Jump to content
jackstem

jackstem

Impaired Nurse Advocate, CRNA, ER,
Member Member
  • Joined:
  • Last Visited:
  • 670

    Content

  • 0

    Articles

  • 15,486

    Visitors

  • 1

    Followers

  • 0

    Points

jackstem has 34 years experience and specializes in Impaired Nurse Advocate, CRNA, ER,.

Addiction Counselor, State Peer Assistance Advisor for Ohio CRNA's. CEO, Peer Advocacy for Impaired Nurses, LLC. Nurse Paralegal and Recovery/Relapse Specialist for the Law Office of LaTonia Denise Wright, LLC.

jackstem's Latest Activity

  1. jackstem

    Poppy seeds

    Can Poppy Seeds Cause a Positive Drug Test? | USADA
  2. jackstem

    failed drug test by First Lab

    PRN4U, I don't know what specific tests they run in Ohio. I do know they will randomly test for alcohol metabolites. Alcohol itself can only be detected in urine for maybe 12 - 24 hours (depending on how much ingested). They test for ETG and ETS which can be detected for up to 80 hours. And I'd be happy to answer questions. Jack
  3. jackstem

    freaking out

    I just posted this in another thread. Most on site testing (screening cups) can occasionally show a false positive or false negative, SAMHSA recommends all positives be verified by GC/MS. There's a link to an article by the National Association of Drug Court Professionals discussing cutoff levels for "incidental" exposure to alcohol. Here's the post: The urine drug screens done on site can show false positives or negatives due to non-specificity of the test (immunoassay). All positive results on the immunoassay screening should be verified by gas chromatography/mass spectroscopy. Here's a link discussing drug testing and cutoff limits for ETG/ETS. The National Association of Drug Court Professionals recommend a cutoff of 500 ng/ml for ETG (ethyl glucuronide) and 100 ng/ml for ETS (ethyl sulfate). This means levels below those numbers can't be ruled out for "incidental" exposure to alcohol through mouthwash certain medications (including OTC cough cold and sleep aids), and possibly food cooked with alcohol. It's a myth that all alcohol is cooked off. I tell my clients if there is the name of an alcohol on the title of the food you're considering ordering, then don't order the food (bourbon chicken, Jack Daniels ribs, beer batter fish, etc.) The chance you'll test positive is low, but with the way the monitoring programs are, why take the risk. Jack
  4. jackstem

    EtG testing - seems impossible?

    Awww shucks...thanks! Been awhile...very busy between work, peer assistance advisor, and my daughter in early recovery (and struggling...a chip off the old block!). The urine drug screens done on site can show false positives or negatives due to non-specificity of the test (immunoassay). All positive results on the immunoassay screening should be verified by gas chromatography/mass spectroscopy. Here's a link discussing drug testing and cutoff limits for ETG/ETS. The National Association of Drug Court Professionals recommend a cutoff of 500 ng/ml for ETG (ethyl glucuronide) and 100 ng/ml for ETS (ethyl sulfate). This means levels below those numbers can't be ruled out for "incidental" exposure to alcohol through mouthwash certain medications (including OTC cough cold and sleep aids), and possibly food cooked with alcohol. It's a myth that all alcohol is cooked off. I tell my clients if there is the name of an alcohol on the title of the food you're considering ordering, then don't order the food (bourbon chicken, Jack Daniels ribs, beer batter fish, etc.) The chance you'll test positive is low, but with the way the monitoring programs are, why take the risk. Jack
  5. jackstem

    EtG testing - seems impossible?

    Here's a good guide to medications and other products to avoid. It's from Talbott Recovery Campus in Atlanta. I provide this to all of my clients when they enter treatment. http://www.talbottcampus.com/pdf/MedGuide.pdf Hang in there! Jack
  6. jackstem

    Suboxone use and the Boards of Nursing

    I don't think Kentucky allows a nurse to practice while on Suboxone. You might want to consider consulting with a nursing license defense attorney. I've put out some feelers from folks who might have the answer to this question. If I receive anything definitive I'll post it. Jack
  7. jackstem

    Help..Meeting with Board of Nursing

    OhioRn, Please be very careful anytime you peak with the BON or anyone associated with the BON. Their job is to protect the public from unsafe nurses, whether due to impairment by some sort of illness or poor practice. Remember, the least amount of information the better. It seems to be human nature to keep talking, hoping we'll be able to "make everything ok". I consult with a license defense attorney and have seen many a nurse go it alone thinking I can make everything better by just explaining everything and end up with a poor outcome (much worse than it would have been if I'd only answered the questions asked). This is why I recommend a nurse have representation when interacting with the BON. The attorney understands the laws, what's appropriate to share and what's not, when to shut up, when to object, and when to leave well enough alone (or proceed more aggressively). The BON has attorneys advising them, shouldn't the nurse have an even playing field? I know, attorneys aren't cheap. Weigh the amount of representation against lost earnings with a poor outcome. Usually not much of an argument when you do that. Contact the American Association of Nurse Attorneys for referrals in Ohio, or contact the state bar association and request an experienced administrative law attorney who has faced the Ohio BON. PM me if you have questions. Jack
  8. jackstem

