Tired of impaired nurses

[epipusher]

Ok...I have been a nurse for almost 20 years and thought I had seen it all. My current employer seems to be a becon for impaired nurses. We currently have 3. The latest one is causing loads of issues. She was a great nurse that worked with us for 1 year. It was found out that she was removing approximately 40 percocets per shift for patients she was not assigned to. Management aproached her and sent her for a drug test. Since she had a personal prescription for the drug, nothing was done. Many of the staff were very uncomfortable when she was around. (She was not signing the MAR--you had to look in the pxysis for the last dose given) Management pushed the issue and she up and quit. Well 6 months go by and she is back (rumor has it that she was terminated from the last place). I questioned my manager about this and she said there would be stipulations. I see none. Her first day back was today and I snooped around in the pxysis. She gave 10 percocet in one shift and once again failed to sign them out on the MAR. None of these patients are alert enough to report that they had not gotten the medication.

What can I do? Does any one know what actions I can take if management continues to turn a blind eye? I know we are short on RN's, but this is crazy. We already have a tough enough job without worrying about team members stealing drugs! A group of us are really upset and not sure what steps to take next. Help!!!

[sissiesmama, ASN, RN]

ms.papa Hey - You read my mind. I have been waiting for OP to post again. I too saw the Recovery forum thread and I think I also was mentioned like you were.

It just bothers me to see some of the opinions as to whether or not "we" should be allowed to nurse, or just be banned so to speak forever, For one thing, if all of "us" were removed forever, there would be one heck of a shortage of experienced nurses. I just hate to see negative opinions from people that have never walked a mile in our shoes, or even yards. I don't tell patients who are getting chemo, I have never had to experience that, thank God.

But, I am not asking to redebate if addiction is a medical, mental/psych issue, or anything else. "We" are all just trying to stay on the right track and prove that we are trying to once again make a difference in people's lives.

Anne, RNC

[JennieO]

Hello,

I am the original poster and I think all of us have had our opinions formed by personal experience. Seven years ago I had the experience of reporting an extemely impaired RN after several other RNs had voiced their suspicions and had been chastised by management for making such an accusation about this fine nurse. Ethically, I had to report him to my NM--fortunately she did believe me and called him in. He fessed up to the NM and the hospital attorney. He opted to go to treatment and then come back. I really looked forward to working with this RN who replaced a vial of narcotic with who knows what and I injected it into my pt. Also, an anger problem that only a few of us were privy to see and I am sure I was on his list. Fortunately, he disappearred and turned up working elsewhere in an OR.

Currently, my unit has a new RN that has been schmoozing with NM (going to her house). Recently, I saw her jump into the Pyxis when someone signed in for a different RN to waste her meds. She was out before the second RN came to the Pyxis. (Yes, we may be lax, but we've never had a problem before but I will certainly be careful). Who know what she did in the Pyxis as her name will not be on it and neither of the RNs were aware of it. Now, an excellent RN of 30 years was heard raising her voice to pharmacy saying "I never took three fentanyl." She was working and wasting meds that day with this RN.

Everybody loves her, even though she is rather "spacey" at times.

In this thread, I have heard little, if any, sympathy for the harm she has and will do to the good reputations of her coworkers. Have we been so brainwashed that we are unable to place responsibility and blame where it belongs. We are made to feel we should forgive this deviant behavior, but WHY should we? Certainly, more concern should be for the nurses that she has harmed. I do agree with the poster that said addicts are selfish and only think of themselves--so why do we absolve them of responsibility for THEIR behavior.

I suppose every innocent poster on this thread would agree if they were ever to have the unpleasant experience of being interrogated by pharmacy and management over a crime they did not commit. We all know these people will now be under suspicion. Personally, this has never happened to me, but I pity the people that it has unfairly happened to.

[Jolie, BSN]

Currently, my unit has a new RN that has been schmoozing with NM (going to her house). Recently, I saw her jump into the Pyxis when someone signed in for a different RN to waste her meds. She was out before the second RN came to the Pyxis. (Yes, we may be lax, but we've never had a problem before but I will certainly be careful). Who know what she did in the Pyxis as her name will not be on it and neither of the RNs were aware of it. Now, an excellent RN of 30 years was heard raising her voice to pharmacy saying "I never took three fentanyl." She was working and wasting meds that day with this RN.

Everybody loves her, even though she is rather "spacey" at times.

In this thread, I have heard little, if any, sympathy for the harm she has and will do to the good reputations of her coworkers. Have we been so brainwashed that we are unable to place responsibility and blame where it belongs. We are made to feel we should forgive this deviant behavior, but WHY should we? Certainly, more concern should be for the nurses that she has harmed. I do agree with the poster that said addicts are selfish and only think of themselves--so why do we absolve them of responsibility for THEIR behavior.

I suppose every innocent poster on this thread would agree if they were ever to have the unpleasant experience of being interrogated by pharmacy and management over a crime they did not commit. We all know these people will now be under suspicion. Personally, this has never happened to me, but I pity the people that it has unfairly happened to.

OOPS! Meant to hit the "Quote" button.

