Nursing Law & Order

Legal Consultations: One Ring to Rule them ALL and Ketchup vs. Mustard

I have from 5 to 40 legal consultations in a month usually by phone with nurses throughout Ohio, Kentucky, and Indiana. 

The benefits of a legal consultation for a nurse are:

1. You have an objective attorney reviewing your case;

2. You are able to ask questions and receive solid advice and counseling about your situation; and

3. The cost is $150-$250.00 in my law firm. Some license defense attorneys charge $500-$1,000.00 for legal consultations. For example, there is an attorney who charges $750.00 for a 2 1/2 hour consultation and this is the minimum and includes all his preparation time reviewing your materials and performing research on the issues therein.

What I am a finding however is that I have a lot of nurses who become quite hostile and argumentative with me during legal consulations because I am not telling them what they want to hear, I am not agreeing with them, or I am being "too direct and too blunt."

I think this is why we lawyers get a bad rep because it is our role to "tell it how it is." If you are paying a professional and the professional is telling you exactly what you want to hear about yourself and your situation, then you are wasting your money. 

Objective advise and counseling: this is what an attorney does. However, most nurses involved in a State Nursing Board case are proceeding pro se, most nurses being monitored by the State Board are pro se, and most nurses who are in a Board Alternative to Discipline program are pro se.

Pro se meaning you are representing, counseling, and advising yourself in the matter. It is difficult to be objective and critically review and analyze your own situation from a legal, clinical, and professional practice standpoint. When you are representing yourself it becomes a epic battle for mankind and the fate of the world rests in your hands.

I had a nurse tell me the following in reference to a State Nursing Board investigation and an employment termination, "I now know how Jesus Christ felt when he was prosecuted." No comment.

It emotionally becomes One Little Nurse vs. the Big Bad State Nursing Board (not the Big & Bad, just Big Bad) which is huffing and puffing to blow down everything you  accomplished: your licensure, your career, your family, and your life. 

It is portrayed to colleagues, family, friends, and "anyone who will listen" as serious as the epic battle for Middle Earth and the "Rings of Power" akin to good vs. evil, the Jedi vs. the Sith, and Ketchup vs. Mustard.  

If you are representing yourself before the State Nursing Board consider a legal consultation with a nurse license defense attorney in your state; it may be the reality check you need to place the case in the proper prospective.  

Guest Post: If Addiction is a Disease, Why don't We Treat It Like One?

If Addiction is a Disease, Why don't We Treat It Like One?

It was a dark and stormy Friday night. I was driving to meet with the family of a young man who is in the midst of a very active addiction to prescription pain medication. I met his sister-in-law earlier in the week when I spoke at the school of nursing she's attending. She had the courage to approach me after the presentation and ask for help for her sister and brother-in-law.

 As I was pulling into the place where we had chosen to meet, I thought, why should it take courage to ask for assistance when someone has a chronic, progressive, fatal disease? More specifically, why should it take courage to ask for help with THIS disease? It doesn't take courage to ask for help with diabetes, high blood pressure or asthma. Why does it take courage to just ask for help for addiction?

 The answer? Stigma.

 Stigma:

1. A mark of disgrace or infamy; a stain or reproach, as on one's reputation.
2. Medicine/Medical .
   1. a mental or physical mark that is characteristic of a defect or disease: the stigmata of leprosy.
3. Archaic . a mark made by a branding iron on the skin of a criminal or slave.

 Synonyms
1. blot, blemish, tarnish.

 Related Words

brand, mark, stain

 Pretty good descriptions of how we (meaning society in general, and as a profession specifically) treat those unlucky enough to have the wrong genetic makeup and exposed to the right triggers (stress, poor coping skills, and exposure to the right substance or substances).

 Science continues to discover the cause of many (if not most) disease states is a combination of genetics and environmental triggers. Lifestyle choices are definitely included as environmental triggers.

