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!!!

[Atheos]

As a mandatory reporter you are required to report abuse. Not just provable abuse but suspected abuse. Ok, now that's out of the way.

Not sure how it works in a hospital but in a LTC facility diverting drugs is misappropriation which is a form of financial exploitation which is abuse. Which must be reported. Of course, the hospital environment may be different so I am not sure how it would apply.

[ms. papa RN AGAIN]

I appreciate all your replies. Unfortunately, I do not have absolute proof of this, so I will keep quiet at work on this issue. I will let someone with more "clout" on the unit raise the alarm. I am not obligated to report something on suspicion alone and I will ensure that I do not see anything that would put me in a position of obligation to report. Remember, I have already reported someone, when six other coworkers who were witness to the same behavior said nothing to anyone but each other. Most of you have never reported an RN for substance abuse, so do not criticize me as I have already had the courage to do so.

As a single mom of a sick child, it would be very irresponsible to jeopardize my job, and daughter's health care, ability to pay for medication, etc. In my situation, the right thing is to provide for my child as she takes a greater precedence to me than this situation. Again, I do not have positive proof so I am not obligated to report anything. I feel fortunate that what I have seen has made me suspicious and I will protect myself accordingly.

Back to the original post, I do not feel the rest of us should be under this kind of duress to accomodate someone who has already betrayed people's trust. We all have problems. The rest of us deal with our problems, but do not take casualties with them.

I like the analogy that someone made of would a recovering alcoholic taking a job as a bartender be the appropriate thing to do. No. Truly, it is the same issue with the exception that narcotic diversion and use at work as an RN are illegal and can effect coworkers legally. I do understand that as an RN the active/recovering addict makes more money than they would make taking a different job. Is this not selfish on the addicts' part to risk pts and other RNs careers so THEY can make more money? If they truly wanted to recover they would not work with narcotics, but the money appeals to them more than the risks to others. It may be hard for many to face, but I do believe that is the reason they return to nursing.

You talk about "us" not critizing you for your choices, yet you stand in judgement of all addicts, regardless of level of recovery, lessons learned or choices made ( I chose not to divert, some others chose to turn themselves in and we all CHOSE to get better, face our fears and return to a job we love.)

You talk about the courage it took for you to turn in one coworker but see none of the courage it takes for someone to recover from something as devastating as "we" have. You had courage once but no more, "we" have it everyday when we wake up and face our lives both past and present without resorting to using drugs/ETOH.

You accuse the recovering RN of only wanted to work in our desired field for the financial security-duh, that would be the reason you stated yourself that you are prepared to watch a nurse you deemed an addict practice daily and by your own words "endangering vunerable patients and casting suspiscion on innocent RNs" and you PLAN to turn your back so you can't be held up to the standard of mandatory reporting that your license/"ethics" require.

Why? B/c suddenly the "innocent wonderful" nurse with this long and stellar career is enabling the addict and will have to deal with the accusations of the missing fentanyl on her own.

You made it sound as if you KNEW the sequence of events to be true and that you witnessed it, but when questioned you say you have no proof. You understandable want to keep your life intact and not make a difficult choice. Even if it means that now all the "vunerable pts and innocent nurses" you are so concerned about "us" (me) hurting one day regardless of our truths- are at risk (at least in your opinion).

But the truth is that you don't know she took them, or that she is impaired at all. Rather that you have formed all your judgements and biases from your initial incident and you are damning all addicts AND this other nurse b/c of that. Or you don't like that so many on the unit like her. Or may be you are right. Nobody will ever know for sure. Because you aren't going to find the courage, take the risks or go the lengths to do the right thing- like all of "us" have.

And the last thing I want to tell you is that I do not expect you or anyone like you to make accomendations for me to return to nursing. I know that it won't be the closed minded and judgemental sort to give my 2nd chance. I also know that when I do get back to work nobody will be at risk legally, ethically or any other way. I know this and don't have to prove it to you. But you are welcome to keep checking back to read how hard it is for me to get hired, or read about other problems caused by our hx and maybe it will help you not think about what you should be doing about the things you can change. Good luck to you.

[Quig]

"but it just seems common sense that the nurse should be allowed back into practice provided he/she is closely monitored and not able to easily gain access to drugs"

Stealing drugs, yeah, could happen, is that the primary thing we need to be worried about? I don't really think so.

Some jobs are a factor of privilege, one doesn't have a right to be something, and that's the way things have to be, the idea of 'fairness' is a false argument, systems don't have to be fair. WE have very few ex-junkie airline pilots, so if one is comparing technical vocations, that's a good one, what's a hospital but a complex journey thing, like a ship or a plane.

[sissiesmama, ASN, RN]

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."

