Helping a friend

Tony* is a nurse with extensive experience in Emergency Department (ED) and in General Medicine as a Nurse Unit Manager. This is his story of trying to support a friend and colleague dealing with addiction:

"When I was based in another country I worked closely with a friend and colleague, John*. Despite this story taking place in another country, I feel that this experience is really relevant to nurses anywhere in the world.

John and I not only worked together, but we played rugby together and socialised outside of work. We had known each other for around ten years, working up through the grades together and becoming Associate Nurse Unit Managers at around the same time. He was extremely knowledgeable and was a go-to person within the ED, due to his calm and collected nature.

Warning signs

John had been dealing with some personal issues, including custody issues, 'going through a bad patch' and heading for divorce number two. Over a period of around three months there were noticeable behaviour changes and lacklustre enthusiasm at work. He had all the answers — lack of sleep, worry over not seeing his child, impending divorce and divorce costs. Outside of work I spoke with him many times with him about his behaviour and performance, but nothing changed. I gathered my courage and finally asked him outright, once and for all, if he was taking anything. He laughed it off and talked about his issues outside work that were just playing on his mind a lot. 

I took this at the time, but deep down I knew there were other issues and the pale, sweaty, not focused appearance with dilated pupils does not normally get past an ED nurse. 

During this period John also had two car accidents, one after night shift when he said he fell asleep at the wheel and the roof of the car had to be cut off, due to him being trapped. The other happened while on a holiday - he lost control and the car went through a hedge on a corner.  At the time the second incident seemed odd as the passenger said they were not travelling fast and that it seemed like John just wasn’t concentrating. This raised my suspicions further. 

I didn't know how to help

At work I felt isolated. I didn’t know it but other colleagues also had suspicions. They only spoke to me afterwards because they weren’t sure how to deal with it. They saw that I was trying to support him, so chose not to talk to me at the time — the stigma had begun. They were less tolerant towards him and his work decisions, even though he was still making the correct decisions. 

I felt like I was supporting him on my own. I was stuck; I had no evidence one way or the other to show he was taking any medication, just gut instinct. He was not willing to own the issue nor would he accept professional help at this time. I kept wondering; if I discussed this with my managers, even in a hypothetical scenario, would this lead to support or disciplinary action.

The hospital I worked at was not the most tolerant and was perceived as disciplinary process driven. I began watching him at work closely, double checking everything, which was not sustainable. I began researching the internet for ways and means to support him, and more about what I should be doing; there was a surprising lack of evidence or advice on how to help him.

Management notified

A couple of months passed and I found a few tablets in one of my shoes in the locker room. Slightly random you may think, however, John’s locker was directly above where my shoes were.

At this stage I chose to take this to the managers and discuss my concerns. They confided in me that they had been having suspicions for some time and that they had been monitoring pharmacy ordering, supply and stock balances. This had provided evidence and they were about to act upon the information. 

In my mind I had brought it to their attention too late. 

The outcome

John had a discussion with the managers and was sent to the Occupational Health Department, similar to an employee assistance program, but they also have medical staff on hand to advise and discuss workers' health issues. 

He willingly underwent a drug screening process, and tested positive for multiple substances. He was absent from work and I tried to support him as and when he accepted contact. This ultimately led to him being suspended from work following a period of support from a professional team, and a pending investigation. 

Sadly he did not return to nursing, and a skilled knowledgeable professional who was fantastic in resuscitation and trauma was lost to the profession. 

If there had been a support service like this one available to us, things may have turned out differently."

What can I do next?

Why not read some of our other articles on topics relating to this story:

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*Names changed