Scared out of my mind

[CRNAspa]

You can try contacting the nursing association in your state. Also, contact the American Association of Nurse Attorneys (taana.org) or call their referral line...866-807-7133. If you have your own professional liability insurance, contact your carrier to see if licensure defense is covered. If so, they can provide you with a referral to an attorney.

The ADA covers those people in recovery. It does not cover someone with active addiction. It also doesn't cover someone fired for diversion or practicing while impaired, even if the impairment results from a valid prescription and the medications are being taken as prescribed. failure to properly document administration of controlled substance is also considered a violation of the nurse practice act. Nurses with chronic pain who take prescribed opioids is one example of being at "risk" for board action if they are impaired as a result of their medication. You might want to check out a program from the Center for American Nurses regarding impairment issues. If I'm not mistaken it covers your situation pretty well. It caught my eye when I was doing a search for information on impaired practice issues.

I know an issue that arises from time to time is a CRNA in my state may be taking suboxone (naltrexone + buprenorphine) to decrease cravings and prevent withdrawal symptoms. The would like to reenter practice but they can't because there is a partial agonist effect on the mu receptors (it's the reason it stops cravings and withdrawal so well). Several studies have been performed on the cognitive effects of suboxone vs methadone (the "other" replacement therapy). While there is significantly less alteration than with methadone, there is still enough that the AANA Peer Assistance Advisors Committee recommendation is no CRNA returns to practice while on ANY controlled, mood altering substance. (SSRIs do not fall into this category).

Impaired practice can result from any number of things. While substance abuse and chemical dependence are the winner by a long shot (85% of impaired anesthesia providers are substance abusers or chemically dependent. I don't know the percentage of nurses as a whole, but I have no doubt it's equally as high), there can be psychiatric reasons as well as physical reasons a nurse may not be able to provide safe nursing care and are therefore considered to be impaired.

[SrenitPlz08]

Thank you for your advice glad to know someone is listening. I've been a staff nurse for 18 years ..I'll never forget how HR and management made me feel, like a loser, a worthless bum with issues that they wanted no part of. A patient killer. In one of our last meetings.,(when they were reviewing my errors).. I said, "you know I don't mean to sound

harsh but I have been in staff nursing for 18 years, I seen some stuff and you don't have to be impaired for these things to happen, they happen!",,they just get swept up under the rug or become someone elses problem, depends on who it is and the day,which way the cards are dealt. Staff nurse nursing becomes just like highschool, it's so clicky and management becomes the same way.AS much as I love the rewards of bedside nursing so tired of same short staffing cutting corners, and the bull****...I will fight for my license but pretty much thru with staff nursing. By the way did u draw Frankenstein too?

[CRNAspa]

Yep! It's actually a self portrait!

[grayson]

