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Information for and about nurses in recovery FALL 2013 “SPAN”ing Volume 11, Issue 3 New York State Inside this issue: Ask Ellen.........................................2 On a course to a better life Why Retain and Hire Nurses in SPAN I was always the cautious one among my involved with peer assistance and went home. and PAP?........................................3 friends. I liked the club drugs but didn’t That night, I used the propofol vials and want to derail my career. Still, crystal midazolam I had smuggled out of the hospital. Regional Coordiantor methamphetamine took hold. Over a 12 year I remember nothing until the next morning. Deborah Koivula..............................4 period, my use increased in frequency and from snorting and smoking to injecting. I had My peer assistance friend called me daily for To receive this newsletter electronically, a clear compulsion for the drug. I knew I was a couple of weeks and said, “You don’t have call 800-457-7261 or e-mail in trouble, but thought I could control it. I to use propofol today.” That reassured me. We firstname.lastname@example.org was wrong. I quit the crystal cold turkey, but went to a 12-step meeting. I immediately felt I began to sample drugs from work, ketamine, was in the right place. midazolam to help me sleep, fentanyl, Although I suffered no professional Mission morphine. I feared addiction to opioids but oddly they gave me pep and lifted my spirits. I consequences, motivated by the potential loss of career and job, I went to an intensive Statement was drawn to propofol. It is short acting, easily titratable and available throughout the hospital. outpatient rehabilitation program, then SPAN’s mission is to be the aftercare. 12-step and SPAN meetings became Propofol made crystal cravings seem trivial! At a part of my weekly routine. I was fortunate resource for New York State first I used at home. But soon, I was walking to be cleared to return to work. nurses affected by substance use around the hospital with a capped #22 in my leg, shooting up on breaks. At that time I was Now, I have no compulsion to use propofol disorders, while fostering public working 2 days per week. When not at work, even when I am around it. I don’t drink or I didn’t have compulsions to use. But when smoke. I live a simple, happy life and have safety through outreach around propofol, a switch flipped. I could not begun to find peace. What’s different? It’s stop using. It was insane. I hated it. In an simple. I’m no longer trying to manage my and education. addiction or my life alone. I have learned attempt to stop using, I decreased my work to 1 day per week, then to 1 day every other to call upon the support of my friends from week. I confided in my closest friends. rehabilitation, SPAN and 12-step meetings Nothing worked. and I share my life with my soon-to-be husband. Life isn’t perfect, but I am learning I would promise myself… NO MORE to be ok with that. PROPOFOL. I broke that promise for over a year. I was certain my coworkers noticed. I The colleague who confronted me likely couldn’t believe I was getting away with such saved my life and my career. I’m grateful to self-destructive behavior. On my last day at her for doing the difficult thing rather than that job, I placed an IV in my leg at home that ignoring my impairment. Her intervention morning and gave myself small injections of set me on a course to a better life and a various drugs all day. I began to slur my new chapter in my career as a nurse. speech. On my afternoon break, I locked After a few years out of practice, I am going “The greatest weapon against myself in the bathroom and injected propofol back into the clinical environment aided by stress is our ability to choose and morphine over several hours. When an understanding administrator. It has taken one thought over another.” I staggered to the unit, I was confronted. time and I have managed a lot of anxiety, but I denied everything, suggesting I had a I am moving forward in my career with —William James medical problem. honesty and confidence. American psychologist and philosopher My confronter sent me home and insisted that SPAN participant I call a friend for support. I called a friend Page 2 “SPAN”ing Volume 11, Issue 3 Ask Ellen... Ellen B. Brickman, SPAN Program Director “The best preparation for good Is SPAN in need of any advocates at work tomorrow is to do this time and what is the process for good work today.” volunteering my services? —Elbert Hubbard, American writer We recruit on an ongoing basis throughout the state. We have current need for volunteer nurse advocates to become trained as group co-facilitators for the following locations: Brooklyn, Elmira, Herkimer, Oneonta, and Plattsburgh. On the web: As many as 1 in 7 nurses have a drug or alcohol problem. SPAN is recruiting The Substance Abuse and Mental Health volunteer advocates to support fellow nurses struggling with substance use Services Administration: disorders. SPAN volunteer nurse advocates assist in restoring participants to http://findtreatment.samhsa.gov safe, effective practice. Volunteering is a commitment of 8 hours per month /iamrecovery.com and training is provided. No experience is necessary, though knowledge in the areas of mental health, treatment and addictions is helpful. All advocates will New York State Office of Alcoholism and be utilized as co-facilitators in our peer support group settings. Substance Abuse Services: Requirements include: www.oasas.gov I Valid NYS nursing license SPAN: www.nysna.org/span/ I Participation at a one-day training session New York State