The steel door closed as I looked out of my cold jail cell. Lonely and afraid, tears began to fall down my face. The sense of shame and guilt flushed over me. I was locked up and had no idea how long I would be here. Desperately isolated, fear gripped my heart as I considered the possibilities. What was next? Would I ever get out? Who would help me?
I began to look back at how I got here in the first place.
College Bound, 1985
It seemed not that long ago that I was a carefree college girl.
The year was 1985. I had decided to go to college to become a nurse. I was socially awkward at the time–frequently feeling out of place like I didn’t belong. I discovered that drinking alcohol eased my anxiety and helped me feel like I fit in. This was not something encouraged in my strict Catholic home as a teen, but now I was free to do as I chose. I found myself drinking alcohol more frequently as the years passed by. My 4-year BSN degree took 6 years to complete, mostly due to my alcohol use. I remember once drinking alcohol all morning and showing up to class, intoxicated, for the final exam. Needless to say, I failed that exam and had to retake the class. In fact, I had to retake several classes due to my behavior.
However, things seemed to be coming together in 1991 when I graduated. I obtained my nursing license and moved back home to Milwaukee. I found out I was pregnant, so I kicked alcohol to the curb…for a while at least.
The new grad nurse, 1991
I began working on a pediatric med/surg unit, but quickly began to excel in my career. I moved up to a pediatric critical care float job, frequently working in the ER, then moved to full-time ER in 1998. Alcohol was a periodic thing for me. I usually drank at nighttime after my daughter went to bed. I rarely went out with friends because I preferred to drink alone, however, I became more social when I met the man who would later become my first husband.
The flight nurse, 2001
In 2001 I was promoted to pediatric transport nurse clinician. In that role, we transported critically ill or injured pediatric patients to our hospital for specialized pediatric care. We utilized the ambulance, the helicopter, or a fixed-wing aircraft, all dependent on the distance from the hospital. I felt like I had found my place and thought I would stay in that role until I retired. I absolutely loved it!
Little did I know that trouble was soon on the horizon.
Percocet, my new friend
In the late 90s, I had a minor surgical procedure and was prescribed Percocet for pain. I loved the way Percocet made me feel. It numbed the ever-present anxiety and made me feel better. After I finished taking all of the prescribed pills I requested a refill of the Percocet, even though I didn’t have any pain. The prescription was refilled without question. I found that taking the Percocet helped me deal with the relationship troubles I was having with my husband. The feeling was better than alcohol, but with an extra advantage–I didn’t have the side effects of being drunk: smelling bad, stumbling around, hangovers, etc. I could take Percocet, feel better, and still be quite functional. It didn’t feel wrong because it was a prescribed medication from my doctor. I began finding reasons for more Percocet. I went to my doctor several times with a complaint of back pain and I was prescribed more of them. My husband, now working as a carpenter, got injured sometimes and he would go to the ER, get pills, and share those with me.
Why waste a good thing?
It was around the year 2000, while working in the ER when I realized that we, as nurses, throw away a lot of good drugs. “Wasting” a drug is when an unneeded or unused portion of a controlled substance is destroyed, typically in the presence of a witness (such as a co-worker). This wasn’t monitored nearly as closely then as it is now. One day, I found myself slipping the leftover meds into my pocket and taking them home. That night, I injected myself with the drug. I reasoned to myself that it was just garbage and I wasn’t really stealing.
The first time experiencing the drug was something I had never felt before. My anxiety and fears instantly vanished. There was a sense of numbness and warmth. It was a very inviting feeling. My marriage was on the rocks, so it was a much-needed escape from reality.
I had to have more.
Fentanyl, the wonder drug, 2003
From that point on I began to keep all of my leftover medications. This continued on for several years. In 2003, while going through a divorce, I tried my first dose of Fentanyl.
Something was very different about this drug.
I had an immediate craving for more– much more intense than prior opioids. After that first dose, I began stealing doses of Fentanyl from the stock at work. By this time I began showing signs of substance use at work–increased irritability, falling asleep at work, wearing long sleeves at work, disappearing for long periods during my shift, and shaking in my hands–but my colleagues explained it away as stress from a divorce and fatigue from working night shifts.
Besides, I was a great nurse. I never had complaints about me, and my yearly evaluations were perfect.
No one suspected my substance use.
World crumbling down
About nine months after I began stealing Fentanyl, hospital management became suspicious. Their suspicions were confirmed when I took a vacation and none of the Fentanyl disappeared during my absence. After returning from vacation I was working my normal night shift when my manager met me in the hall and asked me to join her in a conference room. Waiting in this room were multiple individuals–the hospital’s head of security, the HR director, the pharmacy director, the CNO of the hospital, a police detective, and a sheriff’s deputy (who carried a large gun in his belt). The detective began an intense interrogation and they confronted me with the evidence of stolen drugs. I denied everything because I truly did not know what else to do. I was too overwhelmed to even consider the thought of being caught and too ashamed to admit that I had a drug problem.
They told me I was suspended from my job and walked me out of the facility with a box of things from my locker. It was so humiliating. I found myself in the hospital parking lot at 9 pm on a Sunday night and didn’t know what to do or where to go. Fear and hopelessness began to grip my heart. I finally ended up at a girlfriend’s house who allowed me to spend the night with her so I didn’t have to go home and explain what happened to my family.
In the following days, I hired a lawyer and decided I had to confess my problem. I met again with the detective and I admitted to my wrongdoings. It was a relief to finally admit out loud what I had been keeping secret for so long.
I felt the weight of the world coming off of me.
