Annie was stuck on one thought: How could this happen - again?
A veteran critical care nurse in New Jersey, Annie started diverting Demerol and Dilaudid from the supply closet at her hospital after her grandmother died in 1989.
With computerized records in their infancy, Annie was able to sign for the drugs and inject herself intramuscularly. For a while, she got away with it.
When she was caught, she was actually relieved.
Annie went into inpatient rehab for 28 days. She was reported to the state licensing board and lost her RN license for 2 years.
But her employer stood by her. Once she completed the inpatient rehab program, she was able to continue working in the hospital, albeit in an educational role, where she wouldn't have direct access to medications.
After 2 years, Annie regained her RN license. There was no long-term oversight from the state licensing board, no continuing counseling required.
She was clean for 16 years. Then her mother died. Annie was forced to sell her house and move in with her aging father to care for him. If that stress wasn't enough, Annie chose this period to return to clinical practice ? this time in the ED.
When her father died, Annie couldn't cope. She started diverting Percocet and was caught much quicker. She was reported to the state. She lost her job.
It was 2005. She was 47 years old. She was faced with a grim prospect: losing her license, her career and, if things continued to spiral downhill, her life. And all she kept asking herself was: How could this happen . again?
Cunning & Baffling
Annie is a real nurse. Her story is just one of hundreds of other RNs across the U.S. struggling with the often-misunderstood disease of addiction.
The prevalence of addiction among RNs has been disputed in studies during the past 2 decades. Some researchers say nurses are no more likely to face substance abuse disorders than the general population - less than 1 percent. But because of the long hours, constant stress and other pressures, as many as one in five RNs may face addiction issues during their careers, according to the American Nurses Association.
Drug and alcohol addiction can be devastating for any individual, their family and friends. For nurses with substance use disorders, the effects can reach further, potentially affecting the quality of care patients receive, and in some case, even costing patients' their lives, said Joanne Cole, RN, director of the Recovery and Monitoring Program (RAMP), run by the Alternative to Discipline Committee of the New Jersey Board of Nursing.
"The 12-step programs call addiction cunning and baffling," Cole said. "Many nurses who become addicted ? particularly to opioids ? believe the medication gives them more energy, makes them feel better and, in their heads, they are functioning at a higher level."
Of course, the opposite is true.
Every year, hundreds of nurses in the U.S. have their licenses suspended or revoked because they harmed a patient, diverted or misappropriated drugs, and couldn't safely practice because of their addiction.
Years ago, nurses caught with addiction problems were dismissed or charged. "As we began recognizing addiction as a disease, the focus changed from disciplining the nurse to helping them get better," Cole said.
Today, more than 40 states have non-disciplinary programs in place to work with nurses and other healthcare professionals with substance use disorders.
Florida, North Carolina, Texas, Oklahoma and Tennessee had some of the earliest successful Alternatives to Discipline program models. When New Jersey created RAMP in 2003, they saw what worked in other states and adapted it for use locally, Cole said.
(For a list of State Resources for Nurses Battling Addiction, click here.)