Substance Use Disorder in Healthcare Professionals: When Caregivers Need Care and Treatment

129 Pages·2022·1.962 MB·English

by  Kristin Waite-Labott

Substance Use
Disorder in Healthcare
Professionals
When Caregivers Need Care
and Treatment
Kristin Waite-Labott
123
Substance Use Disorder in
Healthcare Professionals
Kristin Waite-Labott
Substance Use
Disorder in
Healthcare
Professionals
When Caregivers Need Care
and Treatment
Kristin Waite-Labott
Veritus
Hales Corners, WI, USA
ISBN 978-3-031-09989-2 ISBN 978-3-031-09990-8 (eBook)
https://doi.org/10.1007/978-3-031-09990-8
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Foreword
When Kris invited me to write this foreword in my role as the cur-
rent President of the International Nurses Society on Addictions
(IntNSA) I not only immediately said yes but was also extremely
honored. I got to know Kris during her time as a serving Director
on the Board of IntNSA, and her role as the interim President of
the USA Chapter. Her dedication to supporting the advancement
of addictions nursing is paralleled by her commitment to improv-
ing and enhancing our understanding of substance use disorders,
and support for nurses and other healthcare providers (HCPs) who
have themselves been faced with the challenges of problematic
substance use. Her personal journey as a nurse in recovery not only
makes her an expert by lived experience but provides a unique and
insightful perspective on the onset of how these challenges may
emerge for a HCP, but also how SUD can play out in the workplace
for the individual nurse, doctor, or technician, their patients, their
family and friends, and their coworkers and employer.
Knowing Kris, I was not surprised by the compassionate spirit
which underpins the tone of the book. It not only offers evidenced-
based practice, facts, statistics, and an abundance of resources and
signposts to support, but with the effective use of case studies and
scenarios, you are reminded how anyone of us, faced with differ-
ent circumstances, with different life chances, may misstep and
seek out substance use as a solution.
If there is one takeaway note from this book it is the
importance of awareness raising, education, and ultimately the
recognition that recovery is possible. Substance use and
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increasingly substance use disorder is omnipresent, now more
than ever we need individuals, care givers, with an understanding
within our society to assist as part of the response framework, to
be part of the solution. If we fail to protect, support, and prevent
HCPs return to the workforce, particularly those who have sought
recovery and sobriety, we only continue to reenforce notions of
stigma and shame, and repeating the mistakes of the past.
There are many key messages throughout the book, and
whether you are reading this as someone currently struggling with
your own substance use disorder, or worried for a friend, family
member, or coworker, or indeed an employer seeking to enhance
your working policies, this book offers you sound, practical guid-
ance.
I wish to take this opportunity to thank Kris for this contribu-
tion to our understanding. This book is a timely and much-needed
addition on an emerging and less understood area of practice.
Academic Dean of the Faculty Carmel Clancy, PhD,
of Health Social Care and Education BSc-Hon, PGCertHE,
Middlesex University, London, UK RMN, FPH
President International Nurses Society
on Addictions (IntNSA)
Birmingham, AL, USA
Preface
I have been a registered nurse since May 1991. I graduated from a
small midwestern university’s BSN program and went to work on
the pediatric unit in a community hospital after graduation. Even
though I was not sure pediatrics was my calling, it was the only
job I could find. When I started nursing school in 1985, there was
a nursing shortage, but when I graduated in 1991, they had all the
nurses they needed, and jobs were hard to find. I fell in love with
pediatrics, however, and settled into my role as staff nurse. Some-
times, when our patients became critically ill, we would call the
transport team at the nearby children’s hospital for assistance.
They would come and whisk the patient away to the children’s
hospital for more specialized care. It always made me sad to see
my patients leave because I wanted to continue to take care of
them. I was so impressed with that team, and I realized, after see-
ing them a couple of times, that I wanted to do that. So, after about
5 years I took a job at the children’s hospital. I was a float nurse
and then a critical care float nurse working in the recovery room,
emergency room (ER), intermediate ICU, neonatal ICU, and
pediatric ICU. After a couple of years, I decided the ER (trauma
being my favorite) was where I belonged and took a 12-h night
shift job there. After about 3 years in the ER, I heard about an
opening for a nurse on the transport team. I had been working
toward a job on that team since seeing them for the first time at the
community hospital when they came to help with my very sick
patients. I was not sure I was qualified, but I applied for, and got,
that job. I was so excited. As part of the transport team, I went to
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hospitals, clinics, and accident scenes, to bring critically ill or
injured pediatric patients back to the children’s hospital to get the
care they needed. We used an ambulance, a helicopter (my favor-
