Category Archives: Stories of Survival

Survivors of unsafe injections graciously share their stories with us here.

Making Lemonade: One CRNA’s Story of Addiction and Recovery – Part 2

August 19, 2014

Evelyn McKnight and Lauren Lollini

Anita Bertrand, CRNA, will be presenting at the upcoming AANA annual meeting

Anita Bertrand is a certified nurse anesthetist. She will be giving the 11th Annual Jan Stewart Memorial Lecture at the AANA 2014 Nurse Anesthesia Annual Congress. Her story of addiction and recovery is continued from last week. We are grateful to her for sharing her story of addiction and recovery today and next week.

Prevention
During that time of active addiction, it never occurred to me I’d be asked to drug test, as random drug screening was not practiced in any of the healthcare setting I have been employed. But, how often could we identify a HCW with a developing addiction problem or one that is already out of control by instituting random drug screens? Some HCWs could be helped before harm is caused to patients, or before being discovered in a fatal event, as what happens in specific HCW professions such as anesthesia or ICU nursing. The “survivalist” behavior demonstrated as the brain becomes hijacked by the disease of addiction shows us how little control the addicted HCW has over the outcome of the disease. It WILL be fatal to the HCW left untreated, and in the process may contribute to harm to patients as well.

How many physicians, nurses, technicians, and aides working across the country are struggling with this disease and have no resources available due to fear, shame, stigma, isolation? In my state alone there are hundreds of nurses who are being monitored in the alternative to discipline program sanctioned by the state and the Board of Nursing. These are nurses who are getting help and treating their disease while being monitored in their work environment. This does not count the number of nurses who do not fit the profile to be accepted into the program and are under state board monitoring. This does not include the physicians, dentists, technicians, and other HCWs in the state. This does not include the number of HCWs who have not been discovered or who will succumb to the disease in the future.

Since no profession is immune to this disease, 10% of the number of all HCWs would amount to how many across the country? What needs to happen to not only bring more awareness and education to the problem, but to change the mindset of the industry so that HCW can get the help they need and be able to return to their professions as healthy, recovering providers without the stigma and discrimination? I am extremely grateful for the individuals who intervened for me so that I could get the help I needed before harming a patient or causing further harm to myself.

There is no doubt that we are lacking in understanding of the diseases of addiction and alcoholism. When education is provided, it focuses on the patient with the diseases, and seldom includes the HCW as a patient, and as our career choice being a setup for the triggering of the disease. Individuals who gravitate toward a career as a HCW may have a predisposition toward the disease; access and availability become the trigger. This access and availability may complete the gamut of things that fall into place when the HCW is experiencing trials and tribulations of life events…those HCWs who would not otherwise fall prey to the disease.

When we take action to prevent and treat the disease early, we eliminate the need for law enforcement and criminal actions.

Treatment and Returning to the workplace
We know that approximately 10% of society as a whole has problems with addiction/alcoholism, and unfortunately the majority of these people end up in jails, prisons, and institutions that do very little in the treatment of the disease. The disease is the culprit for the criminal behavior and the treatment is focused on treating the behavior rather than the disease.
Some states have alternative-to-discipline programs for HCWs so that they may obtain treatment while maintaining their licenses “National Association of Alternative Programs” .
There are many states that do not have such programs in place. In some cases the HCW chooses not to, or is unable to enroll in these programs due to legal consequences of the disease. For the states that do not have any kind of alternative to discipline program, the HCW’s ability to obtain employment in the future is essentially ripped away as the licensing board suspends or revokes the license.
Returning to practice in the healthcare setting after treatment for the disease of addiction and alcoholism is extremely difficult. Few hospital settings will employ nurses who have had a history of addiction treatment and are under a monitoring contract with their respective board of nursing or alternative to discipline programs. Again, there is a lack of knowledge and support for both the employer and employee. This realization and understanding on the part of the addicted HCW produces another roadblock for the addicted HCW to willingly seek help for this chronic, progressive, fatal disease.