JennieO - I am glad that you "have friends at work, care about co workers," and "enjoy many friendships." Not really sure about the point to those comments, because I am an addict and a nurse, and I also have many friendships at work, care about my co workers. I would (and do) distance myself from a nurse that IS NOT IN RECOVERY AND IS ACTIVELY USING or breaking the rules that we addicts seem to break. You have no way of knowing without a shadow of a doubt that in these friends at work that none of them are or have been involved with any of the things that you bring up in your postings.

So, since I am a nurse and also a recovering addict, does that mean that I am not worthy of having friends and people caring about me? I sure hope not. Is there any difference between a nurse that has been clean and sober for 10 years and goes to meetings, talks to her sponsor religiously and a nurse that is an addict that is still actively using? Yes, they are both addicts, but I see a difference, surely I am not the only one.

I know there is nothing that I could say that will change your mind about "us" as addicts. I just hope that you will not be personally affected by this. I used to think that it wouldn't get anywhere near me, but I was wrong. I had to eat a big piece of humble pie.

Anne, RNC

[sissiesmama, ASN, RN]

Wiat i'm confused.. IF you did NOT report her then you ARE covering it up...

IF you did NOT report her.. then YOU are also creating an unsafe work environment for yourself, your patients, other staff members.

If she wants help she will come forward?... most addicts don't.. its someone saying they need the help that opens their eyes... Should a patient have to die before it opens her eyes that she needs help? I seriously hope your answer is no...

And... if you didn't report what you seen and someone else knew you seen it they could report you...

MIcrunchyRN - some of my thoughts also. She did/does have a responsibility to report. And, like you said, she is also participating in the continuation of the unsafe workplace. And is she knows and just turns a blind eye, she could be contributing to the harm of a patient.

Anne, RNC

[sissiesmama, ASN, RN]

I appreciate all your replies. Unfortunately, I do not have absolute proof of this, so I will keep quiet at work on this issue. I will let someone with more "clout" on the unit raise the alarm. I am not obligated to report something on suspicion alone and I will ensure that I do not see anything that would put me in a position of obligation to report. Remember, I have already reported someone, when six other coworkers who were witness to the same behavior said nothing to anyone but each other. Most of you have never reported an RN for substance abuse, so do not criticize me as I have already had the courage to do so.

As a single mom of a sick child, it would be very irresponsible to jeopardize my job, and daughter's health care, ability to pay for medication, etc. In my situation, the right thing is to provide for my child as she takes a greater precedence to me than this situation. Again, I do not have positive proof so I am not obligated to report anything. I feel fortunate that what I have seen has made me suspicious and I will protect myself accordingly.

Back to the original post, I do not feel the rest of us should be under this kind of duress to accomodate someone who has already betrayed people's trust. We all have problems. The rest of us deal with our problems, but do not take casualties with them.

I like the analogy that someone made of would a recovering alcoholic taking a job as a bartender be the appropriate thing to do. No. Truly, it is the same issue with the exception that narcotic diversion and use at work as an RN are illegal and can effect coworkers legally. I do understand that as an RN the active/recovering addict makes more money than they would make taking a different job. Is this not selfish on the addicts' part to risk pts and other RNs careers so THEY can make more money? If they truly wanted to recover they would not work with narcotics, but the money appeals to them more than the risks to others. It may be hard for many to face, but I do believe that is the reason they return to nursing.

JennieO - I have read your postings and have not offered many comments on this topic, but I have in this thread posted that I have experience both sides of the fence. I have been a nurse that diverted at work and owned up and 9 years later I am still an addict, but I am also still a nurse. You ave NO right to just guess whether not not ANY of us have been in your shoes and reported another nurse. I HAVE, just like you had to. I did it for my co workers and also the patients.

But, I take offense in your comment that the reason that recovering nurses return to their career just to keep making the money that they were used to before they got caught. You have no right to just make assumptions about any of US that went back to nursing. The people you are referring to, I am guessing, live in your area, unless you have nothing at all to base that on and you are just making random comments.

I try to never just make assumptions about other people and their motives, or anything else. But how dare you just make the assumption that the only reason I went into rehab and 9 years later still nurse, still go to meetings, still talk to my sponsor, still help other nurses that are just starting out in their path to recovery is just to get the paycheck that I was accustomed to.

I decided that I wanted to be a nurse at an early age. My grandmother had a stroke and I watched the nurses taking care of her. I was about 10 yrs. old and my aunt bought me a book about Clara Barton and I decided that I wanted to help other people's families the way those nurses took care of my g. ma.

So, let me summarize. I went to nursing school not because of the paycheck, but because it was what I really wanted to do. I went back to work as a nurse after treatment not because of the paycheck, but because it was still what I really wanted to do, and to prove to myself, to my family and my friends at work that I could once again be trusted and be a productive nurse the way I once was.

If all I wanted was a big paycheck, don't you think that there would be other jobs that would pay as well as a nurse, and not have the potential to get a needlestick, or urinated on, or vomited on or get sick from the smell of a purulent draining wound on some little man's old coccyx? Or even get assulted on a psych ward when a 300 lb. bipolar man gets out of control and violent?