 Cancer can be linked to many lifestyle choices, including smoking, drinking alcohol, exposure to ultraviolet radiation (like sunbathing...whether it's actually the sun or one of those goofy “tanning beds”), certain diets, and career choices (shipbuilders, pipefitters, insulation installers, tile workers, and more http://www.lawyershop.com/practice-areas/asbestos-mesothelioma/lung-cancer/high-risk-jobs), etc.

 Cardiovascular disorders have been related to lifestyle choices as well. Diet (high saturated fats, high sodium, etc.), activity (couch potatoes, video game wizards, internet surfers), careers (“High-flying career women with stressful jobs face a higher risk of heart disease, warn researchers.” http://www.dailymail.co.uk/health/article-1273305/Stressful-jobs-giving-women-heart-disease.html), along with genetics increases the risk of hypertension, heart attacks, and stroke.

 

Type II diabetes risk is increased by genetics, diet (high fat/high carb), lack of physical activity, high alcohol intake, obesity, and other lifestyle choices (http://www.emedicinehealth.com/diabetes/page2_em.htm#Diabetes%20Causes).

So if “choices” are an integral part of other chronic, progressive, fatal diseases, why don't we rag on diabetics, cancer patients, and those who have heart attacks and strokes? Because we believe these are all legitimate (or “real”) diseases, while we believe addiction is a lack of will power or a lack of “moral fiber” (the capacity to do what is right, no matter what the circumstance. http://www.urbandictionary.com/define.php?term=moral%20fiber). (If addiction is a disease, why do many colleges place “Addiction Studies” in the Criminal Justice Department?)

 Because of the stigma associated with the DISEASE of addiction, several things occur:

*  People won’t seek treatment;

*  Many health care professionals refuse treat addicts;

*  Colleagues ignore the “problem” as long as possible (allowing the disease to progress and increase the risk of harm to patients); and

*  Insurance companies won't pay for services, or severely limit payment. 

I cringe when I recall some of the things I said to people when I was an ER nurse. “If you loved your family, you'd stop doing this!” Gee. If addiction is a chronic disease that alters the brain and makes it impossible to “stop doing this”, telling the person to stop is pretty stupid, don't you think? “What do you mean your blood sugar is 300!? If you loved your family you'd stop letting your blood sugar get that high!”....”But doctor, I watch my diet, exercise, and take my insulin. I need help!”... “You obviously don't really WANT your blood sugar to go down! You worthless piece of $#%&!! Get out of my ER!”

 So why don't we believe addiction is a disease? Based on my experience as an ER nurse and nurse anesthetist, our educational programs don't educate us about the DISEASE. What they do educate us about is the side effects of the disease...cirrhosis, gastritis, renal disease, infections, etc.).

Research has provided us with the SCIENCE associated with the disease of addiction. It tells us why addiction is a disease. It let's us know the target organ (the limbic brain), how that organ is affected, the signs and symptoms of those changes in the brain (obsession on obtaining the drug, uncontrolled use of the drug(s), and caving for the drug when the addict can't get their drug(s)), how to intervene, how to treat the person, and how to help them maintain remission (called “recovery”).

Unfortunately, if we as health care professionals don't understand the science we continue to base our “treatment” on what I call “the 3 Ms of Addiction” - Myth, Misbelief, and Misinformation.

 If you're a nurse struggling with addiction, or know a colleague who might be, and you aren't sure what to do, contact me at [email protected] or 513-833-4584.

 There is hope. There is help.

Jack Stem

www.peeradvocacyforimpairednurses.com

 

Hello, my name is LaTonia, I am Your Legal Therapist. My office hours are 11:30pm to 11:45pm every 3rd Tuesday of any month ending with the letter "r" or "y"

I terminated my legal representation of a nurse in the past because this nurse was just too difficult to deal work with in a professional relationship. Also the nurse refused to accept any responsibility or accountability for the actions or even acknowledge the obvious.  

We remained professional with the nurse at all times but I should have terminated the representation  earlier. I shook my head when I received the correspondence requesting the client file from the new attorney of the nurse because I would not wish that client on any lawyer.

 The nurse developed a case theory the nurse just knew would work.

I told the nurse in a nutshell even if we pretend, this ain't CSI; it is Nursing Law & Order.