    Escaping your past mistakes

    A person has to want to make progress and "get well". As recovering addicts we all know this. It's no different for those hurt by the using addict/alcoholic. They have to want to "get over" the past, and then make an effort to do so. Some make progress, some don't. Sometimes we (those causing the pain as well as those receiving the pain) need something to remind us that this is a continuous process, not an event. Perhaps that's what this was (or could be). Who knows? Jack
  9. If you have criminal charges you may also hear from the board of nursing (BON) as well. Consider retaining a license defense attorney if that happens. Do NOT use your criminal defense attorney for the BON unless he/she is an experienced administrative law attorney with experience dealing with your BON. If you have your own malpractice insurance (not the hospital's...your own insurance) contact them for names of attorneys for license defense, or you can also contact The American Association of Nurse Attorneys for names in your state. Hang in there! Things really suck right now, but they will get better. Don't use drugs or alcohol, consider attending recovery support groups (AA, NA, or others), contact the state nurses association to see if they have information for nurse support groups so you can talk with other nurses who may have been through similar situations.. Good luck! Prayers coming your way. Jack
  10. jackstem

    An anticlimatic end!

    Thanks "Tex"! I like "popping in". Need to keep everyone on their toes. The last person who said they thought of me often was a bill collector! I miss everyone here, but things have been busy since I started this counseling job almost 18 months ago. (Keeps me out of trouble sometimes). Hope all is well with you and your family. Hope all is well with everyone here at Allnurses! Love all of ya!!! Jack
  11. jackstem

    An anticlimatic end!

    Someone once told me religion is for people afraid of going to hell...spirituality is for those who have been there. Jack
  12. An amends is about you and not the person you are making amends to. It's the willingness to be humble to make the amends which is important. If you are hoping they will forgive you after making the amends and getting a job, you are likely to be seriously disappointed. If you have a sponsor, talk to them about how to handle this. If you don't have a sponsor, talk with someone in recovery you respect and seek their counsel. I've had sponsees and friends in recovery make amends for past transgressions with me, to obtain the release and relief from the guilt associated with past transgressions. They know I will understand and not judge them for things done in the midst of our disease. Self forgiveness begins when we realize our past is as good as it is ever going to be. Those "things" we did cannot be changed, but we can learn from them. We can heal from them when we accept we did the best we could at the time and will not repeat those actions in the future (if we continue to work our program of recovery...whatever that happens to be). We can also pass on the lessons we learn as well as the forgiveness we receive from ourselves and others as we move forward in our recovery. There is a measure of healing in passing on our own healing and forgiveness to others. Remember, we are not bad people trying to become good. We have a chronic, progressive, potentially fatal disease and are trying to become well. Prayers and positive thoughts coming your way. Jack
  13. jackstem

    An anticlimatic end!

