A nurse from a Women's Surgery Center in La Jolla, California recently pled guilty to the diversion of the pain medication Demerol, for her personal use. She was removing the medication from the locked cabinet and aspirating the contents. She would then inject normal saline back into the vial, glue the cap back onto the vial and place it back into the cabinet. So that when routine counts of narcotic medication were conducted, they would be correct, with all meds apparently accounted for.
The saline was then injected into over 250 patients, No harm came to the patients, but they did not receive adequate pain control as a result of her actions. When the clinic found discrepancies in their counts, they initiated a full investigation and the FDA were contacted.
She is now facing a maximum of three years in prison and a fine of $250,000. During a plea agreement, she has been ordered to pay the surgery center for the cost of the stolen medications. A total of $270.00. She has also agreed to enter a 6-month drug rehab program. .
"Vigilant nursing staff discovered irregularities in our supply," says a spokeswoman for La Jolla Women's Surgery Center. "We took immediate action, initiating our own investigation and making contact with the FDA."
I think as medical professionals we need to understand the amount of stress that nurses must endure on a regular basis and the constant access to narcotics is more than some nurses can handle. Addicted nurses tend be in denial of their addiction because they are medical professionals and they often feel like they are in control of their usage.
Most boards of nursing in the United States are in agreement that narcotic and alcohol addiction are diseases. If this is the case, then why do they still take disciplinary action against these nurses? While I agree this particular nurse should not have diverted medications and what she did was certainly wrong. I don't agree with the criminal charges she has received due to her actions. Nor do I agree with the harsh treatment she will be forced to endure by the board of nursing in her state if she wishes to attempt to keep her nursing license.
After all, if this is indeed a disease, then it should be treated as such. These nurses need better resources to handle their addictions and they should ALL be offered an alternative to discipline program. I'm not saying that nurses should receive any special treatment, but it should be recognized that this problem exists because of the direct access to narcotics and extremely stressful work conditions, including nurse shortages.
Many of these nurses are truly regretful of their actions and they cry out for help. They don't want to intentionally hurt anyone, but they are suffering. They are often treated very unfairly by their coworkers and the board of nursing in their state. We should have compassion and empathy for our fellow nurses who experience this kind of health problem.
When nursing boards are investigating a nurse, they interrogate them, suspend or revoke their licenses and mandate them to years of expensive daily monitoring and rehab. Many addicted nurses have nowhere to turn. Without any income, and dealing with the demands of the board is more than some nurses can stand. The cost of the drug screens is highly inflated, ranging from $50-$300.00 and can be required as often as three times a month. They are usually done through a company called Affinityehealth.com. Nurses must call into their system every single day (holidays included) to find out whether they have been selected for a drug screen on that particular day. A regular drug screen through another company costs about $10.00. But the board will usually refuse to accept any other company besides Affinityehealth.com.
The psychiatric evaluations that are required are expensive and often these providers do not take insurance, but instead demand cash in advance payment. If you're asked to speak with one of these evaluators, keep in mind that they are required to contact the board of nursing PRIOR to your evaluation so the board can give them your history. So unlike a regular psychiatric evaluation and even though you are paying them, they are actually working for the board. If you wouldn't inform the board of certain information, don't tell them either. Again, you should always contact an attorney and it wouldn't hurt to have your attorney present for your psychiatric evaluation.
If they are lucky enough to have their license reinstated, it is often under probation and this is explicitly indicated when an employer checks the nurse's credentials. When they are reported to the Office of the Attorney General, they are no longer permitted to work in any facility that allows for Medicaid or Medicare reimbursement. So their chances of getting a job in nursing are slim to none. Combine this with the fact that many probationary periods require the nurse to be employed and it seems very clear to me that the boards of nursing are out to sabotage any chance at a successful recovery. Do you think you could get a job under those conditions?
Also, if a nurse is fortunate enough to land a job under all this enormous control, they must have their employer submit monthly reports to the board of nursing, regarding their behavior while they are on the job.
Generally it is also necessary that addicted nurses attend three Narcotic Anonymous meetings a week for several years. Although, NA claim to not be affiliated with any religious sector, I have actually found them to be highly religious. They talk about God and conduct a "serenity prayer" at the end of each meeting. If that's not religious, I'm not sure what is.
If you're a religious person, then the religious affiliation of Narcotics Anonymous and Alcoholics Anonymous shouldn't bother you. Many nurses have successfully recovered by attending these meetings.
I do have a problem with a government entity like the board of nursing mandating religious meetings. This seems to be a violation of the first amendment stating a separation of church and state. There are many other non-religious options for meetings, including some online. SMART Recovery is a wonderful option for non-religious nurses. But is not recognized by the state boards as a valid option for addicted nurses.
This is a humiliating and cruel experience for any nurse to have to endure and without knowledge of how to handle their addiction, they often trust the board to guide them, which is a huge mistake.
If you are a nurse and you're experiencing addiction, remember that the board is NOT your friend. Consider them the nurse police. They pride themselves on controlling your every move. They report you to the Office of the Attorney General and their ONLY priority is patient safety They gave you the privilege to practice nursing and can snatch that license from you as quickly as they issued it. In some states, they even add your name and the disciplinary action they have taken against your license, to the monthly publication they send out to all the nurses in the state. So much for patient confidentiality, this is a violation of your civil rights.
Don't tell the board ANYTHING without consulting an attorney first. Let your lawyer speak for you and retain an attorney that deals with addicted nurses who are under discipline by the board.
Personally, I don't believe addiction is a disease. And I especially don't buy the belief that it is a disease from which you never recover. I think addiction can be fought with intestinal fortitude. You can fully recover from addiction and return to safe nursing practice.
If you are under discipline by the board of nursing, don't EVER agree to surrender your license without a fight. You worked hard for your degree and you can recover, Contact the American Nurses Association, or whatever association represents nurses in your country for support and further resources.
Although it may seem as if your life is over when you are facing the loss of your license, criminal charges, and addiction. Things will get better. Your number one priority is working towards sobriety. This is the most difficult part of your situation. But the one sure thing in life is change. Get help and fight for your license with every cell in your body. It does get better. Remember "Everything will be okay in the end. If it's not okay, then it's not the end."
Nurses, please share this post so nurses who may be experiencing this type of crisis can read it and get the information and courage they need to get well and keep their licenses.
If you have a comment about this article, you can use the comment box provided below.
UPDATE: Due to the overwhelming response to this article from nurses who are experiencing similar situations and feel they have nowhere to turn, we have decided to begin a PRIVATE chat session beginning in a couple of weeks. Should you know anyone who is experiencing this type of dilemma with their license please tell them about this planned chat room discussion.
It will be for impaired nurses ONLY. If you are interested please fill out the form below. Should you wish to remain anonymous you can simply add a fake name to the form, but please make sure you give us the correct email address. When you fill out the form, please include a little about your story, so we can help you as much as possible.
Please also understand that we are not attorneys and we do NOT offer legal advice. The chat session will be held privately and will be for impaired nurses to help other impaired nurses.
While we encourage comment of all opinions on our website and the community is open for good debates. If you wish to make nasty, rude and harsh comments on this page, about nurses who are suffering from addiction, it will NOT be tolerated. Your comment will be promptly removed.