Anything is possible, Neo but let's discuss the probabilities because this ties into the burden of proof and persuasion.

The spouse of the nurse berated me for not "trusting in and believing in" the nurse. FTW, you are kidding me, right?

I trust and believe Jesus died for my sins.

The spouse told me the nurse would be CLEARED of all charges at a Nursing Board hearing with a new attorney who trusted and believed.

I thought to myself: maybe an imaginary hearing with the Snow White as a hearing officer but certainly not a formal adjudication in an administrative law matter.

The nurse was nasty. This nurse was my nastiest client. By the way, I fired my first, second, and third nastiest clients. Life it too short to deal with nasty clients because I love what I do. I don't want to start calling off at work, taking extended FMLA leaves, or start smoking and then disappearing for 2 hour smoke breaks before and after my lunch smoke as a coping mechanism. 

By nasty here I am referring to a aggressive disposition, a disruptive personality, condescending tone with everyone,  emotional and uncontrollable outbursts ranging from excitement to panic to sadness to rage in 15 minutes, etc. I don't know whether to continue to take notes or  make a run to an exit but not before closing the door to lock Jack in the room.

I am a counselor; a counselor at law that is  pumpkin, not a therapist unless you need legal therapy. I guess I am a Legal Therapist. LOL. My office hours are 11:30pm to 11:45pm every 3rd Tuesday of any month ending with the letter "r" or "y" if you need assistance. I see clients, return calls and answer emails or texts and conduct business only during the stated office hours.

Back to Nasty.

Angry Nasty;

Nasty Nasty; and now

Disciplined Nasty. I mean Disciplined Hard.  I had to read and then re-read the discipline. No hearing by the way: settled.

Just a word of practical advice:

1. Allow your license defense attorney to assist you in developing your legal strategy;

2. Be honest with your lawyer; why pay your a lawyer and then lie to your lawyer? 

That's like going to a weight loss clinic and saying you don't want pills; you just came in to be weighed. It makes no damn sense; 

3. Don't watch CSI and try to develop conclusions of law and findings of fact  for your case based on a CSI episode. It is Nursing Law & Order; and

4. I zealously represent my clients and I counsel and advise my clients. But remember I critically think for a living. I make my money critically thinking about nursing and the law. All day. Remember this when you retain me and start to shovel the ......

5. Life is too short to be nasty to anyone trying to help you help yourself.

Even though you were Super Nasty, I wish you the best with:

a. Securing employment during the years your nursing license is suspended;

b. Meeting the terms/conditions for the reinstatement of your nursing license;

c. Securing nursing employment during your Nursing Board probationary period;

d. Meeting the terms and conditions of your Nursing Board probation; 

e. Having the terms/conditions of your Nursing Board probation lifted; and

f. Your nursing career.  

My Legal Manifesto: No Pro Bono, No Low Bono. Just Racks on Racks on Racks!

The majority of nurses and probably healthcare professionals (maybe except dentists and physicians) represent themselves when contacted by the State Board. This is called pro se and this means you are not represented by an attorney. There is nothing wrong with pro se.

Pro Bono is when an attorney takes a case without payment. Attorneys can donate their services and volunteer to take cases assisting underserved populations. I believe in a few states, pro bono may be required. Most legal professional associations suggest their members take one or more pro bono cases a year or volunteer and provide pro bono services to a underserved group in need of legal services.

What is low bono? This is when an attorney provides legal services to a client at a discounted or almost free rate or charge.

See ABA Model Rule 6.1 which states in part:  

Every lawyer has a professional responsibility to provide legal services to those unable to pay. A lawyer should aspire to render at least (50) hours of pro bono publico legal services per year. In fulfilling this responsibility, the lawyer should:

(a) provide a substantial majority of the (50) hours of legal services without fee or expectation of fee to:

(1) persons of limited means or

(2) charitable, religious, civic, community, governmental and educational organizations in matters which are designed primarily to address the needs of persons of limited means.

http://www.americanbar.org/groups/probono_public_service/policy/aba_model_rule_6_1.html

This has been wild month. I had a nurse call the office who needed assistance before the State Nursing Board.

