it - you bet. Has it only enriched my passion for writing - you bet. Would I do it the same way again - NO! :rotfl: And Brian.......where are you in Minnesota? I'm near St. Cloud. Bonnie, Freelance Writer, retired from the frontlines of nursing

I just read through all of the messages posted relating to drug addiction and the most recent thread. After eight years of being clean and sober and still practicing in my profession after having participated in intensive rehab and the Diversion Program offered in the state I worked in I find this to be one of the most emotionally charged topics we could discuss. It has all of the elements of ignorance about addiction, moral, ethical and legal ramifications for those so intrenched. I posted my personal story in this forum two years ago and to this day I receive e-mails from Nurses who are addicted, read my story and are reaching out for help because they are lost, confused, afraid, do not know where to turn and are sick people who just want to get well. The truth of the matter is that anyone who begins to use addictive drugs, and continues to do so, can become an "addict." No one is "immune." Addiction, when in full bloom, becomes a leveling playing field. As the addicted person travels farther down that road the effects of the chemcials on brain chemistry changes everything about that person's thinking, choices, behaviors, that would otherwise have been considered "normal." As time passes and use increases thoughts of "consequences" become of no consequence. An addict in full bloom lives to use, and uses to live, period. And will go to any length to get the substance wanted and needed. That is a person also who has lost the choice to NOT use, but MUST use. And this is only understood by the addict. It doesn't really matter what triggers the initial use - physical pain, psychological/mental/emotional/spiritual pain. What matters is removing the person from the source of supply, (whether it's the work setting, bar crowd, back alley gang) and getting he/she the treatment they need and deserve - which is another discussion altogether. One may not be addicted to drugs, but are you addicted to overeating, sex, the internet, self-multilation, Mediaography, work, co-dependency, shopping, stealing, - as some examples. There are moral/ethical/legal ramifications and consequences to all addictions. Anything that robs you of your freedom to choose the good and right thing to do to live happy, joyous and free can be a form of bondage. The work begins for you (the addicted one) when you effectively destroy whatever form of denial you are in that keeps you in your prison without bars. I was one of those persons who always said, "It will never happen to me." And it did happen to me. We are only human beings. Just sharing some thoughts after having "been there, done that", but free today and grateful to every person who came across my path to help me get well, stay well, and enjoy life like never before. Thanks for listening. Bonnie Creighotn,RN, Mental Health Consumer Advocate in Minnesota

All of you, too numerous to name individually have given such excellent input, insight, feedback on this ugly subject. And I couldn't agree more.......one that we don't even want to discuss. Just a few comments to add in response to it all: 1. Sloppy Pharmacy administration is no excuse, and being transparent one more time.......I diverted narcotics for three solid years, fudging the numbers, doctoring the count (which can be done) at the same place I worked for 8 years, and Pharmacy personnel ........where were they? What kind of "auditing" were they doing, is a question I asked myself over and over toward the end. 2. Impaired Nurses from, whatever the substance might be, working while impaired, cause a great deal of stress for their peers. There is not only the "moral" issue, but the legal and safety issue as well. Today, if I suspected a colleague was diverting, I would go to my immediate Supervisor first without hesitation. I say this because as the one who was once addicted, I was in horrible inner turmoil, horrible mental, emotional, psychological and spiritual pain, and the denial I was in kept me from "reaching out" for the help I desperately needed, not to mention the fear that was eating me alive. I kept "believing" that my colleagues would "turn me in" for sure because there were so many "red flags" -they could hardly be ignored. And several of my colleagues were personal friends. However, I now understand the feelings THEY were having, and fears as well, and I of course do not "blame" them at all. But, in the final outcome, "someone" had the courage to report me because an intervention did take place. To this day I will never know who it was, but if I could, I would thank that person profusely. 3. It was a little bit disturbing to read one of the posts that indicated a person like myself should be condmened to hell, or words to that effect. People who become addicted to substances are not "immoral" people basically. In other words.....it was not because I had some fundamental lack of moral constrants in my personality that I was doing what I was doing. The addiction becomes set up because of the use.....and as the dis-ease progresses, it affects behavior at every level.......legal, common sense, otherwise "normal" ability to stop something that one knows is illegal, etc. The hallmark of addiction is DENIAL. The user denies it's hurting anyone, denies it's "wrong", denies every built-in feature of self-preservation out of the "need" to "feel ok" because of the drug effects. 4. People who "fail" to recover are usually people who once sober again, and have no drugs affecting their thinking and feeling, are consitutionally incapable of being honest with THEMSELVES. Genuine, sincere, recovery effort is HARD work, because the "work" required is an inside job. And once sober, looking inside is not a pretty picture. The pain of seeing who I really was........lost, no self-esteem, a lifetime of emotional bankruptcy, no healthy boundaries, no spiritual mooring, isolated in every respect, was the most frightening stopping off place I have ever been in my life. I was 50 years old when I went into treatment. Recovery requires starting at "square one" and being willing to go to any length to begin all over again. It is a very personal journey, and few are able to head down that road, which is most unfortunate. We all work in a rich variety of settings, with administrators, supervisors and management styles which are just as varied in their "approach" to this painful subject. I firmly believe that Human Resources Depts. could do much much more in terms of educating new hires, or at the very least provide hard-core inservices for employees, that touches on this subject. It wouldn't take a Rocket Scientist to put in place a pro-active Policy and Procedure that allows employees to freely "report" all of the things you all have pointed out that are so disturbing in your work settings, and do so without recrimination, and with quick and effective action for the impaired colleague. Obviously I am today in favor of random urine, or blood testing for health professionals on the job. And any empoyee who is taking an addictive medication for a legitimate health reason should NOT be singled out, "suspected", when they have a prescription that is valid for the drug. Such health conditions for the most part are "temporary" situations and in no way render the Nurse "impaired" if she/he is using it as prescribed. Thanks again for all of your comments, thoughts, and honest feelings about this subject. Bonnie Creighton,RN, Minnesota

