Issue link: https://digital.copcomm.com/i/1212411
14 Working Nurse l WorkingNurse.com February 17–March 23, 2020 Colleagues Under the Influence are eventually able to return to the workplace with an unencumbered license. I was one of the lucky ones, thanks in part to the nurse colleague who reported me. "You're acting bizarre," she announced at the end of a night shift, with our coworkers milling around. My stomach twisted at the sound of her words and I choked on bile. That moment changed the trajectory of my life. My coworker didn't stop at confronting me; she also told our charge nurse, which culminated in my being escorted off campus by security. Although the days that followed were not pleasant, I could go so far as to say my coworker's actions saved my life. At the time, I resented her for confronting me publicly (which I still don't recommend), but her courage in speaking up was a defining step on my path to recovery. Not long after, I was sober and enrolled in a treatment program. THOUGH CONFRONTING A COLLEAGUE in these situations is awkward and uncomfortable, the ANA Professional Code of Ethics Interpretive Statement 3.6 clearly outlines our responsibilities: "The nurse's duty is to take action to protect patients and to ensure that the impaired individual receives assistance. This process begins with con- sulting supervisory personnel, followed by approaching the individual in a clear and support- ive manner and by helping the individual access appropriate resources." To look at it another way, neglecting to speak up only delays treatment for your colleague while leaving the public at risk. Supporting Nurses in Recovery W hile patients should be everyone's first priority, nurses in these circumstances also deserve compassion and support throughout their exposure, treatment and recovery. When their abuse is discovered, nurses are at high risk of suicide, so it's important not to leave them alone. You can help ensure safety by assist- ing them in reaching out to supportive resources such as a family member, friend, treatment center or spiritual care services. There are also national crisis lines for both addiction (1-800-662-4357) and suicide prevention (1-800-273-8255). IN MY CASE, EVEN AS I WAS COLDLY escorted off campus, a card with a name, number and the words "Care for the Caregiver" was tucked into my hand. Within minutes, my second sav- ior was on the line: a nurse with 20 years of sobriety who was willing to share her experience, strength and hope. Although my next month was a nightmare of humiliation and confu- sion as I waded through legalese and treatment arrangements, I attribute my relative sanity and safety to con- versations with that generous woman. If you know a nurse is in treatment for a substance abuse problem, respect his or her privacy and anony- mity. Avoid gossip, judgments and derogatory labels, but don't avoid the nurse. This is an unbearably lonely time. Not only is the nurse navigating sobriety, he or she may also be facing job loss, tumultuous family dynamics and even criminal prosecution. Reach out directly, but ask permis- sion before asking difficult questions. A nurse in recovery may not be ready to talk, but will appreciate your attempt at connection. IF AND WHEN THEY RETURN TO work, most nurses will have restric- tions on their license such as "may not administer controlled substances, work overtime or float to various departments." These limitations, while temporary and necessary for a safe recovery, are mortifying for the nurse. A compassionate reception from coworkers can accelerate your col- league's healthy recovery. Providing a supportive atmosphere may be a life- saving factor for both the nurses involved and the patients they care for. Ending the Stigma T he National Council of State Boards of Nursing recognizes substance use disorder as an ill- ness, not a moral failure. Similarly, a 2017 joint position statement released by the Emergency Nurses Association and the International Nurses Society on Addictions declares that "drug diversion, in the context of personal use, is viewed primarily as a symptom of a serious and treatable disease and not exclusively as a crime." With our growing awareness of the problem of job burnout and the preva- lence of substance use disorder, the focus of employers and the state boards of nursing should be on reha- bilitation and retention. If nurses per- ceive substance abuse disorder as a career-ending catastrophe, it will just push them further into secrecy, delay- ing treatment and further endanger- ing patients. EMPLOYERS AND COWORKERS alike have the opportunity to end stig- ma by taking an empathetic, non-puni- tive approach and encouraging nurses to seek help rather than hide their problem. Take it from me, a survivor of the opioid crisis: With early identification, proper interventions and holistic treatment, it is possible for nurses with substance abuse problems to recover and successfully — and safely — reenter the workforce. Part 1 of this story ran last issue on January 13, 2020. Find it at WorkingNurse.com. WN Although I resented her for confronting me publicly, my coworker's actions saved my life and were a defining step on my path to recovery. _____________________________________________________________________________________ Tiffany Swedeen, RN, BSN, CPRC/CPC, works in critical care and as a clinical instructor. She is a mom, writer, meditator and VW van road-tripper. She proudly lives "sober out loud." Follow her on Instagram @scrubbedcleanrn or www.recoverandrise.com.