So much anger

SpankedInPittsburgh, DNP, RN · Apr 16, 2018

Hppy:

First congratulations on your recovery and continued efforts at doing what works for you. Second, no Nurse should ever look down on another Nurse. This sort of hierarchy where some nurses think they are more important than others seems entirely nurse created garbage and carries no weight with me. I'm an ER Nurse and could not do your job. I get exposed to behavioral health patients all the time for short periods and honestly a couple hours with them is enough for me.

About the anger an resentment, you are correct!!! I hate this program and everything it stands for. The idea that nurses are forced into recovery when they weren't impaired at work fills be with a certain rage. I have no desire to let loose of that pure and distilled hatred. Not letting the Nazi's win is what gets me through this nonsense. The 12 steps work for you. To each their own but I'm not going to start spewing Pollyannaish jargon about how this process has made me a better person or a nurse. I got about 781 days or so until my next drink & I'm not going to pretend to be in recovery. You don't get shanghaied into recovery its a deeply personal choice with corresponding commitments. I got none of that and don't want it

catsmeow1972, BSN, RN · Apr 16, 2018

Hppy's got a lot of really good points. From my observations as one who was sucked into this over mental health issues, many folks frustrations come not from being required to be in a program but that the programs have cemented themselves into boilerplate, carbon copy contracts with obscenely overpriced, frequently unnecessary rehab stays. Even if a person survives that and settles into life under monitoring, there is little or no room to show that one is doing well and as Hppy says, being able to go in front of a committee to request a lessening or cancelation of some stipulation.

In short it appears (in many states) that the same large heavy book is thrown at the person with an off-the-clock stupid decision DUI as the person with a severe problem that was diverting narcs from the Pyxis. I have said it before. There is a place for these programs. Run in a truly supportive manner and honestly advocating for the impaired nurse, they can be a godsend. They way they are now?, No. More harm than good comes out of them and that sadly is why some lawyers have been able to make a specialty out of representing people dealing with these programs. I believe that at one time these programs were created to be a gift, a second chance....now they a convenient dumping ground with which to punish "bad" nurses and that is very sad.

I also agree that mental health nursing is given a bad rap. I am preparing to attempt to try to attempt (deep breath here) to get back into the workforce. In my happy place I want to go back to OR. I do also have to realize that that may not be possible for my own good. Don't know, we'll have to see.

If my first love proves to be impossible, Psych nursing does appeal to me because that is a population that, also as Hppy says "needs out of the box thinking." That is a population that needs to be listened to and that needs to know they are not being warehoused (you don't have to be institutionalized to think you are being warehoused.) I think we all have a sense of that "warehousing."

Maybe if these programs returned to the novel out-of-the-box thinking they were when they started, there would be less ******** and moaning. The only way to do this, folks? Petitions, letters to your congressmen and efforts. It's a slow process and changes are unlikely in the time we all are on this lousy carnival ride but in the meantime it's what we can do.

Recovering_RN · Apr 16, 2018

I honestly have NEVER come across any nurse who looked down on psych nursing. I have heard (& said) many many varieties of "I could NEVER do psych" or "I 'hate' getting a psych patient", or my own personal expression that I've used (inside my head) "oh, god, there's a psych patient in room 4, shoot me now". But none of those feelings are looking down, AT ALL, on psych nursing! Truly, it's more that we know we do not have the skills, knowledge, empathy and patience for it. I see it as similar to peds nursing. I get peds, once in awhile, and EVERY time I wish those parents had taken their kid to a children's hospital!! Then we look around for that rare nurse who likes peds to help us, just like that (even more) rare nurse who likes psych. We need help with those patients because we know it's something we are not good at. It's NEVER a matter of "looking down" on psych nursing. It's more a matter of looking at ourselves and seeing our own weakness, admitting it, and hoping someone who has more affinity with the psych patients will come along and bail us out!

I know you probably read people saying all the time "I'd never do psych", but that is in NO WAY a low opinion of psych nursing! It's actually the opposite.

allnurses Guide · Apr 16, 2018

I honestly have NEVER come across any nurse who looked down on psych nursing. I have heard (& said) many many varieties of "I could NEVER do psych" or "I 'hate' getting a psych patient", or my own personal expression that I've used (inside my head) "oh, god, there's a psych patient in room 4, shoot me now". But none of those feelings are looking down, AT ALL, on psych nursing! Truly, it's more that we know we do not have the skills, knowledge, empathy and patience for it. I see it as similar to peds nursing. I get peds, once in awhile, and EVERY time I wish those parents had taken their kid to a children's hospital!! Then we look around for that rare nurse who likes peds to help us, just like that (even more) rare nurse who likes psych. We need help with those patients because we know it's something we are not good at. It's NEVER a matter of "looking down" on psych nursing. It's more a matter of looking at ourselves and seeing our own weakness, admitting it, and hoping someone who has more affinity with the psych patients will come along and bail us out!
I know you probably read people saying all the time "I'd never do psych", but that is in NO WAY a low opinion of psych nursing! It's actually the opposite.

