Remember how there was this whole ridiculous thing on House where the titular doctor somehow got by for years blatantly doing drugs on the job? Drugs that he illegally got from his own freaking hospital? You figure that in real life hospital staff is probably tested constantly to keep that from happening. Imagine the consequences of, say, a doctor or nurse trying to resuscitate a patient while they're high as balls.
Well, you don't have to imagine it: I was a registered nurse for two years, and during that time, I was a hopeless drug addict who not only stole drugs from the hospital, but frequently used them during my shifts. And I'm not alone: RNs abuse drugs at roughly twice the rate of everybody else in the country -- as many as 1 in 5 may be addicts, according to studies.
How is this possible? Well ...
#5. There's Nothing to Stop You from Stealing Drugs and Needles
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It might seem crazy that nurses would have a high rate of addiction, considering that we're more knowledgeable about the horrible effects of drugs than the average person. But that's the problem: We're too close to drugs. We have access to all the clean paraphernalia that you could ever need, and we're not worried about overdosing on some dirty batch of brown sugar heroin. These aren't street drugs -- they're FDA-approved pharmaceuticals. Once you learn an opiate's dark and beautiful secrets, you start to think of them as dangerous yet misunderstood, like that girl in torn fishnets you met at a Nine Inch Nails concert, as opposed to just dangerous, like that guy who sleeps at the car wash and hides razor blades beneath his tongue.
That's how I rationalized my addiction for a long time: "I'm not an addict because I know everything there is to know about this drug, and I still take showers and go to work." Of course, just because professional drug addiction doesn't look the same as under-the-bridge drug addiction, it will still end up taking a big shit on your life ... or someone else's.
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You'd be shocked how pissed people get about medical professionals being high on the job.
My drug of choice was Dilaudid, an opioid analgesic typically given to patients who are allergic to morphine (it also happens to be 7 to 10 times stronger than morphine). At the hospital, we stored it in 2-milligram vials, but since physicians almost never ordered that strong a dose, it was really easy for me to administer a portion of the vial and pocket the rest. How is that possible, when every day kids are yanked off the street for having a single rock of crack cocaine in their pocket?
Well, when you dispose of leftover narcotics, you're supposed to find another RN to "witness the waste," meaning you squirt it into a hazardous material bin while they watch. But if you've ever been to a hospital, you probably have some idea of how much people care about watching their co-worker throw something away: Nurses have roughly 50 million places to be at any given second, and about half those things involve saving someone's life, so any unexpected, tedious task is going to be rushed through as quickly as possible. Most of the time, someone would quickly punch their code into the machine indicating that they'd witnessed the waste without actually watching me do anything, then rush off to their next task. Not because they were irresponsible (although that's difficult to dispute) -- they just assumed I was trustworthy.
Spoiler: I wasn't.
Speaking of rushing through things as quickly as possible, remember how I talked about what an expert I was at all things drug-related? That didn't stop me from mistaking Dilaudid for a powerful hypertension medication once when I was in a hurry. I was shooting up in a dark bathroom, focused entirely on the clock (I had a small window of time in which to get high before I went back out to care for the sick and injured), when I suddenly felt a sensation entirely different from the familiar euphoria of Dilaudid, at which point I passed out on the floor and almost died.
That was a big enough kick in the ass to get me sober.
For two weeks.
"Mr. Wallace is throwing his feces at the nurses again."
"... I'll be right back."
Then, a physician I was working with ordered a dosage of Dilaudid that I felt was too high for the patient. When I pointed out that the dose was potentially lethal, he said, "Well, there are worse ways to die." I thought that was pretty convincing, so I shot up again that night. Who am I to argue with a doctor?
#4. Patients Don't Know if They're Being Shortchanged on Their Meds
Like any addict, I got to the point where the leftover vials I was sneaking from my fake "wastes" weren't enough, and that's when I discovered that stealing drugs from patients is really, really easy. Seriously, it's more difficult to steal a Game Boy than to swipe controlled medication from people who desperately need it.
Think about the last time you were in a hospital: If the nurse had given you a fraction of your dose of painkiller, would you have noticed? Probably not -- the placebo effect would more than make up for the difference, and if you still needed more, you could always press the call button and ask. Of course, you'd have to writhe in agonizing pain until the doctor decided it was safe to give you another dose, at which point your drug addict nurse would be free to skim even more off the top, and the cycle would begin anew.
"Hey, you look like you're in a lot of pain, let's get another dose in you."
"No, I'm actually-"
But honestly, even if you never stopped hurting despite receiving countless rounds of supposed medication, you'd just assume your pain was too severe for the drug. The last thing you'd suspect is that the helpful, friendly nurse was stealing it from you. We automatically earn your trust by virtue of working in a hospital and wearing scrubs. That's actually one of the most mysterious parts of our culture: You wouldn't let a plumber fix your toilet without checking his references on Angie's List first, but you'll show up in the emergency room at three in the morning with a broken arm or blood shooting from your face and trust that everyone there is absolutely qualified to inject chemicals right into your bloodstream. You don't think twice about it.
I used that implicit trust to become very good at manipulation. Nursing is all about the rapport you establish with your patients and their families: A lot of so-called bad bedside manner results from medical professionals who prioritize solving your medical issue over being your friend. Meanwhile, I could have shortchanged you on your pain medication (which quite literally can endanger your life), but you and your family loved me because I was so fucking high, I couldn't stop grinning and telling jokes. I regularly got compliments (and even gifts) from patients' families, thanking me for the exemplary care that I gave them while blasting through the stratosphere on their stolen medication.
"I demand that you be pleasant and charismatic while you're saving my life!"
But some patients are more perceptive. After shortchanging one patient on his painkillers, he looked me right in the eye and said, "I know what you did." But there was nothing he could do, because ...
#3. It's Easy to Get Away With It (Even if You Get Caught)
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When I started working as a nurse, I quickly established a reputation of never turning down any request to go above and beyond. I picked up extra shifts when needed and worked in different departments to help out. On the surface, I looked like an exemplary employee busting his ass for the greater good, but in reality, I was doing it all to feed my addiction. Work was where the drugs were, so naturally I wanted to be at work all the time.
As I mentioned, a patient caught me swiping his medication one time, but that's no big deal -- who's going to take the word of some sick person over a medical professional? No, it was much worse when a doctor caught me.
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"Hey! This is where the doctors shoot up! Nurses down the hall!"
He noticed that I had altered some paperwork, removing pages that showed a patient was on a certain narcotic so that I could steal it (in case anyone's still unclear on the implications here, I was literally putting patients' lives in danger because I really wanted to get high). That physician turned me in to my supervisor ...
... who responded by heroically throwing the incident out, insisting that I was one of the best nurses he had and he wasn't about to let any bastard doctor start any rumors about me.
"Except for the big penis rumor. You can let that one go."
You see, doctors and nurses both think that they're the ones who really run the hospital, so any time one of their own jacks something up, it casts a bad light on all of them. When the shit hits the fan, doctors will cover for doctors, and nurses will cover for nurses, because if somebody gets busted, that's a scandal. And it's not just office politics here -- remember, hospitals are multimillion-dollar entities. Minimizing scandal protects their financial interests, too. Sure, they'll drop the hammer on you if you harm a patient (and open them up to liability), but they have no desire to publicize systemic drug use among their staff. Which also means ...