All of the responses are insightful, heartfelt, and appreciated. Thanks to each of you for your own open-ness in sharing your experiences as well. To "mamabear"......CONGRATULATIONS to you......LOVED the "avitars".....and am glad you too are unashamedly able to be open and honest about your own sobriety. There is always hope. There is always help. We share openly in this way because this is a very real, very fatal dis-ease if left untreated. It is a dis-ease that will first take everything in your life, then your very life, just like terminal cancer or any other untreated terminal illness. And, "anitame".......thank-you for the kind words. Kind words are good "medicine", and I am grateful to be on the "good" end of life today!! FYI in general.......I have received many private e-mails from people who I will keep anonymous. There are many many "hurting" Nurses still among the ranks. Bonnie Creighton,RN in Minnesota

In response to questions and comments by those of you who have replied: Sorry if I confused you somewhat regarding the conveniently "forgot" part.......what I believe I said was that the Nurse who is diverting for her own use (or to sell), conveniently "forgets" to chart that the narcotic was "given" on the patient's med sheet, thinking wrongfully that because she/he didn't chart it as "given", no one will notice or care. (The drug is floating around in the Nurse's brain instead.) To answer "JNJ" and the question: "What prompted you to post this?" For whatever reason, recently I have received private e-mails from members of allnurses.com who are new members who have posted, and who read one of my entries over a year ago when I shared about my own personal journey into the hell of addiction as a medical professional. The most frequently asked question was: "How do Nurses divert drugs anyway?" A legitimate question and one no one likes to ask. On August the 8th of this year I will celebrate 8 years of continued total abstinence from any addictive drug (including alcohol since that was where it all began for me in the first place), and it's a topic that is near and dear to my heart. I was most fortunate to have an employer who understood this as a "dis-ease" and saw to it that I got the help I desperately needed at that time. My employer effected an intervention that resulted in my being restored to sound mind, body, and spirit. I self-reported to my Board of Nursing and entered the Diversion Program that was available. I reached out to all and whatever help was available and as a result of all of that help, from many many people......professional and non-professionals alike........I am living a new way of life I never dreamed could be possible. I never lost my license, I never faced criminal charges, although the possibility was very real at the time. The statistics we have available for a Nurse recovering from narcotic addiction are grim indeed, and we rarely hear about the "successes." I continue to practise my profession today without restrictions because I believed in the hope that was held out to me and RAN for that help!! Narcotic addiction for Nurses who are practising in the profession is a huge problem that continues to be "swept" under the carpet because hospitals do NOT want that kind of "publicity" (and rightfully so) and prefer to "get rid of" the problem in many instances by firing the Nurse, or bringing criminal charges, as opposed to recoginizing addiction for what it is: a cunning, baffling, and powerful dis-ease that destroys good people, who deserve the best in treatment if they would only reach out for it when it is offerred. Much progress has been made on the part of employers, but we have a long way to go toward embracing our suffering colleagues as the caring professionals they truly are and doing it with the intent of helping them recover. I was not a "bad" person who needed to become "good" again, I was a very, very sick human being, who needed to get well.........and I have, and am so grateful for all of the help I received when I needed it the most. I welcome any questions about my personal experience and if you so choose you can e-mail me privately at: [email protected]. Thank-you for your comments as I continually learn more, the further I travel down this road we call "recovery." Bonnie Creighton,RN, Minnesota

