Rates of substance use disorder have continued to grow in the United States and studies have shown that 10-15% of health care professionals abuse substances at some point in their lifetime. Many individuals working in the health care field are dealing with patients, so these numbers present serious safety issues for their patients if a professional is impaired. To get some first hand insight on this issue, I have asked two nurses in recovery, Kristin L., RN, and Cynthie K., RN, to share their experience and knowledge on the subject to shed awareness on this issue.
Kristin has been sober for 13 years and began abusing prescription opioids during her career in nursing. She has been able to retain her license despite facing legal consequences.
Cynthie has been sober for 6 months and is still facing consequences from her drug and alcohol abuse.
How did your addiction affect your career?
Kristin was working with intubated patients where they administered Fentanyl and she began stealing any extra Fentanyl because, as she explained, after she took it once, she had to have it every time she went to work. After 9 months she was caught and arrested the first time, resulting in the loss of her medical license. Kristin felt like she dodged a bullet by ending up with misdemeanors, but she began working as a medical secretary where she immediately started calling in prescriptions for herself. When she was caught doing this, she spent 4 months in jail and is now carrying the weight as a convicted felon. Fortunately, she was able to retain her nursing license after a 5 year monitoring program.
When Cynthie made the decision to get sober, she was working as Director of Nursing. She explains that working while impaired affected her judgement and decision making. She wasn’t able to perform to the best of her ability and no longer had the enthusiasm about work that she once had. She frequently called out of work because drinking became more important. Since her judgement was off, she thinks it could have had an effect on patient outcome which was potentially dangerous for families who were in difficult situations. She notes that she lost her job due to a DUI, but was able to maintain her license through the help of a nurse who worked with a statewide program for professionals with substance use disorder.
What kind of programs and support were you offered?
Through the Professional Assistance Procedure (PAP) program in Wisconsin that Kristin participated in, she was given a restricted license so she could still work as a nurse. She had to do weekly random drug screens, attend counseling, 12 step meetings, and submit quarterly reports to the nursing board. If at any time she did not comply to these standards, her license may have been suspended again.
In New York, Cynthie was able to get help through the Statewide Peer Assistance for Nurses (SPAN) program. A nurse who worked with SPAN helped Cynthie go to detox and treatment, allowing her to get help before her license was revoked as a result of her DUI. In this program, individuals are subject to random drug screenings while being closely monitored by a supervisor so they may continue to practice while obtaining the help and support of professionals.
What would you add to these programs to make them more effective?
Kristin and Cynthie both feel strongly that anyone working with narcotics or controlled substances should be subject to random drug screens. Both women believe that if we tested more people in hospitals and clinics, the numbers of addicts silently suffering would be astonishing. Kristin estimates that many providers would lose about 10% of the workforce due to substance abuse problems. She suggests that a great addition to the programs offered to her would be a yearly training on how to report to the nursing board. With these ideas implemented, the hope is for health care professionals to feel safe reporting anyone suffering in silence.
What measures can be taken for prevention of substance abuse in the health care field?
Despite different stories and consequences, both Kristin and Cynthie agree that more conversation about substance abuse, in both the health care field and within society as a whole, need to take place. Both women explain it would be beneficial to invite a recovering health care professional, who has personally suffered through addiction, to share their story with others at yearly conferences or trainings. Kristin explained that having a person share their experience, as a health care professional suffering from addiction, can potentially help reduce the stigmas surrounding addiction. Kirstin also believes this could help not only the individual struggling, but their families as well. Bringing awareness to the disease of addiction can help reduce the stigmas of addiction and open the lines of communication for other nurses in similar situations, in hopes of allowing them to reach out and ask for help.