OK..an update and a big thanks to Srenitplzo8 and Jack..just read your inputs...first off..want to say this...after all is said and done, I'm kinda thankful this all happened to me..not because it forced me to get out of the life of an abuser (my ex)who physically and mentally abused me everyday...but also to realize that I may have a problem as well...even though i did not take the Demerol for myself..I realized that ever since my car accident 10 yrs ago I have been on chronic meds on and off for that whole time..and I think in the end, it's what impaired my judgement on everyday decisions..I never looked at my medication as a problem because I never had the urge for stronger meds, nor did I ever think about taking IV meds for myself..i took them as prescribed...but then when this all happened to me, I took a step back an dlooked at my life and realized that i'm afraid to get off these pills because I have been taking them for so long! 10 yrs! It makes no difference that i took them as prescribed I guess..i was told by my doctor that i would be on them the rest of my life in order to function. And that is what I'm afraid of..To stop takin them and be in horrific pain. There have been periods I didn't take them for a week or two and boy, I couldnt walk! My back was so bad..it's damaged so bad from the accident, yet I am not a canidate for surgery yet because it wouldn't help. THerefore, I am really scared but viewing this as an opportunity to get off the vicodin! I honestly think the pills have caused me to gain 40 lbs over the yrs because i used to be very fit and active until I started takin the meds..anyway..I learned from my mistake and I went to my first group therapy last week. I was kinda wierd because as I was sitting in the room with all these nurses and CRNAs and doctors, and they told me the short version of their story, well, a part of me felt like i didnt belong there...they were all IV drug abusers and got to the point of Odin before getting help...I'm not sure if i'd call myself an addict..but i guess if i'm afraid to get off the pills then i must be? As far as my court case goes...still not done..and don't know when i'll meet again with the prosecutor and my lawyer but i think the fact that i'm already in therapy and in HPRP will help my case..at least I hope it will...and to SrenitPlz08 and your comment how HR and management looked at you like a loser...i know the feeling girl...and its' hurtful and wrong or people to be so judgemental when their life is far from perfect! So next time you feel that way..remember, they are losers in their own way and reflect it upon others to make themselves feel better about their life...and they can kiss my ass!!! LOL...I havnet ment with the BON yet..feel that is comin really soon..I am still looking into getting a pro bono lawyer. And appreciate all the comments and help on here...sorry it took me so long to check back in..but i will always be checkin back in!

[grayson]

SrenitPlz08...i said "i know the feeling GIRL" not knowin if you were female or male..so I hope I didn't offend! LOL..and Jack..nice drawings! I draw as well..just haven't in a very long time! You are very good!

[CRNAspa]

SrenitPlz08...i said "i know the feeling GIRL" not knowin if you were female or male..so I hope I didn't offend! LOL..and Jack..nice drawings! I draw as well..just haven't in a very long time! You are very good!

Thanks Grayson! It's a talent I would most likely never have discovered had I not gone through all my fecal episodes in life.

Are you being managed by a pain specialist (as in board certified...not someone who decided to call themselves that to make additional $$)?

Chronic pain is best managed by a multidisciplinary team. Anesthesia, psychologist/psychiatrist, physical therapy, spiritual counselors, meditation, hypnosis, etc. Chronic pain is similar to addiction in that it affects the "whole person" (body, mind, soul). If we don't face all of these aspects we can get caught up in the downward spiral of depression and isolation. My Dad is finally dealing with childhood sexual abuse (he's going to be 84 in January). The physical "symptoms" of this unresolved abuse was seen in panic attacks and gastrointestinal symptoms (ulcer, irritable bowel, etc.) His scopes have been normal with the exception of a couple of polyps. When he finally told us about his abuse (my sister was abused by an uncle and now leads support groups), some of the things going on with him began making sense. He's been seeing a counselor and attended a 6 week program at my sisters church. I went with him and it was interesting to see the similarities in the personal struggles addicts and those who have been abused share. Dad and I have joined with three other men to form an ongoing support group. Last night we talked for almost 3 hours! Much of what I have learned over the last 19 years in recovery has been applicable in these meetings. Interestingly enough, Dad hasn't had any abdominal distress for almost 4 months. I pointed that out to him last night and you could see the light bulb go on, not only for him, but for the other gentleman. It's been a most interesting and rewarding time developing a fellowship with these men. One that will no doubt assist me in my recovery, and with the folks I meet as a peer advisor.

Keep working on your recovery. Labels don't matter. Results do. I wish you all the best. Keep us updated on your progress.

Big hugs and lots of prayers!