The nurse told me the following immediately:

1. I have no money;

2. I have been out of work for 3 years; and

3. I need you to take my case pro bono or for a small fee.

I told the nurse immediately:

1. I am sorry you have been out of work for 3 years;

2. I do not take pro bono or low bono cases; and

3. I will be happy to speak with you by phone about your options but I cannot represent you; I am sorry.

The nurse then proceeded to tell me she was referred to me by a healthcare employer who suggested she retain me and suggested she inquire about "pro bono services" with my office because all lawyers must do pro bono.

I informed the nurse I do not take nurse license defense cases pro bono.

She replied do you not have to take so many pro bono cases a year?

I wanted to reply, "you are shitting me, right?" but I don't use that kind of language in real life, only online as the Nursing Law Bandit.

Attorneys in Ohio, Kentucky, and Indiana are NOT required to take or perform pro bono services.

Okay so here it is:

My Legal Manifesto: No Pro Bono, No Low Bono. Just Racks on Racks on Racks!

1. Nurse License Defense is right there with Criminal Defense and Family Law with the emotional stress, strain, and the wear and tear.  

There is no way in hell I would do this just to do it. This is my passion but I would never compromise my ethics by taking a case pro bono or low bono as a license defense attorney. Please explain, LaTonia because pro bono is all about service to others and the ethical responsibilities and moral underpinnings of the law as a profession.

Helping nurses is my passion and license defense is my mission but I also need gas money. 

Also I am working with nurses over an extended period of time and usually for years. I have nurse license defense clients I have worked with since the early years of  my solo practice, 2001 to 2004.

I am on board with my nurses until:

a. They fire me;

b. I fire them; or

3. Attorney or Client dies. 

It is written this way in my flat fee legal service agreement. 

When you see an end in a license defense case, it is a visual hallunication directly related to 4-6 hours of sleep M-F, alternating coffee and Pepsi q2 hours until 2am, and/or you failed to clean your eye glasses. 

This is why I would NEVER take a pro bono or no low bono nurse license defense case. Its a professional relationship and I am on your team throughout your nursing career after you retain me and I cannot do this unless there is monetary compensation for me. Sorry!

Show me the green or swipe your credit/debit card, baby!

Racks on Racks on Racks!

I don't know the lyrics but I love the beat to this song!!

Racks on Racks on Racks!

2. Do you as a nurse work for free?

Probably not, so please don't ask me as a nurse and an attorney to work for free for you?

If you are a nurse and you work for free, send me your CV as I would LOVE to have you assist me in my law practice. I will even tip you.  

3. RNs average $25-$35.00 an hour or more. Would you work for $9.99 an hour as a RN? Probably not, so please don't ask me as a nurse and attorney to take your nurse license defense case for a flat fee of $500.00 or try to low bono me.

4. LPNs, RNs, and APRNs are not the underserved populations you think of when you think pro bono legal services. Sorry.

5. When the American Nurses Association publishes a pro bono guide for RNs (vetted and recommended by the ANA House of Delegates) suggesting nurses provide 50 hours of skilled nursing care for free and it becomes a part of Ohio Nurse Practice Act and the Ohio Board of Nursing regulations, text me on my cell at 513-604-9330 and say  "LaTonia will you defend me to the end for a tube of lip gloss, a case of Pepsi, and a turkey burger/fries with a strawberry lemonade from Ruby Tuesdays."   I will text you back and say "you got yourself a lawyer. Now what is your name and what is your alleged action or inaction?"

Nursing Law & Order is Seeking Four Nurses to serve as Regular Contributors

Seeking Freelance Nurse Authors to serve as Regular Contributors

I am seeking four freelance (hint: 1099) nurses to serve as the regular contributors for a monthly publication.  

Each nurse author will be paid a flat fee for a 500 word article with web references. The regular contributor will have his/her name listed as the contributor for the piece and will be able to include a short bio with his/her contact information including email address.  There are several benefits to being the regular contributor for these column including opportunities for professional growth and development.