There was nurse here recently that said something like "I now only get to work on psych and everybody hates psych patients" something like that psych patients are poor lost souls who need help.

Secondly to Cats - I understand what you are saying when I went through this the programs were more liberal. I did not have to go to in patient as I had already don out-patient treatment and I was advised by my monitor to request release of stipulations when I could. I even had three false + Etg tests the only resulted in 4 days off work each time for a verification test and my employer was standing right there waiting for me when I was cleared each time.

Hppy

Persephone Paige, ADN · Apr 17, 2018

I was Pollyanna. I knew I needed help and I have gotten it. I just wish I could get a job. I don't mind the money, I don't mind the monitoring, I don't mind cleaning up the wreckage of my past. But, I do mind that there is no one as some sort of a liaison between us and the employment aspect. Even prisoners get help upon parole! We don't even get that!

Yep, you need help! Yep, you need monitoring! Yep, you need an RN refresher! ( But, the hospital won't let me in! SORRY!Can't help you there ) Yep, you need a job to complete your monitoring! ( But, I can't get a job! SORRY! Can't help you there ).

beekee · Apr 17, 2018

Hijack! I love your posts hppygr8ful. They are inspiring and insightful.

I'm grateful that there are nurses like you, Hppygr8ful. I personally enjoy taking care of patients with psych diagnoses, but I'm not sure I could do it full time. Psych nurses have mad skills. I'm in awe when I see good (psych) nursing in action.

Carry on!

catsmeow1972, BSN, RN · Apr 17, 2018

I was Pollyanna. I knew I needed help and I have gotten it. I just wish I could get a job. I don't mind the money, I don't mind the monitoring, I don't mind cleaning up the wreckage of my past. But, I do mind that there is no one as some sort of a liaison between us and the employment aspect. Even prisoners get help upon parole! We don't even get that!
Yep, you need help! Yep, you need monitoring! Yep, you need an RN refresher! ( But, the hospital won't let me in! SORRY!Can't help you there ) Yep, you need a job to complete your monitoring! ( But, I can't get a job! SORRY! Can't help you there ).

That lack of real help, I think contribute to the anger also. These things have degraded into a method of punishment. Persephone is right. Even prisoners get help upon parole. I have little (okay, no) personal experience with the probation/parole system but my understanding is that it's cut and dry. Here's the rules, you follow them verbatim. You don't screw up, you may be done early.

I suspect many of us just feel as though we are being flogged and flogged without mercy. I have to wonder how many nurses are lost due to the onerous financial aspects that, if one cannot get a job due to the restrictions (some appropriate, some ridiculous, many loosely interpreted seemingly dependant upon the direction of the wind and the case manager's mood) one cannot continue to pay for very long.

A liason between the programs and employers would be a grand idea. Someone that does more than claiming to "oh we educate employers on the program." Yeah, whatever. The assistance needed should be individualized. In my opinion a program participant should be able access this persons services solely for the purpose of employment help. This should not be the case manager. Not everyone needs employment help. Not everyone is in the same area of the state. This person could be one who runs interference between HRs in large hospitals in a state (I just think those are most likely able to work with stipulations) and program participants. Before long a database of contacts is built. I should think that an employed, thereby probably more likely to be successful participant would only add to the "successful completion and thereby our reason to continue to exist" statistics.

I think I just wrote a job description. I wonder if it's realistic.....

ruby_jane, BSN, RN · Apr 17, 2018

Today I am happy, grateful and free of the clutches of my addiction. The job I got while in monitoring ignited a passion for Mental Health Nursing that has become a career I love. It always hurts me to see my profession so looked down upon by nurses who think they are better than psych nursing. Frankly Psych nursing requires a lot of outside the box thinking.
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I always appreciate your perspective. You seem like you're using the additional tools/lessons that life handed you in the most positive way.

rn1965, ADN · Apr 17, 2018

When I first came to this forum in 2015 I was already done with my monitoring program but was hoping I could add some experience, strength and hope to help others get through this process, There was a lot of real support that I don't see now. There's a lot of anger some of it very justified by people who were never impaired at work, who got in some kind of trouble prior to even becoming a nurse or for people sucked in due to mental health issues.You know who you are and this is not aimed at you.
If you are here for diversion of narcotics it might interest you to know that this was considered a felony before these monitoring programs started. Nurses were stripped of their licenses, prosecuted and sent to prison, sometimes for as long as three years.
For those of us who battle addiction it's important to remember that addiction is a disease of self-will run riot. Those who suffer from it have 2 character flaws in common, anger and resentment. My therapist was a nasty woman who told me that I needed to start living or get on with dying. I had to let go of all my anger and resentment in order to reclaim my life. I followed every rule, went to every meeting, got an approved job and always asked for some stipulation or another to be lessened or canceled every time I went in front of the diversion enforcement committee. So much so that I had my narcotic privileges within a year. I was never bullied, belittled or made to feel less than because of my addiction and by choosing to be open with friends about my circumstances, I learned who my friends really were.
I never burned any bridge with anyone.
Today I am happy, grateful and free of the clutches of my addiction. The job I got while in monitoring ignited a passion for Mental Health Nursing that has become a career I love. It always hurts me to see my profession so looked down upon by nurses who think they are better than psych nursing. Frankly Psych nursing requires a lot of outside the box thinking.
There's always a time to complain and B & M. But instead of egging on people's anger and despair maybe we should be trying to help by giving real examples of how to deal with the situation described.

