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Fall 2013 - New York State Nurses Association


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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
 span@nysna.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:
                                                    I Valid NYS nursing license
 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 span@nysna.org 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.
 Al-Anon or Alateen:
 National Institute on Alcohol Abuse
 and Alcoholism (NIAAA)                    Calling all NYSNA Members...
 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
                                           daniel.ray@nysna.org or johanna.villanueva@nysna.org and copy Ellen Brickman (SPAN
                                           Program Director) at ellen.brickman@nysna.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).
 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.

   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
  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: span@nysna.org
                                             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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