 The monthly publication is not a nursing journal. Therefore the writing style required is  somewhere between a nursing blog and a nursing magazine.

Nursing Law & Order: Criminal Intent™

* This column will focus on forensics and criminal law with a nursing and healthcare twist.

Author Qualifications:

* RN, BSN with at least 5-10 years direct care experience;

* active nursing license in any state; and

* law, legal, or forensics education, experience, training, or interest preferred.  

* RN/JD, LNC, Nurse Paralegal or RN law student encouraged to apply.

Nursing Law & Order: KVO™

* This column will focus on the latest and most current news and professional practice matters facing nurses.

Author Qualifications:

* RN, BSN with min. of 5 years direct patient care experience;

* active nursing license in any state; and

* diverse nursing background, training, and experiences in a variety of healthcare settings.

Nursing Law & Order: NPO™

* This column will focus on addiction, substance use and abuse as well as recovery, relapse, and return to work issues for recovering nurses.  

Author Qualifications:

* RN, BSN disciplined by the State Nursing Board and/or who has completed a Nursing Board Alternative to Discipline Program for Chemical Dependency. Disciplined nurses encouraged to apply;

* has at least 5 years of sobriety;

* has a active nursing license; and

* has returned to nursing practice providing direct patient care.

Nursing Law & Order: Scoped Out™

* This column will focus on practice and trends for those of us with the broadest scope of practice and possibly the most potential for liability: APRNs.

Author Qualifications:

* APRN with at least 5 years of direct care experience as a APRN;

* active nursing license in any state; and

* diverse RN background, training, and experiences in a variety of healthcare settings and roles.

How to Apply?

If you are interested in being the regular contributor for one of the columns above, please send the following as attachments by email [RE: Nursing Law & Order Contributor] to Tina, my virtual assistant at [email protected]  (you can copy me on the email at [email protected]) by May 16, 2011: 

1. an updated resume/CV;

2. writing sample or journal publication;

3. a copy of your State Nursing Board license (just print it from the Board website); and

4. a cover letter detailing why you are interested in being a regular contributor for the column and what skills you bring to the role.

Additional information will be made available. Thank you for your interest. If you have questions, you can email me at [email protected].

Nursing Law & Order Blog is accepting Guest Posts from Nurses

Do you have something you want to say to the Nursing Law & Order readership?

Do you want to write and publish but not necessarily in a traditional nursing journal or magazine?

If so, consider submitting a Guest Post to the Nursing Law & Order blog.

Why? More of us need to publish and formally express our thoughts online outside of an online chatroom or forum.

Benefits? Money, Power, Prestige, and a New Lexus. (just kidding)

I would love to see Guest Posts on the following topics:

* Unions and collective bargaining;

* Predictions for nursing in 2020;

* Legal issues encountered in a specific practice setting;

* Night Shift Nursing;

* Nursing education;

* Self-employment for nurses;

* Career coaching for nurses;

* Career development for nurses;

* Substance use and abuse;

* Recovery, Addiction, and Impairment;

* Clinical practice issues;

* Transitioning from a student to NCLEX-Applicant to newly licensed nurse;

* Entry level nursing management and how to transition from staff nurse to manager; and

* Emerging issues in the nursing workplace and workforce.

  Guidelines for a Guest Post on Nursing Law & Order

• Your Post must include full name and a personal email address. No blind posts will be accepted for publication;
• Your post must be original and must have never been published before on the Internet;
• You agree to not publish the post anywhere else (i.e., in your own blog or as a guest post in other blogs);
• You can include one link in the byline, which will be displayed at the bottom of the post;
• Your post must be educational or informational.
• Your post must of course involve nurses or nursing.
• Your post should be at least 400 words.
• Your post cannot mention a specific organization, group, or association unless you are authorized to speak on behalf of the organization, group, or association.  
• Your post cannot trash a State Nursing Board or a nursing employer, group, or association.
• Your post should directly or indirectly relate to one or more of the many categories for blog posts on Nursing Law & Order.
• You must be a nursing student, LPN, RN, APRN or have nursing training (if your license is suspended or revoked).

