What would you do if you knew someone was actively using

Posted

Hypothetically speaking of course...I have two friends who are also RNs and work together. One friend is using, we both know this, and are at a loss as to what to do about it. I brought her a coffee the other night while she was working, and she was high. Our other friend reports that she is now coming to work high. We value our profession very much, and know that what she is doing is not okay. Her outlook is different. She has cleaned up and relapsed over and over, and somehow feels more accomplished for being able to make it this far "strung out". Before she sat for her boards I talked to her, told her that as it stands she has nothing to lose, but when you accept a job caring for real patients and are still using, the stakes become much higher. I'm upset, I understand completely that addiction is a disease, but finding yourself relapsing and in a downward spiral after you have been working, is not the same as going into it knowing that you have a problem, knowing that you will likely be diverting medication, putting patients at risk, etc. She will deny it when I bring it up, but she is an open book. We've been friends since we were kids, some people can hide it, she absolutely cannot. I don't understand how no one has questioned it yet. I don't work with them, but do I have a responsibility here? What about the friend who does work with her? Is it black and white? Report it? There seems to be a lot of grey area here...I'm torn :(

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, SOL (Student of Life). Has 20 years experience. 4 Articles; 4,437 Posts

I can only speak for I would handle this situation personally which would be to talk to the nurse first - Tell them that I suspected they were using or impaired while at work and that they needed to get help immediately or I would turn them into the BON. Then I would be faced with the action of following through. Sure you can stay silent and say "Not my monkey! Not my circus!' but think about how you would feel if a patient or even a co-worker was injured due to this person's addiction. There is a huge "Code of Silence" in our profession with regard to nurses working under the influence. There is also a certain naiveté where in many nurses fail to see or recognize what is happening right in front of them. So it may not be obvious to other nurses that she is "High". Still when the poo hits fan all will claim how betrayed they felt by her actions and nod their heads together claiming they "Just knew something wasn't right about her."

You make it seem like a forgone conclusion that this nurse and by innuendo that all nurses with substance abuse issues will likely divert. This is not necessarily true , but those who do, get caught (without question) sooner or later. At that point your friend's friend will be forced into a treatment program or be forced to give up her career.

It's a very sticky situation and you have to use your own judgement in how to proceed. If I were you I would sleep on it and decide what is best. It appears obvious that this friend who is using is not ready to stop on their own. They may need a push in the direction of recovery. If you do make a complaint don't be afraid to put your name on it. Anonymous complaints tend to lack veracity and can be ignored. Be prepared to state what type of drugs she may be using and dates and times when you believe she may have been impaired. This may be enough for someone to call her in for a random UDS. Then let the cards fall where they may with a clean conscience that you have done the right thing.

Hppy

:(

Thank you...

This is one of my oldest and dearest friends. I am not drawing any conclusions about any other nurses with abuse issues, let's just say I know, we are very close and have been for a very long time. I have approached her, and will again. Sadly, I am thankful to not be working together, but still this issue causes me a great deal of distress. I am worried that someone will eventually get hurt, and that someone may be her, a co-worker, or a patient. This isn't some dabbling here and there, honestly it's life or death. I don't want to jeopardize her license, livelihood, and ability to care for her family, but if she's dead she won't be caring for anyone.

Nashvillejeanne

Nashvillejeanne

Specializes in Hospice and Palliative Nurse. 78 Posts

I am so sorry to hear you are in this bad spot. I can only speak from my own experience. I lost my oldest son last year from an overdose. He was only 30 years old and had been clean a year, then relapsed. Do whatever you have to do to save your friend. Deal with the fall out later. Try an intervention maybe, get her into rehab. Losing someone you care about to an addiction is a horrible loss, the guilt is unrelenting. The I should have, could have, can make you crazy. Do whatever you can. Best of luck to you. Love your friend, but addiction can take someone out quickly, so get with the family and see if you can help her. Good luck to you and your friend, she is lucky to have you.

NashvilleJeanne,

I am so very sorry about the loss of your son...there are no words. We have lost some very good friends and family to this awful awful disease, most during times of relapse after considerable clean time. I am her family, she has one sibling here, but no other family. I will do what I can to help her.

As many people that I have lost, family and friends, I cannot imagine your pain. We lost my 12 year old nephew to a freak accident this year, and as much as I thought I knew about love and loss, it is just devastating. To lose your own child must be just about unbearable, and I am so sorry. I wish you all the strength you can get to make it through, and enough love, memories, and subtle little signs to find comfort each day.

Thank you for your response ❤❤❤

1sttime

1sttime

299 Posts

I wish someone had pulled me aside and told me to quit right that minute...

I got caught, the pieces are about picked up, I am better for it...

Some people need to be "caught", some people can bow out gracefully- either way do it before she dies...

brillohead, ADN, RN

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty. Has 5 years experience. 1,781 Posts

I couldn't live with myself, if I knew that someone was under the influence while caring for patients.

I would report it to her employer and report it to the BON. It's a nice thought to "warn" her, but honestly, it's not like she doesn't know what she's doing is wrong / unethical / illegal.

Whether she diverts or not isn't the issue, IMO -- she's accepting responsibility for patients that she's not competent to care for, and the patients deserve protection from someone like that.

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 25 years experience. 20,949 Posts

I am so sorry for your loss. This disease is 100% fatal if not tackled and dealt with. I can't imagine your pain, even today. My heart truly goes out to you and your loved ones.

I am so sorry to hear you are in this bad spot. I can only speak from my own experience. I lost my oldest son last year from an overdose. He was only 30 years old and had been clean a year, then relapsed. Do whatever you have to do to save your friend. Deal with the fall out later. Try an intervention maybe, get her into rehab. Losing someone you care about to an addiction is a horrible loss, the guilt is unrelenting. The I should have, could have, can make you crazy. Do whatever you can. Best of luck to you. Love your friend, but addiction can take someone out quickly, so get with the family and see if you can help her. Good luck to you and your friend, she is lucky to have you.
traumaRUs

traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU. Has 30 years experience. 164 Articles; 21,143 Posts

I too speak from personal experience: my son is serving a long prison sentence due to a crime committed during his addiction. Though not dead - its not so much fun to visit my son in prison year after year after year!

Be a friend - call her on it! Before she is in prison or dead!

TammyG

TammyG

434 Posts

I would run, not walk, to the DON or employee health or whatever and tell them of your suspicion. They will keep it anonymous. They will pull her in and do a drug screen. You cannot let this nurse treat patients -- especially in an acute environment -- when you know she is high.