This is the "how" Nurses divert drugs for their own use. The extent to which this goes on depends on availability. In the hospital setting, Nurses who are in advanced stages of addiction pick work settings where availability is certain, frequent, and a sure thing every shift they work. Oncology is the most desired setting for obvious reasons, but when needing narcotics, any setting where they are given is good enough. The addicted Nurse receives his/her assignment, even "bartars" with his/her peers to "switch" patients so that she receives the ones who have orders for narcotics. She/he starts his/her shift by "reviewing" his/her patients med sheets to identify sources of obtaining addictive drugs. This Nurse looks in particular for poly-pharmaceutical orders so he/she can "bait and switch" at his/her own behest. The Nurse then "assesses" the condition of the patients and determines which ones are "confused", which ones are deeply sedated, which ones would be the least likely to know meds were being played with. The Nurse then takes the narcotic, signs it out, and intends to use it for himself or herself. If the same patient has some other drug like Benadryl, Vistaril, Ativan, that is what is given in lieu of the narcotic. If a patient is on a Morphine or Demerol infusion the Nurse goes to the room, removes the 50cc syringe, having already emptied out a 30cc vial of 0.9normal saline for injection bottle, withdraws the drug, injects it into the empty saline bottle and replaces the 50cc syringe volume with the withdrawn 30cc of saline so the volume remains the same. The same technique is used with 50cc bags of narcotic infusions. Nurses who are "stockpiling" narcotics for their own use come to work wearing a Lab coat, smock, or longsleeved, deep-pocketed smock. Morphine, Demerol, and Dilaudid carpujets are easily hidden in clothing, under the arch of the foot in the shoe, or in any body orifice that will accommodate them. The Nurse often "forgets" to document the narcotics supposedly given, on the patient's med sheet in the chart. The Nurse who is an advanced stage of addiction diverts narcotics and uses them while on duty. They are injected in the thigh muscles on a trip to the bathroom at break times or anytime that's convenient. A bandaid or two over the injection site assures no blood leakage onto the pants uniform. Pill forms of addictive drugs: Vicodin, Valium, Ativan, Xanax, Librium, Oxycontin, Oxycodone, MS Contin, are easily "palmed" and dropped into the pocket and taken later on that break to the bathroom.......or stockpiled, and hidden at home later. Clothing with pockets also serves as a hiding place for needles, syringes, tourniquets, vials, carpujets, if needed at home or on the bathroom break. On a busy, shortstaffed, highly stressful unit, all of these things are easy to come by, and easily hidden. In late stages of addictive disease the Nurse is NOT thinking about his/her illustrious career, the consequences that are inevitable, let alone how it will affect family, career, - or the patient and the people with whom they work. This Nurse needs that "high" and will go to any length to get it. The addicted Nurse is NOT necessarily the "most suspicious" looking one of all, but is more likely to be the most admired, most excellent Nurse on the Unit, and in fact is the least likely Nurse expected. Addiction is no respector of person, position, race, color, creed. There are few, if any, State Boards of Nursing that do not offer a diversion/rehabilitation program for such Nurses. However, if it is discovered that the Nurse is diverting for the purpose of sale and distribution solely, or along with personal use, that Nurse is NOT eligible for these programs according to the law. Bonnie Creighton,RN, Minnesota