Gratitude
Personally, I am grateful for the program in place that directed and monitored me before and during my return to work as a healthcare provider. I am extremely grateful for individuals who supported and employed me, giving me a chance to demonstrate that this disease is treatable, and that with treatment, it is possible to continue my career as a HCW and provide safe patient care.

At the end, this is my wish. In the effort to continue to provide safe patient care I encourage HONOReform and all of its great colleagues to continue to do all they can—at the state and federal levels—to prevent drug diversion and help addicted healthcare workers. I pledge my support to my HCW colleagues. As my friend Evelyn McKnight says, “Lives depend on it.”

Making Lemonade: One CRNA’s Story of Addiction and Recovery – Part 1

August 11, 2014

Evelyn McKnight and Lauren Lollini

Anita Bertrand, CRNA, will be presenting at the upcoming AANA annual meeting

Anita Bertrand is a certified nurse anesthetist. She will be giving the 11th Annual Jan Stewart Memorial Lecture at the AANA 2014 Nurse Anesthesia Annual Congress
September 13-16, 2014 Orlando, Florida. We are grateful to her for sharing her story of addiction and recovery today and next week.

A recent report by the CDC identifies drug diversion in health care settings as the cause of potential exposure of blood-borne pathogens to nearly 30,000 Americans over a ten year period “Outbreaks of Infections Associated With Drug Diversion by US Health Care Personnel”. Drug diversion is commonly attributed to healthcare workers (HCW) who are addicted to drugs. In my experience as an addicted HCW, I understand how this inconceivable incidence can occur, although it seems incomprehensible that I could be the cause of such devastating harm to my patients, others and to myself. I also understand the impairment the disease of addiction causes to the HCW’s ability to make rational and safe decisions for both self and for patients under his or her care.

There are many unanswered questions and I don’t have all of the answers:
• How many HCWs are suffering from the disease of addiction/alcoholism and hiding in fear of the future, not getting treatment and/or have no access to treatment upon discovery?
• How many of my colleagues are practicing and do not recognize or are willing to admit they are chemically dependent?
• How many HCW recognize the dependency and have no idea what to do?
• How many families, friends and employers suspect a problem and don’t know what to do to help?
• Can helping addicted HCWs contribute to drug diversion prevention and lessen the risk to patients?

Addiction is a disease, not a choice.
My experience as a HCW with an addiction to opioids has demonstrated that I did not, and do not have, control over my behavior when actively using. The disease had taken over my thinking and decision making capabilities when it comes to the use of, and administering of drugs to patients.

My behavior was incomprehensible, both in terms of what I did in order to obtain the drug of addiction as well as in the manner in which I took care of patients. The harm caused to patients by HCWs is both direct and indirect, in the lack of care, provided by the HCW and in the inability to be cognizant of the care provided. The HCW active in the disease of addiction is constantly focused on when and how to obtain/divert the next drug, thereby not focused on the patient and his/her needs or care. I understand how unsafe injection practices occur when addicted HCW are not identified and treated. I also understand how the disease continues to progress to more and more risky behavior for both patient and provider when action is not taken to arrest the disease.

There are many limitations to identifying HCWs with the disease of addiction. My disease was permitted to progress for many months as I became more careless and harmful to both myself and patients under my care. In the end I was grateful to have been discovered, for I realize today that the fear and shame would have carried me to my death.

Stigma of Addiction
Fear and shame are the emotions that isolated me. Even though I knew how to find support and treatment, the tremendous fear and shame of being identified and removed from the workplace in order to get treatment paralyzed me. I knew the insurmountable stigma of this disease would follow me, in terms of my license and career.

The disease of addiction/alcoholism causes abhorrent and sometimes, criminal behavior. Discovered in active addiction/alcoholism, HCWs are commonly terminated. Removal from the workplace is the only appropriate action for both patient and provider safety. But with termination, they are left without a means for the desperately needed treatment for the disease. When HCWs have a stroke, a heart attack, are diagnosed with cancer, or a hyper/hypoglycemic crisis, they are removed from the work environment, encouraged and supported in treatment for their disease, and permitted in most cases to return to the work when their disease is stable or in remission. Additionally, it is common that friends and colleagues go to great lengths to assist the HCW by covering shifts, providing meals for the family, and even giving up PTO time to help the HCW in financial crisis due to their disease.

