Tuesday, May 13, 2008

Primum non Nocere

I am always the first to say that any monkey can pass the nursing boards when people express their awe that I am an ER nurse.

But truth be told, in actuality it is tough to get into a nursing program in our state. For most of the programs there is a 18-24 month wait list. It takes more than good grades to get in. You have to also be interviewed, have a good work history, go thru extensive background checks and be highly recommended by past and current employers and acquaintances.

Once in the program it is even harder to stay there. On the first day of class you can look around and know that come graduation 50% will have failed or bailed out.

With all the obstacles,work,sweat and endless nights studying to get your license it always amazes me that a nurse would do anything to jeopardize it. I protect my license with my life. It is what makes it possible for me to support my family and keep them well taken care of.

There are many ways to lose your license including practicing outside your scope, substandard care, falsifying documentation, assaulting patients, being convicted of DV in your personal life, and the one I find the most unbelievable the diversion of narcotics.

It is estimates by the ANA that 1 in 7 nurses has a drug/alcohol addiction. With approx 3 million nurses holding a license that is a lot of caregivers in need of help themselves.

I have worked with several nurses that have had drug issues and been caught diverting drugs but thru a drug rehab program for medical personnel have been able to keep their license all be with extreme limitations and hoops to jump thru.

They must first go inpatient for detox, after completing they must submit to random drug testing, attend either AA or NA weekly, have their work schedule modified, are not allowed any overtime, working nights, or be a supervisor. They are restricted from handling narcotics for at least a year, and must go thru psych counseling and comply with their recommendations. These requirements last for a minimum of 2 years but can be extended if they deem necessary or the nurse messes up.

When these nurses complete all that the state nursing board asked of them their record is cleared of all charges and their license is return to full activity, but for me I have a hard time just letting it go.

I have a hard time trusting them again and refuse to ever sign off on a narcotic waste with them, as I have no idea if the clear liquid in the vial is a narcotic or water. My biggest issue with these nurses is that generally they obtained their drugs by signing them out in the pyxis under the guise of medicating a patient in pain, and instead pocketing the med. And later when the pt request pain medication I have to refuse them because according to the records they had already been medicated. A patient has to suffer in order for them to get high.

And that I find unacceptable. Our patients trust us to care for, comfort and advocate for them. But nurses can not do that if they are high or preoccupied with how to get their fix instead of remembering "Primum non nocere" FIRST DO NO HARM"

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