Email your Guest Post as an attachment [RE: Nursing Law & Order Guest Post Submission] to Tina, my virtual assistant at [email protected]. You can also copy me on the email at [email protected].

If your Guest Post is not accepted for publication to Nursing Law & Order, you will be notified by email. I reserve the right to reject any Guest Post for any reason but an unlawful reason at any time, something like at-will employment. If you have questions you can email me at [email protected].

Alot vs. A lot: Constructive Criticism about Nursing Law & Order. What about allot?

When you blog alot and you have an extensive readership, you can expect alot criticism. You put yourself out there. I have no problem with alot of constructive criticism of Nursing Law & Order. It goes with the territory and I have a thick skin. For example, I know my alot blog posts throughout the years since I have blogged since 2006 have typos and grammatical errors. I used to run alot of my blog post through a spell check and grammar check software but when you wear multiple hats as a solo and you are trying to get the information out to nurses something has to give. When I post a blog post, I am not writing an article to a nursing journal and if I put the time into my blog posts that I put into reading, re-writing, and proofing a document, I would have may 85 blog perfect blog posts instead of 1100+ blog posts. Yes, I blog hard, baby. I blog alot.

However incorrect grammar and typos should not appear in any blog or in any publication especially one written by a lawyer. What is the solution for someone like me with a heavy case load who loves to blog but can't take 4 hours to draft and proof a blog post like a legal document? Tina, my VA.

I recently hired a virtual assistant to work with me on alot of administrative projects and tasks. My virtual assistant Tina will actually start with my most recent blog posts and work her way back, one hour each week, correcting alot grammar and typos in my blog posts. If you find something and you just feel the need to pass it along on the blog, send it to Tina at [email protected] with the Date and Name of the Blog Post and she will take care of it. Actually she may thank you, Lisa the NP for providing her with alot of additional tasks to bill. Make sure you include [RE: Nursing Law & Order Typo and Use of Alot]

Who is Lisa, the NP? She is a NP who sent me an email this evening about using alot (which is not a word) instead of a lot because use of alot instead of a lot is a Pet Peeve of hers. I like alot instead of a lot because that extra space is wearing down my thumb and  I am sure I have alot and/or a lot throughout my blog posts alot over the years as Lisa also noted. Although, Lisa noted I used alot more than a lot in alot of my blog post; she did not give me a percentage however of my use of alot as compared to alot vs. allot. Lisa, the NP, thank you for taking alot of your time with your review and thanks alot for the constructive criticism of my blog. You spent alot of time reviewing my blog and the only thing you commented on was my use of alot vs a alot; nothing about the content. Go figure!

I will make sure Tina corrects my use of alot in all not just alot of my blog posts from 2006-2011 starting with this one. I may also take a refresher course this year on the proper use, balance, and mixture of the King's English vs. Urban and Rural Slang in niche blogging. Thanks alot, Lisa. Thank you alot more, Tina.  

My Name is Jack: I am a Recovering Addict and a former CRNA who is clean and serene!

This is a guest post by Jack Stem.

My name is Jack, and I'm a recovering addict who is grateful to be clean and serene today.

20 years ago, when I began my journey in an attempt to be “normal” again, I wouldn't have been able to say those words out loud, let alone write them down and then publish them on one of the most read nursing law blogs available. As a health care professional, I believed that my training would keep me safe. Guess what...that's one of the biggest myths associated with this disease (and yes, it IS a disease).

I was an emergency room nurse and then went on to become a Certified Registered Nurse Anesthetist (CRNA). I had found my dream job. I was good at what I did. Every day was a new challenge that would test my skills and knowledge. Shoot, there were times when I thought to myself, this all has to be a dream come true. Beautiful wife, wonderful, healthy daughters, a great job, nice home. My colleagues respected my abilities and I had one of the highest request rates of anyone in the department. That all changed in 1990.

 I had spondylolisthesis and dealt with chronic back pain since my late teens. Nothing I couldn't handle with a day off and a couple of doses of percocet. In 1990, my pain flared up and I did my usual prescription and a little time off. This time was different. This time the pain didn't improve. In fact, it became worse.