Compared with other disease conditions, support for the addicted HCW is in short supply. Lack of knowledge and understanding of the disease, stigma, and misjudgment prohibits others from being helpful. The recent USA Today piece, “Doctors, Medical Staff on Drugs Put Patients at Risk” covered some of my story. But, there is much more to say. My husband was left with a two year old, starting a new job and having no immediate family in the city while I went off to treatment 1000+ miles away for 18 weeks. Where were all our friends? Where were all the colleagues I’d worked with all those years? Nobody brought over a casserole or offered to babysit so he could have a break and take care of himself. The inability to ask for help extends to the families, who also face the stigma and shame surrounding this disease. Addiction and alcoholism impacts everyone who cares and knows the HCW.

This stigma only perpetuates the disease, the denial, and the ability to obtain lifesaving treatment. That fear, shame, and stigma prevented me from asking for help early in my disease when I had a moment of clarity. It prevented my husband from understanding the depth of the problem so that he could seek help for me.

Next week, Anita continues her story of addiction and recovery.

The many “Love Stories” that have been altered by unsafe injection practices

December 23, 2013

Evelyn McKnight and Lauren Lollini

Evelyn & Tom McKnight are survivors of the Nebraska Outbreak

On behalf of my wife Evelyn and everyone who helps sustain the efforts of HONOReform, thank you very much for your support. In the letter I sent in November, I ask the wonderful people we have met and worked alongside through the years to provide a donation to HONOReform. This request is getting a good response. I thank you all.

And, naturally, I encourage everyone to please think of HONOReform here at the end of the year…and throughout 2014 and beyond. We depend on your kindness and generosity. Every donation is meaningful. You are helping us continue to help safeguard the medical injection process in the United States. If you haven’t already, will you please consider a gift to HONOReform?

In a blog post scheduled for early next year, our executive director, Steve Langan, will share some of our highlights of 2013—and some of our goals for 2014. We encourage you to join us!

In my appeal letter we mailed in November, I shared part of my story, our story—what can happen when a loved one is affected by unsafe injection practices. Even one unsafe injection can devastate a person and his or her family. Every part of the injection safety process “from manufacting through disposal” (as Evelyn says) must be done correctly.

I talk about the many “love stories” that have been altered by unsafe injection practices. I have been there. Many others have been there, too. Let’s continue to work to prevent outbreaks and infections caused by unsafe injection practices.

I would like to switch gears for a minute, and talk to you about injection safety from the point of view of health care providers. As many of you know, I have been a family physician for many years. It is not a stretch to say, at this point in my career, “I’ve seen it all.”

I call on my colleagues—not just physicians but nurses and every member of the staff in a clinic or hospital—to always provide a safe injection, each and every time. This continues to be my goal. A call to action to everyone who gives an injection…to make sure it’s being done correctly.

That said, it is now more important than ever that we communicate. There is so much technology in play in hospitals and clinics—from electronic medical records to apps of all kinds—that I think we providers sometimes forget to take some time to talk with one another.

My wish for 2014 is that we emphasize communication here in Fremont at our clinic. And that we are never shy or hesitant about addressing a situation in which any aspect of health care is questionable. As they say in the airports, If you see something, say something. This especially applies to any potential violation of the injection safety. Lives depend on it.

I extend this important call to action to my fellow providers, here in Nebraska and throughout the country.

“I know I have to forgive” – the Brader family story

November 11, 2013

Evelyn McKnight and Lauren Lollini

Amanda and Mary Brader

Dwight and Mary Brader had a storybook life. They had a loving marriage, a young daughter who was the apple of their eye, and they lived on a farm in Nebraska. Mary worked nights as a nurse at a hospital thirty minutes away and Dwight had just finished training as an electrician in addition to keeping up with the farm chores.

And then their lives took a sudden, sharp turn. Dwight was diagnosed with nonHodgkins lymphoma. The local oncologist was optimistic that Dwight would be cured, even though his tumor was the size of a grapefruit.

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