Have you stepped forward to share the information that you observed this nurse "jump into the Pyxis" on the day that 3 fentanyl went missing?

I admit that I would be very leary of working with a recovering addict due to the potential for relapse and casting of blame for missing drugs on unsuspecting co-workers. But it seems that you have the ability to help straighten this mess out in favor of an innocent nurse. Have you made an effort to do so?

[sissiesmama, ASN, RN]

JennieO - I am sorry that you have had an unpleasant experience working with a nurse who is an active addict. I do understand that that is very frustrating experience, because I have been on both sides of the fence. Before I started using (yes, I worked and acted like a normal person) at one time. During that time, I did work with some nurses, both RNs and LPNs that were still actively using. I was also a patient in that was taken care of by one of these nurses. And, yes, this nurse did divert some of my pain meds and yes I was very very angry. This person was a friend and I thought "How could he do this to me. How dare he take my meds when he is up doing whatever he wants and I am lying here in the bed, hurt and sick?"

I also had a nurse (different hospital, different time) that I was friends with, or so I thought) that snuck into the pyxis after me and took out a med in my name. And, yes, I was angry. Very very angry. This happened after I had gone to treatment and gotten to recovery. So, yes I know how it feels to receive the phone calls from Pharmacy and all the others that start harrassing you when they think you have screwed up. I had to pee in a cup so many times I didn't think I could ever pee without a cup again. And I had to meet with all the usual people to defend myself against something I DID NOT do. I stayed angry for a LONG time about that.

When I came out and went to rehab, one of the things I had a lot of trouble dealing with was forgiveness. When I was there, the counselors did a lot of work with us and anger on a couple of layers. The fact that we had been taking drugs from someone else or stealing them from a pharmacy, or whatever we did didn't mean that we were so bad that we didn't deserve forgiveness.

Long story short, I have been there, done that on both sides of the fence. I am sorry you feel angry. I am also sorry that you feel like you are forced to forgive "us". If I were one of your co workers and had been using, I think I would have to tell you "Don't bother if it's that hard." At least when the addict nurse is in rehab, she learns how to forgive her self.

I would rather know up front where you and I stood, instead of you being forgiving to my face and another way behind my back.

Anne, RNC

[leslie :-D]

I am sorry you feel angry. I am also sorry that you feel like you are forced to forgive "us". If I were one of your co workers and had been using, I think I would have to tell you "Don't bother if it's that hard." At least when the addict nurse is in rehab, she learns how to forgive her self.

Anne, RNC

anne, you do understand her reaction though, right?

i'm not exactly a bleeding heart when it comes to addicts and their addictions, and don't find myself feeling sympathetic.

yet i am very supportive to those who are earnest in their recovery process.

if people don't easily forget the wrongs inflicted on them (and others) by the addicts, i would think it's understandable.

bottom line, is learning how to forgive oneself.

it doesn't matter what the sin is, but the ability to redeem and forgive oneself.

leslie

[sissiesmama, ASN, RN]

anne, you do understand her reaction though, right?

i'm not exactly a bleeding heart when it comes to addicts and their addictions, and don't find myself feeling sympathetic.

yet i am very supportive to those who are earnest in their recovery process.

if people don't easily forget the wrongs inflicted on them (and others) by the addicts, i would think it's understandable.

bottom line, is learning how to forgive oneself.

it doesn't matter what the sin is, but the ability to redeem and forgive oneself.

leslie

Leslie - Yes, I do understand her reaction. I have been in both sides of the fence, so to speak. I have been the nurse that has been taken advantage of by an active addict nurse and have also been the addict before recovery. I also know that it is VERY difficult in forgiving. When I was the patient, that is when I felt it hardest to forgive. I don't think we should come out of rehab and think we should be forgiven automatically just because we stayed 30 days or 60 days or whatever. The addict has to earn the forgiveness and it should not be easy. They should have to earn it.

I guess I am kind of middle of the road as far as that goes, since I have been the victim and also the addict. Like I said, the addict has to show remorse and the fact that they have changed and show remorse for their actions. I know my posting sounds screwed up, and I don't want to sound like "Oh, poor baby. She was locked up for ____ days, ... " We have to earn it and show every day that we have changed. I know it is very difficult to forgive the person. I do try to show my support for other addicts that are trying so hard to change.

[leslie :-D]

thanks, anne.

your post made total sense.

and ftr, you have my total admiration and respect.

leslie:redpinkhe

[sissiesmama, ASN, RN]

Leslie - I hope the post made a little sense. Like I said, it is really hard to be able to forgive someone for committing something like this to another, especially to a patient in the hospital, because they are sick and/or hurt and that is the oath that we took and the promise that we should carry out every day that we put on the scrubs and punch the clock.

I sincerely hope that you did not feel that my posting was offensive, because I feel that when reading a lot of your postings, I feel that I can see some of me in yours. I guess when you take these counterparts,

1. being the nurse that is still an active addict and stealing drugs,

2. the patient that gets Tylenol 2 tabs and the nurse swallows the Lortab 2 tabs that he ordered post op "Oh, Anne doesn't really need them, and my______ hurts."

