Issue link: https://digital.copcomm.com/i/1200039
Working Nurse l WorkingNurse.com 17 January 13–February 17, 2020 one part of the picture. I pushed myself relentlessly in every aspect of my life, neglecting self-care. Internal and external pressure to be the best employee, daughter, mom and partner felt insurmountable. Because I lacked effective coping skills, Vicodin became one of the few tools that relieved tension while synthetically (and temporarily!) boosting my energy. Silence Keeps Us Sick The subject of addiction is effectively taboo among nurses, mentioned only in whispers and pejorative terms: "junkie," "thief," "unfit to be called a nurse" and worse. When my opioid use escalated from legit to recre- ational and then to all-out abuse, I saw no safe place to turn. Although I'd heard of nurses "in the program," my knowledge of diversion programs was fairly basic. I didn't trust such programs because I'd heard that shame and stigma follow recovering nurses long after they achieve sobriety. Instead, I met sporadically with chemical dependen- cy counselors, taking pains to preserve my privacy. Anonymity was paramount to me for reasons of per- sonal pride and job security. I couldn't acknowledge that my secret was keeping me sick or that I would never be able to manage it on my own, no matter how sharp my nursing skills. If I had had a better understanding of alternative to discipline (ATD) programs like the one I'm enrolled in with Washington Health Professional Services, I might have sought treatment sooner. An ATD program monitors and supports nurses pursuing sobriety while also taking steps to ensure the safety of the public. These programs don't prevent an employer from terminating the nurse for substance abuse and they may require the nurse to stop practic- ing for a time, but they can make it easier to attend treatment, avoid license enforcement action and obtain future employment. [See sidebar for informa- tion on the California BRN's Interventional Program.] I had become a burned-out nurse, exhausted and in pain. I also had a legitmate Vicodin prescription for migraines. It became a recipe for drug-addicted disaster. An Ounce of Prevention FOR NURSES, BURNOUT AND ADDICTION often go hand in hand. Here are some steps you can take to protect yourself: Recognize the indicators of job burnout: • Depersonalization of patients or yourself • Physical/emotional exhaustion • Feeling a lack of accomplishment. Understand your risk factors: • Personal or family history of substance or alcohol use disorder • Tendency to want to be everything to everyone • Night shift or rotating shifts • Perfectionism • Lack of work-life balance • High-stress environment and/or fre- quently facing trauma or death (e.g., ICU or emergency department). Integrate meaningful self-care into your daily routine: • Physical exercise • Meditation • Yoga • Adequate sleep • Quality nutrition • Spirituality • Music • Connecting with nature.