DO NOT make assumptions about people you have never even met. You can not read my mind, so you don't have the right to just assume that I just went back "for the money".

Anne, RNC

[shelly304]

OK, I'll bite. Been a nurse for 5 years.

I've been clean and sober since october 6, 1989. Way before I was a nurse. From everything I've read, the OP doesn't feel I should have even become a nurse.

I agree with the other posters. If you know this happening, then report it the BON. Done. Over. You did your part. If you choose to remain silent then quit complaining. You are a part of the problem. We can whine and cry all day long about how the world is wronging us. Until we take responsibilty for our actions, we sit in our *hit and point fingers. So quit being a part of the problem, take action, and do the right thing.

[sissiesmama, ASN, RN]

OK, I'll bite. Been a nurse for 5 years.

I've been clean and sober since october 6, 1989. Way before I was a nurse. From everything I've read, the OP doesn't feel I should have even become a nurse.

I agree with the other posters. If you know this happening, then report it the BON. Done. Over. You did your part. If you choose to remain silent then quit complaining. You are a part of the problem. We can whine and cry all day long about how the world is wronging us. Until we take responsibilty for our actions, we sit in our *hit and point fingers. So quit being a part of the problem, take action, and do the right thing.

Shelly - hello- Thank you for your posting. I know this is a sensitive subject for some people, but this is one that just really cuts you - the OP knows nothing about me except for the few words that she can see on my public profile. She has no right to judge or even just assume that the only reason I returned to the field of nursing would be $$$.

You and I and all other recovering nurses who read or post on this thread do not have anything to prove to her. I get up, don my uniform and stethescope and clock in at work EVERY DAY to prove to myself that I can still be worthy of once again being a nurse. Every day at work that I don't go home with a gleutus full of Demerol, or whatever med I am around I prove to myself that I am still on the right path to recovery. Every day I prove to my family and my sponsor and my director that they were not wrong to give me a chance to once again do what I have wanted to do for the last 25 years, which is ... a NURSE!

Anne And when I hit enter on this message I will be saying our serenity prayer over and over because there is nothing I can do or say to change your opinion of "us", nor do I want to run my BP up in futile effort to do so.

[shelly304]

Anne, Please remember you have to prove nothing to the OP. Your responsibilty is to God, your family, and your work.

As far as I am concerned the OP can keep posting negative posts about her situation. Until she takes action, her situation will remain the same. By not doing what is right, harm is flying in every direction. Sometimes our own guilt has an odd way of festering. As it has done here. By making excuses and pointing fingers at others.

[leslie :-D]

OK, I'll bite. Been a nurse for 5 years.

I've been clean and sober since october 6, 1989.

wow, you too shelly?

you know, it's very interesting...

many of my favorite posters are recovering/recovered addicts.

i try not to stereotype, but have found similiarities in the posters i admire so much:

honesty, assertiveness, sincerity, accountability, tremendous sensitivity, empathy...so many endearing qualities.

i just needed to put that out there.

sev'l of you guys, i never even knew about until after i had become smitten.:)

must be something in the recovery process that brings you guys to new heights and insights.

bless you all.:redpinkhe

leslie

[shelly304]

wow, you too shelly?

you know, it's very interesting...

many of my favorite posters are recovering/recovered addicts.

i try not to stereotype, but have found similiarities in the posters i admire so much:

honesty, assertiveness, sincerity, accountability, tremendous sensitivity, empathy...so many endearing qualities.

i just needed to put that out there.

sev'l of you guys, i never even knew about until after i had become smitten.:)

must be something in the recovery process that brings you guys to new heights and insights.

bless you all.:redpinkhe

leslie

Thank you! That means so very much to me.

[sissiesmama, ASN, RN]

Anne, Please remember you have to prove nothing to the OP. Your responsibilty is to God, your family, and your work.

As far as I am concerned the OP can keep posting negative posts about her situation. Until she takes action, her situation will remain the same. By not doing what is right, harm is flying in every direction. Sometimes our own guilt has an odd way of festering. As it has done here. By making excuses and pointing fingers at others.

Shelly - You are so right. I get up every day and do what I know I am supposed to do for me and for my recovery. And I know she is not the only one that feels like that and I know there is nothing I can do or say to change her feelings toward me as a recovering addict and a nurse. I guess it just saddens me to think about it because thank God when I got caught, went to rehab, and returned to work as a recovering nurse, I had support from co workers, my family, friends, ect. Thank God I was given a chance and am so grateful for that. August 15th, 1999 was a day that I will never forget, in part because I would probably not be here if I hadn't gone to rehab and took accountability for my actions and behaviors.

Anne, RNC :paw::paw::paw::saint:

Shadow, Bea, Sissie, Sam and Cookie