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
email@example.com 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.
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
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:
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 firstname.lastname@example.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
email@example.com or firstname.lastname@example.org and copy Ellen Brickman (SPAN
Program Director) at email@example.com.
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,
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,
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.
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
Highlight: Deborah Koivula
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.
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.