The birth of ‘No One Dies Alone’

Some letter writers take issue today with the Star Tribune’s ongoing series on the number of nurses who shouldn’t be nurses, either because they’ve become addicted to some substance or because they have a criminal history.

A nurse brings up an outstanding point: there’s often no place to go for nurses who find themselves in trouble.

“I went to my doctor, counselor and more with my concern that I was becoming addicted to narcotics,” Marie Mechley wrote. “Each one of them was licensed by a board and was under oath to report me to my board. If they gave me advice or even listened and didn’t report me, they risked their own licenses. Not having a resource was the main reason I spiraled into severe addiction. How to help nurses before it affects the public would be a great direction to focus on.”

It’s fairly well proven that people who feel they’ll lose their job, will not look for help. That much we know from the airline pilots of a Northwest flight, who flew drunk. Joe Balzer, one of the pilots, told me his story in 2009. He spends his time now letting pilots know that the system has changed now and alcohol counseling will not lead to dismissal.

That’s the situation that Hazelden writes about on its website:

Impaired nurses trail other health care professionals when it comes to accessing confidential, non-disciplinary recovery resources. During the 1980s, the American Medical Association lobbied state legislatures to allow impaired physicians to keep a medical license in good standing-as long as they completed addiction treatment and agreed to let a state board monitor their recovery. By the early 1990s, all 50 states had such programs-options that offered confidential peer assistance for addicted docs and diversion from discipline if they followed the program.

Karla Bitz, RN, associate director for the North Dakota Board of Nursing, tracks diversion programs for nurses. In 2000, she reports, 40 boards of nursing across the country had non-disciplinary programs for addicted nurses. However, some states still offer no such option and some with diversion programs take a tougher approach, one that favors more discipline versus compassionate care.

“Addiction in nurses needs to be looked at as a disease,” says Bitz. “Without an alternative, nurses will probably end up going through the disciplinary route. But our board feels strongly that these people-with the proper help-are excellent nurses.”

“When it comes to assistance for addiction, I just don’t see the clarity around nurses that I do for physicians,” says Chris Lind, RN, national health services director for Hazelden and supervisor of the Health Care Professionals Program. “But it’s improving with the public consciousness that addiction is a treatable disease. We have an extreme shortage of health care workers, especially nurses, and we need to help these folks access treatment in order to save their careers and save their lives.”

Marie Mechley, the Star Tribune letter-writer, asks another great question in the nurses story: Why are nursing getting addicted in the first place? “Workload? Pay? Stress? Lack of connection to the doctors for help? Acuity of patient? There is something wrong, but there is a bigger picture than what the Star Tribune is writing about,” she says.

Coincidentally, another story involving nursing today has its roots in the workload and stress of the job. The Rochester Post Bulletin profiles Sandra Clarke, an Oregon nurses who was in the city recently to talk about her program, No One Dies Alone, which had its roots in a hospital with an overworked nurse who couldn’t be with a man when he breathed his last breath.

“I couldn’t give somebody comfort. That’s all they were asking for,” she said.

The program was started in Rochester by Amanda Meyer. “This program feeds my soul,” she said.

It’s a program that might not exist had Clarke not channeled her guilt into action. Her original situation speaks to the reality of her profession: It’s a psychologically challenging profession that should require a system to support the needs of those who are compelled to do it.