Below is a post from a nursing web site followed by my response. The nurse who wrote the post has graciously allowed me to reprint her question here (Thank you!)
“I see that this category has been slow moving lately and I wanted to start a new thread with a different direction. I would like to get everyone's opinion (even the people that have never suffered with addiction). What do you think about your state's peer assistance/recovery program? Do you think it is too harsh or not harsh enough? What state are you in, and do you know the rules or guidelines of your states recovering nurses program?
I just want to get a general view of nurses' education on the matter. I have noticed lately in my hospital that the nurses do not know that there is a recovery program out there. They don't know that there are options and many are scared to report someone, especially if it is their friend. They are scared to report themselves if they need help.
I know that there are more impaired nurses out there than any of us want to admit. I think that if we were educated more on the matter, we could get a better grasp on the situation.”
When I attended nursing school back in the 70's (ancient, I know), no one discussed this issue. In fact, the only real education I received about substance abuse/addiction discussed the physical effects of the different substances with the main focus on ETOH. The actual DISEASE of addiction was never discussed...ever. Working in the ER, first as an orderly and then as an RN, my attitude was these people did this to themselves and if they loved their family they would stop, or at least get help!
My education in anesthesia didn't touch on the disease, it focused on how to manage the addict while under anesthesia and postoperatively. The fact that substance abuse and addiction are the number one health risk associated with the practice of anesthesia was never mentioned, even in passing! NEVER!
A little over 8 years after graduating from anesthesia training I found myself addicted to opioids (spondylolisthesis and an eventual spinal fusion AFTER my addiction was triggered). My disease progressed rapidly as a result of access to the most potent opioids in clinical use on the planet (fentanyl and sufentanil). I went from my first IM injection to IV injection to almost dead and an interrupted suicide attempt (my Angel story) in less than 6 months.
I entered treatment "voluntarily" after an accidental OD. At the time (October 1990), there were very few programs with a focus on the addicted health care professional. Since that time numerous programs have developed for those of us unlucky enough to have this disease and be healthcare pros. In general, these programs are longer and more intense than the "standard" 28 day program. Our intelligence, access, and comfort with administering these powerful medications to our patients make us an even tougher nut to crack than the "average" addict. Because of denial (in ourselves AND our colleagues) and professional co-dependence (our tendency to make excuses and/or cover-up for an impaired colleague), the disease is allowed to progress and flourish. This means by the time a nurse gets "caught" (instead of diagnosed) the disease will be even tougher to treat, and sustained recovery is less likely. Combined with insurance companies paying for less than appropriate treatment, employers who want to "eliminate" high risk employees, and our society's desire for "justice" rather than treatment, we have the settings for exactly what most of us have experienced...total mismanagement of a chronic, progressive, unnecessarily fatal disease that destroys families, our colleagues and profession, and society, before it finally destroys the addict who "doesn't get it".
Can you imagine the outrage that would occur if cancer, diabetes, cardiovascular disease, or any OTHER chronic disease were managed the way addiction is managed? What would happen if a nurse who was also a "brittle" diabetic was fired after an episode of hypoglycemia and everyone thought she was an alcoholic? Justifiable outrage! This DOESN'T happen because diabetes is seen as a "legitimate" disease that can be managed. Even if the nurse with difficult to manage diabetes does have an occasional "relapse" no one is calling for their dismissal because it's known and accepted that this can happen with diabetics. In fact, everyone jumps in to lend a hand, cover their work schedule, and generally do whatever they can to make "recovery" happen as quickly as possible.
The above response doesn't happen for the addicted nurse because there is an appalling lack of knowledge about addiction by a majority of the profession. Read the posts here and on other nursing sites and its clear many RECOVERING NURSES don't really understand the disease. They still believe they are evil people who should have known better. When a relapse happens because of inadequate treatment and inappropriate continuing care combined with poor monitoring services and a thorough return to work contract...the nurse says "I really screwed up. How could I let this happen?" Would they say that if they had cancer, received an inadequate course of chemotherapy, little or no follow-up, and didn't know the early signs that the cancer might be active again?
People say, "Well THAT would NEVER happen!" That's probably true. Why? Because of the appropriate education nurses receive about the "real disease" of cancer.
None of this will change until our profession begins looking at the DISEASE and the risks inherent in the profession. That won't happen until the educational system governing the establishment and certification of nursing programs faces the reality of this DISEASE and the totally inept manner in which it has been dealt with to this day. That change won't happen until recovering nurses begin to step out of the shadow of the stigma associated with the disease and begin to demand change at all levels of our profession. Once that happens (and it WILL happen), society will begin to change as well.
As Bernadette Higgins Roche, CRNA, EdD states in her book, "Substance Abuse Policies in Anesthesia";
"Anesthesiologists and CRNAs must establish a culture of courage within the anesthesia community; advocating for a chemically impaired colleague requires tremendous courage and a strong commitment to integrity."
As recovering nurses WE need to be the people who make that change happen in the nursing community.
Jack
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