    You might consider contacting TPAPN to see if there are any support groups for recovering health care professionals (sometimes called Caduceus meetings). While some can be 12 Step oriented, not all are. It IS important to have friends in recovery who understand what we've been through. While family and friends not in recovery can be supportive, they have no idea what it's like to be triggered, have a sudden craving (yeah...it's that whole altered brain thing associated with the disease of addiction which gets better but never quite goes away), or to have professional colleagues who should be better educated about a chronic, progressive, potentially fatal disease but aren't, and who tend to be judgmental (not all, but far too many in my book). Where do you meet other people in recovery? Well, unfortunately (or fortunately if you happen to be able to look past some of the things you don't agree with), one of the best places happens to be at 12 Step meetings. I know, some meetings can seem like revival gatherings (don't go to those kind). I know, you said you didn't like them. But the interesting thing I've discovered in almost 19 years of recovery is that I can choose to focus on the things that work and help me stay clean and sober while choosing to ignore the rest; or I can choose to focus on all the things that I don't like and be miserable and have no friends in recovery. I can also choose to remain isolated, or choose to begin to share my story of recovery with others in the profession who have walked this same path. I can also choose to reach out to other health care professionals in treatment and early recovery to let them know they are not alone. One of the things I love about recovery is I have all sorts of choices I am able to make today. When I was using, my only "choice" was to keep using...keep lying, hiding, isolating, in order to keep using. Today I can choose to be clean and sober, to work on becoming a better father, son, brother, friend, person. Today I can choose to reach out to the addict who still suffers...to pass on my recovery, to share those little things I've discovered about myself, my life, my relationships, and my connection with others, living a life of freedom and joy which I never thought possible almost 25 years ago. It took me going to treatment three times, over 5 years of intermittent abstinence, and facing 8 years in prison before I finally realized, and accepted, that I could make the choice to recover (which isn't just abstinence) and live a full and rewarding life, or I could continue doing what I was doing and be a miserable, white knuckled abstinent individual. A gentleman named Chuck Swindoll said it best, and I took it to heart: The shame is understandable and part of the disease (and yes...it IS a disease). None of us asked for this to happen. I recommend the DVD "Pleasure Unwoven" to help understand the disease process. We are not bad people trying to become good. We have a chronic, progressive, potentially fatal disease which alters our brain, and we are trying to become well. It's interesting, since the day I began speaking about my addiction, which began as a result of chronic pain from spondylolisthesis, my life has changed significantly. I went from someone who saw themselves as "bad", "stupid", "weak" and "evil", to someone who finally realized I had a disease which could kill me but could also be gotten into remission and kept there if I did a few simple (but not easy) things. the most important thing I did was stop hiding. It began accidentally when I was asked to speak at an anesthesia conference back in 2003. I spoke, not because I had a desire to change the world or to rally the troops. I spoke because I didn't know anyone where I was asked to speak (the shame thing), and because they were going to pay me an amazing fee and all my expenses to talk for one hour. I needed the money badly. I received much, much more, although I wouldn't realize it until much later. A series of events was started that day which led to me becoming a peer assistance advisor for Ohio's nurse anesthetists as well as the chair of the peer assistance/wellness committee (volunteer position). This led to a job as a consultant with a nursing license defense attorney, and eventually led to a career as an addictions counselor. Tomorrow evening I'm speaking at a church about the issues of addiction in conjunction with childhood sexual abuse. This happened because of a few brave souls in my family (my sister, Dad, 2 nieces, and a daughter) willing to speak out about being sexually abused as children, and seeking help. In the case of my daughter, she was abused at the age of 7, gang raped as a freshman in college, and is now dealing with the disease of addiction (in treatment through a drug court system). If I had not had my experiences I would not have been able to effectively assist my daughter and family members. Speaking out, sharing my story, and not hiding have been the things that not only saved my life, but changed it as well. You and all of our colleagues suffering with this disease and it's fallout are in my thoughts and prayers. Change is possible. So is happiness. I wish you well. Jack
  14. jackstem

    good book- Jackstem??

    Hi Lori! You are most welcome! I'm working as an addictions counselor at an outpatient facility just east of Cincinnati. Extremely challenging and rewarding. Also nice to know my experiences can make a difference for someone else. So how the heck are you? Jack
  15. jackstem

    good book- Jackstem??

    We ARE friends!!! And thanks for your kind words. I know what you mean about your mom getting sick (let alone your spouse as well). My dad died last January after open heart surgery. He lived three months after a complication that couldn't be repaired. I was most fortunate to be clean and sober and able to care for him the last three months of his life. Hope your mom and husband recover quickly. Jack
  16. jackstem

    Can I become a Nurse Practioner?

    You might also consider a consultation with an experienced license defense attorney. They can provide an opinion based on the administrative laws and the nurse practice act in your state. The cost of a consultation when compared to the tution of an advanced practice nursing program is well worth the money. As far as acquiring an advanced degree in order to prove something to yourself and/or others. I tell the clients I work with as an addiction counselor to keep one thing in mind. We are not bad people trying to become good. We have a chronic, progressive, potentially fatal disease and are trying to become and remain well. Speaking as a former advanced practice nurse (a CRNA), attempting to obtain an advanced practice degree is difficult when you really want to enter that particular profession. Attempting to do so to prove something to yourself or others can make achieving that degree even more difficult. I'm not judging your desire to achieve that degree, I'm just giving you something to consider that may not have occurred to you. Also, it has been my experience over the past 8 years as a peer advisor for nurse anesthetists, that people with less than 5 years of solid, continuous recovery struggle with the pressure and stress of an advanced degree program. Focusing on your recovery program and re-entering practice as a nurse will provide enough challenges without the aded pressure of trying to obtain an advanced practice degree/license. Once you have returned to practice and remained clean and sober, you'll have the much needed experience to determine if you want to obtain an advanced degree/license. Good luck and keep us posted! Jack