Would you say this nurse has a ' problem?'

[IMABSNRN]

This post may delve into the philosophical realm but I've been thinking on it lately.

I work with this nurse who-I don't know if confided is the right word-but told me she has gotten used to winding down at the end of the day with a 'Lortab' or other painkiller before going to bed. Apparently, she (or one of her 9 children) have various medical procedures done from time to time and she is taking what is left over that they don't use. At one point she asked if I knew about ordering painkillers online (illegal, I believe). She claims the medication helps her relax and sleep better, and they work better than the antidepressants or anti-anxiety meds she has been prescribed. I got to talking to her and she says when she stays busy with a project or some other activity she doesn't even think about using them but she goes through bouts where she is bored (depressed?) and can't rest and the narcotics in the painkillers help a lot.

This is an excellent nurse. She's very impressive on the floor, actually. Her attitude is great. The facility where we work is very strict on narcotics and has no reason to believe she is stealing meds (there are several nurses who have raised suspicion and are being watched and she is not one of them.) There are absolutely no red flags, she rarely gives prn pain meds, gives the minimum dose ordered when she does, and none of the patients on scheduled pain meds complain of anything out of the ordinary after she has worked. Also, she has been there several years.

I understand that using narcotic medication for anything other than what they were prescribed for is prescription abuse. She claims that she doesn't always have these meds at home but it's nice when she does. Would you say she has a " problem?"

Another question, pain is not only physical but emotional. I know the Cymbalta commercial says " depression hurts." If she takes antidepressants and has been diagnosed with moderate to severe depression but claims Lortab (or Vicodin...etc.) helps the symptoms, could this not be a way to treat the pain as well?

[kcochrane]

Most likely she is using the pain meds to self medicate the depression. Considering she has been prescribed meds for depression and/or anxiety..this is probably the case. Unless she is working impaired or stealing narcs, I would leave it be.

If the issue comes up again and you think she would be receptive, you could encourage to see her dr. again to get a new Rx that would actual work for her.

[JomoNurse]

she takes it at night before bed. i would leave it alone.

[BEDPAN76]

Yes, agree with above poster. Leave this alone. Keep your eyes open and offer support to her prn. She obviously trusts you. You don't have anything to report.

[ohmeowzer RN, RN]

yes leave her alone .. she takes it at night.. she's not hurting anyone..

[Dalzac, LPN, LVN, RN]

I could be a beginning of a problem The minute you suspect her of diverting or maybe impaired at work Talk to her. I see so many nurses who think they have no problem whatsoever and then WHAM now they do. It is like an invisiable line that they have crossed and they never realized it Addiction is so sneaky. Also don't think of it as being a snitch or anything like that It could be a life saving event for her. If she is talking about it she could be worried about it.

[Hoozdo, ADN]

I understand that using narcotic medication for anything other than what they were prescribed for is prescription abuse. She claims that she doesn't always have these meds at home but it's nice when she does. Would you say she has a " problem?"

Another question, pain is not only physical but emotional. I know the Cymbalta commercial says " depression hurts." If she takes antidepressants and has been diagnosed with moderate to severe depression but claims Lortab (or Vicodin...etc.) helps the symptoms, could this not be a way to treat the pain as well?

I would say she has a problem. What happens if she has a random urine screen at work? I would encourage her to get her own prescription for Lortab with HER name on it.

My

[Mrs.Rollins, ASN, RN]

Personally, I agree with those who said leave it alone. If you feel comfortable with encouraging her to talk about it and encouraging her to get some help for her depression, then do that. But it's not related to her work at this point; she's not impaired at work and you have no reason to suspect that she is, based on your post. Otherwise she has to make her own choice. You know, that accountability thing that's such a big part of what we do...

[kellyc034]

Leave it alone. Sounds to me like she was just confiding in you and talking to you as a friend. If you suspect her of diverting or something else illegal, or working while impaired then by all means go forward. However, do not jump to conclusions without proof or solid suspection of wrongdoing. Even if an allegation of use/abuse is proven wrong, the stigma would still remain and I would hate to see someones career or livelyhood ruined without merit. She is an RN, it's not like she does not know about using prescription drugs prescribed for family members.

[yetanotheramanda]

I would say she has a problem. What happens if she has a random urine screen at work? I would encourage her to get her own prescription for Lortab with HER name on it.

My

This is a VERY good point. I agree with the posters who say leave it alone...but if she were to be tested she could be in a world of hurt. When/if she brings up the subject again you should give her the above advice.

[luvmy2angels]

No, i don't think she has a problem. I take vicodin sometimes when i am having trouble sleeping, sometimes i take benadryl and i don't think i have a problem. As others have said, I would leave it alone.

[PostOpPrincess, BSN, RN]

She has a problem. Please help her if you can. This isn't a normal way to cope with "lack of sleep."

Michael Jackson liked propofol for sleep and he didn't end up well, did he?