Jack

[grayson]

[B]You are the strongest most wonderful man!God Bless your father! And good for him for stepping up! Currently I am only seeing one doctor for my pain and the therapist I see for HPRP and Group is refering me to a doctor who will likely put me on suboxone ( the medication you spoke of above) I am afraid to take it, because I have never handled mood altering drugs well..I remember being prescribed Xanax after my accident and I took it for a few days and just hated it because I was so tired I didn't want to do anything. Anyway, we'll see what comes of it. But I found out the hard way that I should have NEVER spoke with the investigator without a lawyer present. I know I was advised on this web site not to speak with anyone else..but my loser of a lawyer told me to go ahead and talk with him and not to worry, then the investigator told me the informatin I gave him would have no bearing on my court case. He promised me it was only for the BON and they were the only people he would share my information with. That is the only reason I felt comfortable to speak with him. Well, he turned around and sent a copy of my interview to the Trooper and the prosecutor which really isn't going to help my case. So I emailed him and basically told him in a not so nice way what a hateful untrustworthy scheming man he was. HE wrote back and told me he was under no obligation to tell me the truth. I am so over trusting people of law I could puke. Anyway, I'll keep you posted and we'll see what happens now that the investigator turned out to be a disrespectful ass! Again so proud of your father (even though I never met him) And so proud of you for being so strong hearted and wonderful! [/B

[grayson]

Oh you were so right about not talking to the BON investigator without legal help! Actaully my "so called lawyer" was the one who told me to go ahead and talk to the investigator and it wound up hurting me more then it did help me. My advice to ANYONE out there is NEVER talk!!! NEVER talk to the police to the investigators etc..do NOT trust them..they will hurt you even if they tell you they are there to help and are so nice you find yourself trusting them..the Ass hole that questioned me was so nice and I thought he really cared with is advice and his demeanor. Turned out he LIED to me..right to my face..told me it would have NO bearing on my court case..told me he would only share the information with the BON..turned out a few wks later i got the copy of the interview in the mail from the state trooper who charged me and the prosecutor in my case..when I emailed the investigator, he told me he had no obligation to tell me the thruth! I went off on him via email..told him what a dishonest person he was and he was no better then I! I don't care what happens or if he shares my email with the BON..that was WRONG and I'm beyond angry..if the only way to keep my license is to let jerks like him degrade me and scheme to get what they want, well, they can wipe their butts with it!..I just wanted him to know what a piece of dog S#$% he really was! I will give my kids the same advice in life..DO NOT trust the police or any person of law! I learned the hard way..and my father used to be a cop..poor guy! NEVER again! Not even if the cops need my help because I witnessed a murder..NOPE..they can all go to hell!:bite methat is to all people in law enforcement! LOL)

grayson,

I strongly advice that you seek legal help immediately for this!!

And what ever you do, DO NOT talk to the BON investigator without legal counsel!!

I am not a lawyer, but have read a lot and helped others with questions by looking at states nursing regs. Diverting drugs for personal use and diverting for sale or distribution to others are 2 VERY different things.

personal diversion is the result of addiction, which can be treated but diverting for distribution is much worse, ( in the eyes of the law and the BON)

There is no way that you can place this act on your exhusband, abuse or not. You alone commited the act, and it was not something that you were Had to do... Just because he asked you to get him drugs does not make him the guilty one here... you could have said no.


I am worried about this for you and how this will be handled both criminally and by the BON.

[whome3]

Oh you were so right about not talking to the BON investigator without legal help! Actaully my "so called lawyer" was the one who told me to go ahead and talk to the investigator and it wound up hurting me more then it did help me. My advice to ANYONE out there is NEVER talk!!! NEVER talk to the police to the investigators etc..do NOT trust them..they will hurt you even if they tell you they are there to help and are so nice you find yourself trusting them..the Ass hole that questioned me was so nice and I thought he really cared with is advice and his demeanor. Turned out he LIED to me..right to my face..told me it would have NO bearing on my court case..told me he would only share the information with the BON..turned out a few wks later i got the copy of the interview in the mail from the state trooper who charged me and the prosecutor in my case..when I emailed the investigator, he told me he had no obligation to tell me the thruth! I went off on him via email..told him what a dishonest person he was and he was no better then I! I don't care what happens or if he shares my email with the BON..that was WRONG and I'm beyond angry..if the only way to keep my license is to let jerks like him degrade me and scheme to get what they want, well, they can wipe their butts with it!..I just wanted him to know what a piece of dog S#$% he really was! I will give my kids the same advice in life..DO NOT trust the police or any person of law! I learned the hard way..and my father used to be a cop..poor guy! NEVER again! Not even if the cops need my help because I witnessed a murder..NOPE..they can all go to hell!:bite methat is to all people in law enforcement! LOL)

Greyson,

I am sorry that this has happened but in reality, this happens all the time, in both criminal cases and with the BON where unsuspecting nurses are victims of their own doing based on lack of knowledge as to the tactics used to obtain info.