 Our case load was high and I couldn't take any more time off. If I did they would have to close one of the OR's. Being the good, co-dependent nurse, I sucked it up and returned to work. When I'd get home, I would lie on the floor with an ice pack and take my percocet. One pill became 2, then 3, then 4. After several prescriptions my doctor wouldn't write anymore (“Jack, your pain can't possibly be as bad as you say.” Thanks doc!)

 When I couldn't get any of the residents to write me a prescription, my addicted brain (yeah, there's no doubt in my mind my disease had developed by then) said, “Jack, you are squirting perfectly acceptable fentanyl down the drain everyday. How dumb is that? Take the waste home and get a good night sleep!”

 So that's what I did. Well, once the beast is released, the speed at which the disease progresses is determined by the potency of your “drug of choice”. I always find that phrase to be ironic. As an addict in active disease, THERE IS NO CHOICE!

I almost ended up dead...twice. The first time was because I didn't want to be alive. I didn't want to hurt and embarrass my family (which is exactly what would happen if I was ever found out). I had prepared a mixture of drugs that would have killed me and 5 other people. Fortunately, I never was able to put that plan into motion. Someone walked into the locker room before I could complete the deed. It gave me plenty of time to reconsider what I was about to do. I had 2 daughters who loved me. My wife and other family members did too. So I changed my mind (thank GOD!)

 A couple of days later I had a semi-emergent spinal fusion (foot drop and numbness that wouldn't go away). I was off work for almost 5 months. When I returned to work, I wasn't prepared for what happened. When I opened the first vial of fentanyl for my first case, I broke out in a total body sweat, my hands and legs began to shake, and I thought I was going to puke! I had just experienced my first “trigger”. Since the brain of an addict is transformed as a result of their genetics (yes...addiction is a genetically based disease) and the chronic misuse of large quantities of mood altering chemicals, repeating some of the actions associated with “using” can trigger huge activity in the limbic areas of the brain. This activates a craving (the uncontrollable desire to obtain and use your drog of choice). I didn't return to use that day. But when I did later in the week, I accidentally overdosed. Fortunately, my then 4 year old daughter forgot her swim suit for lessons and had to return to pick it up. She came into the bedroom where daddy was taking a nap to give me a kiss. She told my wife, “Daddy is a funny color.”

The next thing I know I'm in the back of an ambulance heading to the ER. That's when I finally admitted I was addicted to opioids and entered treatment. I struggled for quite awhile before I finally was able to get clean and remain clean. My addiction cost me almost everything...my career, my marriage, my home, and almost my life.

Today, I am able to say I have 16 years and ten days clean. I'm a peer advisor for Ohio's CRNAs. I consult with LaTonia to assist her clients dealing with substance abuse and chemical dependence. I provide educational presentations to schools of nurse anesthesia and nursing programs to fill the huge gap that all nursing schools, medical schools and other health care programs leave out...education about the disease of addiction. I'm grateful to those recovering individuals who have helped me achieve and remain clean. I'm grateful to LaTonia for having the foresight to allow me to use my experience, strength, and hope as well as my anesthesia and nursing background to assist my colleagues in achieving recovery and return to the practice of nursing. I'm grateful to be able to help one person at a time realize that they aren't stupid, evil, people.

 The person unlucky enough to develop the disease of addiction isn't a bad person trying to become good. They have a chronic, progressive potentially fatal disease affecting the brain, and they want to become well. Sadly, our profession rarely helps their colleagues when they suspect someone may be struggling with substance abuse or addiction. No, too many nurses ignore their colleague until they can no longer ignore them anymore, or until they find them dead in the locker room or call room. I'm doing my best to change things.

Look for more posts in the future. Until then, keep taking it one day at a time!

Look for some of my posts on AllNurses.com in the “Nurses in Recovery” section.

 Jack Stem

Peer Advocacy for Impaired Nurses, LLC

www.peeradvocacyforimpairednurses.com

513-833-4584

[email protected]