Smoker’s Quitline: I Participation at regularly scheduled training meetings www.nysmokefree.com/ I Donating 8 hours per month to advocate activities Gamblers Anonymous: New training dates are added throughout the year. For information, contact www.gamblersanonymous.org/ NYSNA’s Statewide Peer Assistance for Nurses at 800.724.6976, ext. 265 or To find an Alcoholics Anonymous by e-mail at email@example.com and request an advocate application. Once this is meeting: www.aa.org submitted, you will be contacted by a Regional Coordinator who will meet with you to review your application and discuss the role of the group co-facilitator. To find a Narcotics Anonymous meeting: After that you will be required to attend a training session and if successful, then www.na.org your application is submitted to me as the Program Director for formal National Council on Alcoholism and Drug appointment as an advocate. Dependence: www.ncadd.org Al-Anon or Alateen: www.al-anonfamilygroups.org National Institute on Alcohol Abuse and Alcoholism (NIAAA) Calling all NYSNA Members... www.niaaa.nih.gov National Clearinghouse for Alcohol and We are looking for nurses to serve on the Drug Information (NCADI): www.ncadi.samhsa.gov Statewide Peer Assistance Committee (SPAC). This resource committee meets three times yearly (January: Latham, May: New York City, October: Syracuse) to review position statements, consider nominations for NYSNA’s Peer Assistance Award, and work on specific projects related to peer assistance and the Statewide Peer Assistance for Nurses (SPAN) program. Nurse volunteers should forward a letter of interest and resume (or CV) to firstname.lastname@example.org or email@example.com and copy Ellen Brickman (SPAN Program Director) at firstname.lastname@example.org. We need representation from all parts of the state. Knowledge about addictions and mental “When you get to the end of your health issues is desirable. Each member of the committee is expected to attend a minimum rope, tie a knot and hang on.” of two of the three yearly meetings and will be reimbursed travel expenditures. Each term is currently two years in duration with an option of being extended for an additional term. —Theodore Roosevelt Nurses considering volunteering for this committee must be current members of NYSNA. Volume 11, Issue 3 “SPAN”ing Page 3 Why Retain and Hire Nurses in SPAN and PAP? , By: Barbara Nahmias, NPP PMHCNS-BC Addiction is a growing public health issue Program (PAP) is an Alternative to Discipline 4. The direct and indirect cost of turnover and an occupational hazard for nurses. It Program, which monitors nurses with SUDs in nursing may be anywhere from 60 to is a chronic, relapsing brain disease, and affords immunity to qualified nurses 100% of the former nurse’s salary, plus characterized by compulsive drug seeking from two counts of professional misconduct the salary of the new nurse (Van Doren, and use, despite negative consequences. related to substance use. M., 2011). Drugs change the structure and functioning of the brain. Like other chronic diseases, it is Unfortunately, many employers feel it is a 5. When employers retain or hire nurses preventable and treatable (NIDA, 2008). liability to retain nurses with SUDs and to in the PAP, they have a nurse with an hire nurses in recovery. Here are some points identified risk who is closely monitored. Nurses are not immune from this disease. to consider: Other nurses potentially have unknown Research indicates that 15-20 percent of liabilities. nurses struggle with a substance use disorder 1. Treating addiction as a medical illness (SUD) at some time in their careers that requires treatment, with reasonable 6. By contacting SPAN, the employer has (Bettinardi-Angres, K. &Bologeorges, S., accommodations for employment, is the access to: free education, information 2011). Employers of nurses have a vital role first step in removing stigma (Dunn, 2005). on prevention and early intervention, in ensuring patient safety by assisting nurses assistance with humane policies to as they strive for optimal health. Yet many 2. Sixty-six percent of illicit drug abusers address the health needs of nurse employers terminate nurses’ employment, and seventy five percent of heavy alcohol employees, timely needs assessment of making it difficult for them to obtain the drinkers are employed. Firing these the nurse, and referral to the PAP. Taking proper treatment for their substance use employees won’t make the problem these steps leads to a healthy nursing and later to find nursing jobs. go away. In fact, positive employment workforce and protection of the public. approaches can lead to higher New York State has two programs to help productivity, reduced absenteeism, Kevin McCauley, MD, an Addiction nurses with serious addictions and less and better workplace relations Specialist, states: “If addiction is a disease, severe substance use disorders. Each (SAMSHA, 2011). then addicts are patients and punishment is program offers assistance to the individual not only ineffective, it is unethical and non- nurse, to the employer, and to the public. 