3. the nurse that has a co-worker "sneak up" on the nurse in the pyxis and gets in before she gets out of it.

When I was the victim, it was really really hard to understand and forgive the other nurse. When I became the recovering addict nurse, it was really really hard wondering if my friends, co workers, and staff that I had been working with would forgive me and if I was even worthy of forgiveness and continuing my career as a nurse and trying to earn back the respect that I lost.

Thanks, Leslie!

Anne, RNC :paw::paw::paw: Shadow, Sissie, Bea and Cookie

[heron, ASN, RN]

In this thread, I have heard little, if any, sympathy for the harm she has and will do to the good reputations of her coworkers. Have we been so brainwashed that we are unable to place responsibility and blame where it belongs. We are made to feel we should forgive this deviant behavior, but WHY should we? Certainly, more concern should be for the nurses that she has harmed. I do agree with the poster that said addicts are selfish and only think of themselves--so why do we absolve them of responsibility for THEIR behavior.

I don't see that anyone has asked for absolution or forgiveness ... just a chance to prove that real change has happened. Any addict who is in recovery will tell you that she is still an addict. My late partner celebrated thirty two years of sobriety before she died, yet still identified herself as an alcoholic.

You asked "should drug addicted nurses be allowed to return to practice?" You didn't distinguish between active addicts and those in recovery. I think our answers DID distinguish between the two.

Or ... do you not believe that change is possible?

For the third time in this thread, I have to say that you are not required to forgive, forget or otherwise make nicey-nicey about the havoc wrought by active addiction. In fact, that's the worst thing you can do - it's called enabling and only serves to perpetuate the behavior. If you feel under pressure to do so, something is very, very wrong in your situation.

I grew up in an alcoholic household, cared for addicts on the job and worked with actively addicted nurses. If it would help your situation to talk privately, please feel free to PM me. Heron

[embarrasingfield]

I believe these things should be handled case-by-case.

If you have any social life at all, you'de know that dui convictions are way up because of the BAC requirements and the overall "Witch Hunt" mentality of society. Its silly to take ones livilhood from them because of something like this. Why don't they strip a license for all the nurses (and anyone else) who swerve off the road when talking on a cell phone??

Other than that, of course if there is a true addiction involved, there should be conditions placed on the license.

If Nursing is the "science of care," then how can you NOT care about your fellow nurses????

[JennieO]

Dear Embarrassing,

I do not know how getting a DUI is the same as diverting narcotics at work, working impaired and potentially ruining the careers of other RNs.

Let's not compare talking on the cell phone while driving with stealing and using narcotics while perfoming pt. care. This trivializes being an impaired RN, which is not trivial as any BON will confirm.

As for the science of caring, it is more important to care about the innocent RNs and yourself as opposed to the harmful, out of control behavior that an impaired RN has chosen. Again, the needs/wants of the impaired RN do not supercede the needs of others. This is called enabling, as a previous poster stated. I personally will not engage in this enabling behavior or prioritize the drug addicts needs over anybody else's. Drug addicts want you to feel sorry for them so they can continue to manipulate and not take responsibility for their actions. Frankly, the path they chose is just that, chosen. I do care about my coworkers and enjoy many friendships at work. I will continue to have friends at work and will distance myself from the drug addict as she is on her own "path" and she will arrive at her destination by herself. Fortunately, most nurse's do understand drug addiction and have the good judgemnt not to associate too closely with a suspected/confirmed drug addict, much to the chagrin of users and previous user's.

"If you lie down with dogs, don't be surprised if you get up with fleas."

[BradleyRN]

Frankly, the path they chose is just that, chosen.

Jennie,

It could easily be that many addicted nurses started out as addicted patients. Hydrocodone is the most prescribed narcotic in this country. At the same time, it is also the most abused. I have seen several times patients that begin as normal people with an injury, and end up with an addiction. I have also seen elderly people in nursing homes that were addicted to oxycontin. They dont even realize that their behavior is demonstrating addiction. There is a fine line between seeking treatment for pain and becoming addicted to that treatment. Hopefully, none of us will ever be put in that situation.

When a patient comes into the hospital, and is allergic to a whole list of narcotics except for one, then it is pretty clear that he/she is drug seeking. Or if a patient is very upset to be switched from an IV form of a med to it's PO equivalent, then they may be drug seeking. In the cases where we suspect that they are drug seeking, nobody seems to want to be the one to address the situation with them. I propose that anytime we give a patient a prescription for an addictive narcotic, then it should be part of our patient teaching to explain the risks of addiction, with literature that can lead them safely to NA. If we had this talk with every patient that received addictive narcotics on our watch, then it wouldnt be so difficult to accost the drug seeker about the same issue, since it would be part of our routine.

In many cases, such as an elderly woman addicted to oxycontin, or a patient that was in an accident, took a prescription for a few weeks, and wound up an addict, their path was not a conscious choice. Since we arent psychics, then we have to treat all addicts as we would treat these cases, because whether they are nurses or not, they may have started in the same way.