If I say just say I have an addiction and I stole drugs, the Nursing Board will go easy on me? This is Common Knowledge!

I was asked this question this week. A nurse was told this by several colleagues that with State Nursing Board investigations the Nursing Board will "go easier on you" if you say you have an addiction and you stole drugs; this is "common knowledge."

Its just that simple, right? You admit to having a drug addiction, you stole drugs, and everything is in an instant made better, right? 

A few of things I can say are "common knowledge" in my 12 years of law practice and 8 years of license defense:

1. Nurses in general proceed pro se for the most part and represent themselves before the State Nursing Board in complaint investigations;

2. Nurses in general proceed pro se for the most part and receive "legal" counseling and advising on license, criminal, professional practice, workplace, and employment related issues from other nurses, family, friends, and co-workers. This includes the online chat rooms, message boards, and other online forums;

3. Nurses are very trusting professionals and in general assume that "everyone" has their best interest at heart; and

4. Nurses for the most part do not purchase their own individual professional liability insurance policy based on misconceptions and myths.

Impairment and addiction may have physical, mental, social, financial, criminal, license, employment, civil, workplace, regulatory, and career implications for LPNs, RNs, and APRNs and navigating through this maze and haze is anything but "common knowledge."   

Comments

[latonia]

Jack, I would like to know how your presentation went and what were some of the questions. You are right, there is such a stigma associated with addiction and this prevents alot of us from seeking the necessary treatment.

[Jack Stem]

I'm speaking tomorrow (Tuesday June 9, 2009) at the College of Mt. St. Joe here in Cincinnati. A student had the courage to contact a complete stranger to discuss this highly charged, extremely unpopular topic. Her class is having a debate between disciplinary measures to deal with an impaired nurse vs. "alternative to discipline" methods of dealing with the disease and the nurse who suffers with it.

I'll post the results tomorrow evening or Wednesday on my blog (Advocacy for Impaired Nurses: http://advocacyforimpairednurses.blogspot.com/). It should be an interesting day.

Thanks for having the guts to take the less than popular stance, Samantha!

[Jack Stem]

I spoke with a nurse facing possible board action as a result of an addiction to opioids, primarily dilaudid (hydromorphine) and morphine. She had been diverting for two years and was warned by a couple of colleagues that she was "being looked at" by the hospital. I spoke with her for an hour and 40 minutes, explaining the basics of the disease called chemical dependence. I spoke with her husband as well. I stressed the need to enter treatment as soon as possible for a couple of reasons. First, because this disease is fatal when left untreated. Second, because the urgency of the current situation, i.e., possible loss of job and potential legal actions and imprisonment can be the "interventions" blasting through the armor of denial that is the most difficult part of addiction to overcome. And that's just to get the addict into treatment! Once the pressure of the moment begins to wane, the addicts denial kicks into high gear and it becomes more difficult to get them to admit their life is seriously impaired and they need help beyond their own capabilities and resources.

I told the nurse and her husband this disease is treatable but it takes courage on the part of all involved to do the things necessary to get the process started. They were concerned their insurance would not cover treatment at the facility I recommended. I offered to check with the facility and also determine if they offered payment options if there was only partial reimbursement. They said they would discuss the situation and get back to me later that day. I haven't heard a word, by phone OR email. This is the most common scenario when dealing with this disease. When the pressure on the addict is relieved, even just a little bit, they and their primary "enabler" begin to rationalize that things weren't nearly as serious as they originally thought. And then the cycle begins again, and the disease continues to progress.

I think the naivete of nurses when it comes to the parts of nursing beyond empathy and compassion are rarely discussed during training. This leads to a false sense of safety and the sense that our colleagues will "be there" when things don't go according to plan. By the time they discover the "defecation hits the ventilation", their fate has been determined and it's difficult to change things.

Jack Stem
Peer Advocacy for Impaired Nurses, LLC