This I say with full confidence. No amount of factual education on the subject of addiction would have prevented my progressive decline into impairment. In fact, I knew a lot about addiction. I had a whole section in my home library on the topic. I built my denials on top of every page. I was thoroughly convinced that none of it applied to me. Denial is the insidious nature of addiction.

What, then, do we do about nurses like me? How shall we keep the public safe from nurses like me? My suggestion is that, as with other practices that result in errors and patient harm, we talk about it. We communicate. We suspect. We tell. We discourse. We have a duty to raise awareness and learn to recognize and intervene.

“Why isn’t this happening?” you might ask. Well, part of the answer is this. In many states, diversion programs are offered as an alternative to discipline or revocation of licensure. As an enticement into the longer, more rigorous and comprehensive diversion programs, graduates are guaranteed confidentiality in exchange for their voluntary compliance (except for their worksite monitors and hospital administration, and except in the case of relapse). Perhaps this practice should be reconsidered. Maybe addicted nurses in recovery have an obligation to speak out…be examples of hope…serve as warnings to those at risk

My February 11th represented only one incidence of my being impaired at work. I was impaired to some degree every day for months. There were signs. One day, a month or two before the day that finally ended my downward spiral, I approached my ED director and asked for a ride home. I told her I was not ok to work. I used the word “impaired.” I provided an explanation… that I had had a change in medications and was having difficulty adjusting. I got the ride. There were never any questions.

I even took pills in front of people. Was I daring them to ask? Was I hoping to be caught? I really can’t say. It just never happened. I was a great nurse. I worked hard, took the difficult patients, knew my stuff. I had a BSN, was bilingual, and had 10 years of experience. It would not have been easy to call me on my impairment. And no one did until February 11th 2005. My charge nurse saved my life, and potentially the lives of the patients I would have cared for that day. I am so very grateful for his act of courage and kindness…and his words… “Honey, I can’t let you work like this.”