3. Proactive policies and procedures that therapeutic” (2010). It is essential to preserve The Statewide Peer Assistance for Nurses acknowledge the existence of these our nursing resources by treating addiction (SPAN) program is a confidential support disorders in the nursing work force, lead as we would any other illness. The SPAN and advocacy program for nurses who are to safer work conditions and improved program has successfully supported over anywhere on the continuum from substance employee morale by enhancing 2,000 nurses both in their recovery and use to addiction. The Professional Assistance identification and referral. return to safe, effective practice. Bettinardi-Angres, K. & Bologeorges, S. (2011). PDF file. National Institute on Drug Abuse. Summary of national findings, NSDUH Series H-41, Addressing chemically dependent colleagues. HHS Publication No. (SMA) 11-4658. Rockville, National Institute on Drug Abuse (NIDA). National Journal of Nursing Regulation, 2(2), 10-15. MD: Substance Abuse and Mental Health Services Institute of Health. (2008). Administration. Dunn, D. (2005). Substance abuse among nurses- NIH Pub No. 08-5605. defining the issue. Operating Room Nurses Journal, Van Doren, M. (2011). 10 good reasons to 82(4), 572-602. Substance Abuse and Mental Health Services hire/retain TPAPN nurses: A commentary. Texas Administration (SAMSHA). (2011). Results from the Nursing Voice, (Reprinted with permission from McCauley, Kevin (2010). Retrieved from: 2010 National survey on drug use and health: Texas Nurses Association) 1-2. http://Instituteforaddictionstudy.com/recovery/Q&A. What SPAN can offer your hospital or agency: SPAN SUPPORT GROUPS I Employee education and supervisor I SPAN brochures for orientation, HR, etc. Adirondack: Canton, Herkimer, Oneonta, training Plattsburgh, Utica I SPAN newsletters via electronic mail I Assessment and referral, short term ready to be distributed to nursing staff Central: Binghamton,Elmira, Rochester, problem resolution for individual nurses Syracuse (2), Watertown requesting services I 1-800-457-7261 SPAN Helpline Eastern: Albany, Highland,Latham, Middletown, Saratoga Springs I Facilitation of return-to-work agreements I NYSNA website on peer assistance at www.nysna.org (click on peer assistance) Metropolitan: Bronx, Brooklyn, Elmhurst I Identification and resolution of fitness-for- Manhattan, Orangeburg, Pleasantville work concerns related to nurses affected I Presentations on addiction as an Southeastern: Bohemia, Brentwood, by substance use disorders occupational hazard for nurses along Farmingdale, Malverne, Riverhead, Selden, with resources Staten Island I Consultation/review of written policies, procedures and other components of a I Articles for employee newsletters Western: Batavia, Buffalo (2), Olean, drug free workplace program West Seneca I SPAN exhibit at hospital (or agency) health fairs For more information, please contact your I SPAN posters for the facility (with regional coordinator or the SPAN HELPLine at signs and symptoms to look for in 1-800-45-SPAN-1 or 1-800-457-7261. the workplace) September is National Recovery Month SPAN thanks Huntington Hospital, part of the North Shore/Long Island Jewish Health System, for their dedication to the support of nurses recovering from substance use disorders. Huntington Hospital has developed policies which allow nurses to enter treatment and return to practice under the supportive supervision of their Employee Health Nurse. Kudos to Huntington Hospital for extending the same compassion to their nurses as they do their patients. NYSNA Statewide Peer Assistance for Nurses 11 Cornell Road, Latham, NY 12110 Phone: 1-800-45-SPAN-1 • Fax: 518-786-3007 Regional Coordinator E-mail: email@example.com Highlight: Deborah Koivula SPAN staff: Ellen B. Brickman, MPH, MS, RN, NPP 1) Describe your experience regarding the first 6 months as a Program Director Regional Coordinator. My colleagues have been an invaluable Sheila Brady, MA, RN, CARN support to me and I thank them for their time and mentoring. Central NY Regional Coordinator My first priority has been getting to know the nurses in the Eastern Region who are actively involved with SPAN. I’m also Tracey Brown, RN, MSN, NPP attending as many Professional Assistance Program (PAP) panel Southeastern NY Regional Coordinator meetings as possible and learning the process of monitoring and discipline within New Becky Eisenhut, MS, RN, CASAC, CARN York State. Doing this has allowed me to advocate for participants’ recovery, support Adirondack Regional Coordinator their progress and treatment needs and also better understand the common struggles that nurses are facing in my region. Maureen Farrell, MSN, RN Metropolitan NY Regional Coordinator 2) What prior work experience prepared you for this position? I have been in the mental health and substance abuse field for 18 years as a registered nurse. My experience includes Deborah Koivula, RN, CARN direct care, managed care and supervisory work. I am an advocate for nursing excellence Eastern NY Regional Coordinator and encourage my colleagues to practice the specialty area of addictions with esteem. Michele Schultz, BSN, RN Recently I obtained my specialty certification in addictions as a Certified Addictions Western NY Regional Coordinator Registered Nurse (CARN). My experience and studies have played an important part in developing the skills to accurately assess substance abuse disorders, make appropriate , Barbara Nahmias, NPP PMHCNS-BC treatment referrals and advocate for recovery. Outreach Coordinator 3) What are some goals you have set for the coming year? I will continue to grow , Angela Grabowski, CPS, CAP CHAP my relationship with the participants and look forward to that. I also plan to continue Confidential Assistant to the Director outreach in my region. I want to provide education to hospitals, nursing homes, schools Sandra Hair of nursing, administrators and individuals about addiction. My desire is to increase Confidential Office Coordinator awareness of the unique challenges nurses face in prevention of substance use disorders, treatment and recovery.
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