ite), and a fixed wing aircraft. We went down the street and we
traveled to other states. We went on bright sunny days, in subzero
temperatures, and snowstorms. It was an exciting, independent
role, one that I loved and in which I excelled. I felt I had found my
niche, my calling, I felt at home. My supervisors would say I had
perfect yearly evaluations and was a role model for my peers, but
that was before they knew.
I did that job for 2 years and 7 months until I was caught steal-
ing fentanyl in 2004. I had been diverting substances since work-
ing in the ER. I was fired from that dream job that I had worked so
hard to get and I lost my nursing license. I ended up spending
4 months in jail after getting caught a second time, this time for
calling in prescriptions for myself. That was my “rock bottom.” I
knew I had to change. I had to do better for my two daughters, and
myself. When I was released, I threw myself into my recovery
program. I was finally ready to ask for help and to let others help
me. I listened and I learned. I worked as hard as I ever have on
anything. I have been clean and sober since that time, and I con-
tinue to work my program of recovery today so I can maintain my
sobriety.
I regained my nursing license in 2007 after entering an intense
monitoring program through my state’s nursing board (I have
since completed this program). I work with nurses now who are
going through what I went through. I help them navigate the ardu-
ous, but necessary, process of seeking license reinstatement, alter-
native to discipline programs and monitoring, and return to safe
practice.
I write this book because I am a healthcare worker with sub-
stance use disorder. After losing nearly everything, I have a per-
sonal stake in this issue. I want to teach so that healthcare workers
everywhere know the scope of the problem, know what to look for
in their peers (and themselves), know what to do if they recognize
it, and become willing to be a part of the solution. They can do
this by learning about the issue, contributing to diversion
Preface ix
prevention, and helping to decrease the stigma that infects every
aspect of substance use disorders.
Substance use disorder in HCPs is not talked about often
enough. I want all HCPs to know that they can get the help they
need before the bottom drops out on their life and career like it did
for me. I speak to colleges and universities and at healthcare con-
ferences around the country to get the message to all HCPs that
there is a solution and if they are brave enough to ask for the help
they need, they can get that help before SUD destroys all they
have worked so hard for.
Much like diabetes or cancer, SUD is a disease. That disease is
plagued with relapse and surrounded by stigma. Stigma makes it
difficult to ask for help. Fear of job loss, license loss, loss of repu-
tation and the respect of our peers are real and happen often to
HCPs with SUD. But they do not have to. So many do not know
there are alternative to discipline programs. Reaching out for help
before getting to the point of diversion and patient harm can be the
difference between a confidential recovery process and a public
process for all to see.
This can happen to any HCP. There is not a mold that HCPs
with SUD fit into. It can happen whether a HCP has an excellent
work history (like me) or someone for whom negative issues
plague their work. Not one of my coworkers knew I was strug-
gling. They did not know what to look for. There were signs that
pointed to a SUD. All HCPs need to learn the signs of SUD so
they can help contribute to the solution and end the denial that
exacerbates the problem.
This SUD problem running rampant in our healthcare system
has real consequences. Consequences for the HCP, their cowork-
ers, their employer, and, most importantly, those they care for. It
also has real solutions. Working together we can help those HCPs
suffering with SUD find the help they need and return to practice
safely. We must work together if we are going to eradicate this
from our healthcare system. It starts with you. Awareness is the
first step.
Hales Corners, WI, USA Kristin Waite-Labott, BSN, RN, CARN
Contents
1 Healthcare Professionals and Substance
Use Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 The Current State of Healthcare Professionals
and Substance Use Disorder . . . . . . . . . . . . . . . . . 1
1.2 A Brief Overview of the Current State
of the Opioid Crisis in the USA . . . . . . . . . . . . . . . 5
1.3 Stigma and Substance Use Disorder . . . . . . . . . . . 10
1.3.1 Healthcare Professionals Experience
Stigma Too . . . . . . . . . . . . . . . . . . . . . . . . . 11
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
2 Why and How Substance Use Disorder Occurs
in Healthcare Professionals . . . . . . . . . . . . . . . . . . . . . 19
2.1 Attributes in Healthcare Professionals Making
Them More Vulnerable to Substance Use
Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
2.2 Factors that Can Increase Risk of Substance
Use Disorder in Healthcare Professionals . . . . . . . 23
2.3 Description of Methods Healthcare
Professionals Use to Divert Medications . . . . . . . . 28
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3 Overview of Substance Use in Healthcare
Professionals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
3.1 Recognizing, Intervening, and Training . . . . . . . . . 35
3.2 What to Do if Substance Use Is Suspected . . . . . . 41
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