Most nurses escape criminal charges but for those who don't this is a very new and scary thing. We are typically not people that discuss the things to be aware of and what to do when a cop or investigator is at the door, asking questions. In my case, I too was a fool with a police matter and was badgered into something that could have been avoided if I had said and done things differently.

As far as the BON, nurses are also unaware of how they work, and many nurses also have no idea what to expect, and are not prepared when the BON investigator shows up at your doorstep. I was lucky in that I was prepared on what to say by my counselor in treatment, and she asked that the invesigator come to the tx center, so she could be with me. In my case, I did not deny and wanted help, and it was straight forward. Not all states are as easy...

It is too bad that your lawyer was not with you when you talked to the investigator. From what you have said, he did however advise that you say that you diverted for self use, and to enter into the voluntary program,,, but sounds like you maybe did not do this at the time??

I am also thinking that since this is a criminal matter, the DA can request any info from the BON involving this, and this was not done voluntarily by the investigator...

I hope that this will help others who read this, and that the concept of NOT TALKING to anyone that is involved in legal action in ANY capacity is heard.

My main point here is for any nurse with BON involvement is that it is always wise to do research and to be aware of the potential actions from what you are being investigated for.

[CRNAspa]

You have the right to remain silent. Anything you say can, and WILL be used against you in a court of law (and by the board of nursing).

You have the right to an attorney to be present with you for any and all questioning by the board investigator(s) and by the board. If you cannot afford an attorney, one will be appointed to you for criminal cases only.

If you have your own liability insurance with a licensure defense clause, your attorney will most likely be covered. If you rely solely on your employer's liability insurance coverage, you might be in big trouble if the employer settles the case and then decides to come after you.

NEVER face the board of nursing or any other licensing board without an attorney with experience facing that licensing board (criminal defense attorneys usually have no idea what facing a board of nursing investigation is about).

NEVER, EVER believe an investigator when they tell you it will be OK, they only want to help, or none of this will be on the record.

ALWAYS hire an attorney if you want to have the best shot at keeping your license and practicing again. If you don't have the money...BORROW IT! This is not a game and it certainly can ruin your career by NOT hiring one. Facing an investigation by the board of nursing, the pharmacy board, the police, etc. is an adversarial situation. The board is not your friend and doesn't have your interests at heart. Don't talk about the incident or the investigation with anyone from work...not even your best friends, since hearsay evidence is admissible in a board investigation and hearing. Don't seek legal advice for use in your investigation from friends, colleagues, or nursing chat rooms (including this one). Just because someone else's situation was similar and everything came out alright doesn't mean yours will!

Here are the Miranda warnings that we hear so much about on "Law and Order" and other shows. It makes sense to remember them. Stick them on a business card and keep them in your wallet if it helps to remember them in the heat of battle.

You have the right to remain silent and refuse to answer questions. Do you understand?

Anything you do say may be used against you in a court of law. Do you understand?

You have the right to consult an attorney before speaking to the police and to have an attorney present during questioning now or in the future. Do you understand?

If you cannot afford an attorney, one will be appointed for you before any questioning if you wish. (This is only accurate for criminal cases.) Do you understand?

If you decide to answer questions now without an attorney present you will still have the right to stop answering at any time until you talk to an attorney. Do you understand?

Knowing and understanding your rights as I have explained them to you, are you willing to answer my questions without an attorney present?