Hppy

Hppy,

Thank you so much for your words. I, myself, identify as an alcoholic and addict. Although I was never impaired at work, either, it was only a matter of time. I got sober in a 90 day residential treatment that I checked MYSELF into. It was a scummy place with scummy people, but, just what I needed. I did not get involved with the other residents and their drama. I was there for me and I was able to mostly remain focused on my recovery. Not everyone can.

I thank you for your dedication to Psych nursing. I hope to be able to follow in those footsteps and maybe even work with addicts/alcoholics who are seeking treatment.

I know there are places out there that house those who are using rehab/treatment as a means to avoid jail/prison. There were certainly plenty in my treatment facility. However, among them is that one sole who really, really wants to lead a more productive, fulfilling life and is sick and tired of being sick and tired. I want to be able to help that one person.

I applaud you and your accomplishment ! Keep up the good work!

Recovering_RN · Apr 17, 2018

A liason between the programs and employers would be a grand idea. Someone that does more than claiming to "oh we educate employers on the program." Yeah, whatever. The assistance needed should be individualized. In my opinion a program participant should be able access this persons services solely for the purpose of employment help. This should not be the case manager. Not everyone needs employment help. Not everyone is in the same area of the state. This person could be one who runs interference between HRs in large hospitals in a state (I just think those are most likely able to work with stipulations) and program participants. Before long a database of contacts is built. I should think that an employed, thereby probably more likely to be successful participant would only add to the "successful completion and thereby our reason to continue to exist" statistics.
I think I just wrote a job description. I wonder if it's realistic.....

Although not NEARLY as comprehensive, TPAPN has attempted this with their advocates. Each TPAPN participant is assigned an advocate who is a volunteer that is supposed to be there to help in any way the participant needs, such as navigating the process, definitely getting the paperwork completed after getting hired. Originally they were supposed to attend the "back to work" meeting that happened with a participant and their new employer, explaining the 8 page document that had to be signed by he employer. It's the contract that describes all the restrictions, the quarterly reporting requirements, the need to allow the nurse to leave for drug testing if necessary etc. They also originally attended all the quarterly status meetings between the employer and the TPAPN nurse. Nowadays, there just aren't enough people volunteering to be advocates, so they aren't required at any of these back to work or quarterly meetings anymore. I'm actually thankful for that since I don't want a third party between me and my employer! My advocate also helped me during the job search by sending me information about interviewing, resumes, etc. Probably nothing I didn't know or couldn't find myself, but she tried. These advocates are often previous TPAPN participants so they know the ropes, but unfortunately mine was not, she was just someone who'd heard about TPAPN and wanted to help out nurses who'd experienced problems with drugs or alcohol. The advocates do not have any special knowledge or influence with area hospitals, though, and that would've made all the difference! That would be great. My advocate was nice and tried to be helpful, but after I got my job and got settled into TPAPN, I didn't need her anymore and I was able to drop the required weekly contact with her.

So yeah, the TPAPN advocates don't go anywhere near the level of support that you describe, but I do think that someone at TPAPN was at least trying to offer that type of help.

Persephone Paige, ADN · Apr 17, 2018

I would just like it if there were facilities we could depend on to be IPN friendly. Perhaps the monitoring programs want deniability? I have a really good group and everyone is doing well in their jobs. No one has relapsed, or taken medication from a facility, etc... But, there is always the potential for that to happen. By not getting involved in that aspect ( who hires us ), IPN can say, " we get them help, but if you hire them it's on you."

It not that I am opposed to doing the footwork, I'm not. I am very capable, I always was. Employers do not have an appreciation for the bulging 3 ring binder I have that proves how truly capable I am. They are not impressed by essentially 8 years of progress towards this moment. The very things that make me twice the nurse I was before, are the very things I can't speak about in an interview. After 10+ years of freedom from having a rod up my ass, I must now pretend that what 'happened' ( my fall from grace and recovery ) was just a blip on the radar and focus on my marketability.

There needs to be a blending of all life experience and an appreciation for obstacles overcome outside the nursing realm. A liaison could help with that. I don't need a 3rd party during my interview, but an introduction would be invaluable.