Reality sets in
We all love the stories of those with substance use issues who admit their problem, kick their habits, and then move on to a victorious and happy life.
Let me just tell you this–that usually isn’t how it happens.
It certainly isn’t how it was for me. It is a process. Reality kicked in when I had to turn in my nursing license and I was unable to work. By this time I was a single mother with 2 daughters and no means to support myself. Nobody would hire me–not even McDonalds. I had a small savings, but that soon evaporated and I began living off credit cards simply to survive. I was jailed briefly (5 hours) and ultimately given probation for my crime. I vowed to stop using substances for good.
A second chance
Three months after being fired from the hospital, and still on probation, a kind doctor hired me to work as his medical secretary. It was good to be back to work in healthcare, even if wasn’t in the capacity of a nurse. I had been clean from drugs for about 3 months. I was trying to stay clean through 12-step groups, but was drinking alcohol, intermittently.
Unfortunately, my substance use reared its ugly head once again.
I began calling in opioid prescriptions for myself under the doctor’s name. (That’s the problem with substance use disorders–they take first priority over relationships, friends, and even common sense. Here I was, finally getting a second chance, and I totally blew it). It wasn’t long before the pharmacy suspected something was amiss and the doctor was notified. He confirmed that no prescriptions had been authorized. The day of reckoning came when I arrived at the pharmacy to pick up my prescription and was met by the police. They arrested me, placed me in handcuffs, and brought me to jail. This time I was scared–really scared. This time it felt so final. They placed me in a jail cell and there was a sense of doom as those doors clanged shut.
I felt like my life was over.
Life behind bars
I cried the entire first night of jail. I was alone in that cell for many days not sure what to do. Finally, 10 days later, my probation officer came to see me. He told me that I would be spending 6 months in jail.
6 months? I was in shock.
I could not imagine being away from my daughters or how I would survive in such a place for that long. I seriously felt like I was going to die.
Thankfully I was given some hope when they transferred me to a different correctional center where I was given the job of working in a print shop. This was a Godsend for me. Don’t get me wrong–it was still jail–but having the ability to walk outside on the jail grounds gave me hope of better things to come.
I was surprised 4 months later when they released me sooner than anticipated. Tears filled my eyes–but this time they were tears of gratitude. I would get to see my 5-year-old daughter whom I had not seen since I was arrested. These were the most life-changing 4 months of my life.
Hope on the horizon
As I mentioned before, recovery isn’t always a linear path. It is usually a winding and rocky road full of surprises. I began rebuilding my life after being released from incarceration. It wasn’t until 2 years later, with prompting from my therapist, that I considered seeking to regain my nursing license. Before that, nobody at my hospital had offered me any resources or told me about a program offered by the Wisconsin Board of Nursing where someone in my circumstances could return to practice.
I enrolled in the Wisconsin Board of Nursing monitoring program (https://dsps.wi.gov/Pages/SelfService/Monitoring.aspx) which involved weekly random drug screening, weekly therapy appointments, twice weekly 12-step meetings, quarterly reports, and work restrictions. It was NOT an easy process, however I was given a limited nursing license which meant I could return to nursing practice. I was overjoyed! Five very long years later I completed the monitoring program and received full reinstatement of my nursing license. I also had a renewed appreciation for my career.
The new nurse V2.0
The new nurse V2.0 Being able to return to safe nursing practice has been quite a journey. I have held several different roles since that time. I have worked in a clinic, a dialysis center, spent some time doing clinical research, and more recently have worked in behavioral health. I’ve discovered that my true calling is to help those who have struggled with substance use. I am currently the admissions coordinator for a substance use disorder clinic in New York (working remotely from WI). I have also returned to work in a local emergency department. Through my work with the treatment program in NY, I learned that other states have peer support programs for nurses struggling with substance use. I was amazed to hear this, and in Sept 2021 I decided to start one here in Wisconsin. It is called the Wisconsin Peer Alliance for Nurses (WisPAN). WisPAN is a non-profit organization that provides peer support meetings and education on substance use disorder in nursing. This is something that I was never offered through the nursing board during my recovery. I felt very alone and overwhelmed. It would have been helpful to talk to someone else who had gone through, or was going through, the same struggles. Thankfully, today there is more support for our nursing colleagues.
Compassionate Approach for Drug Diversion
We have also started work on the Compassionate Approach for Drug Diversion, or CADD program. The program is designed to standardize processes that facilities can follow when diversion is discovered. (Drug diversion is a medical and legal term for prescription medications that are obtained or used illegally). The goal of CADD is for leadership to consider retaining a staff member (instead of terminating them), to offer a leave of absence or short-term disability, and to bring them back into a safe role when they are ready and safe to return. This process helps the person (who, if fired, will lose their insurance and ability to get treatment) and helps the facility by retaining experienced and trained staff. It asks leadership to see diversion as a symptom of the disease of substance use disorder. Reporting to their licensing board and law enforcement still needs to happen, however supporting the healthcare professional through that process can be lifesaving.
Not perfect, just a better ME
Life these days is meaningful and rich. I look back on the years I spent using substances with a sense of sadness, but also with gratitude. Without that time, I wouldn’t have the life I have today. This life is beautiful, most days anyway, and I choose each day to stay in recovery and work to help others. My goal now is to reduce the stigma and shame associated with this disease, so others can seek help before their life falls apart.
If you or someone you know is struggling with substances, let me encourage you to seek compassionate care. There is hope. If you are concerned about a colleague, there are some signs to look for. Check this post for more information. My wish is to reduce the stigma of substance use disorder and to educate healthcare professionals on how they may help themselves and their peers.
